The Relationship Between Gender Dysphoria and Perinatal Depression Open Access

Abstract

Gender dysphoria, which is characterized by clinically significant emotional distress due to incongruence between one’s sex assigned at birth and their gender identity, is most prevalent among trans and gender expansive (TGE) individuals. Given both the steadily increasing number of TGE people choosing to pursue parenthood through childbirth, and concerns about depression in this population, it is essential to know the extent to which gender dysphoria might be associated with depression during the perinatal period. This study examined the association between gender dysphoria and depression symptom levels within a sample of pregnant or postpartum TGE individuals and explored potential mediators of the relationship. We found a significant, positive association between gender dysphoria and depression symptom levels. Further, we found a significant, positive association between gender dysphoria and perinatal depression when reported feelings of positive affect are high. Finally, we found no suggestion of support for feelings of community belongingness as a moderating variable for this relationship. This study is the first to report on this association within a TGE cohort and will help guide medical providers in treating gender dysphoria in TGE individuals both during and after pregnancy.

Table of Contents

Introduction…………………………………...................................…………..........…………………........…….…….….. 1

Method…………………………………………………......................….………....………............................................… 7

    Researcher Reflexivity Statement.....………………................…………............................................................ 7

    Study Design........................……………......................................………......…............................................. 8

    Procedure and Measures………………………………........................……………………...…………………….….…..... 8

    Approach to Analyses……………………………………………….........................…………………………..……...….… 11

    Data Validation and Cleaning………………………………………....................................................................... 12

Results. …………………………………………………………..………......................................................................... 13

     Participants......................................................................................................…………........................... 13

     Aim 1.......................................................................................................……………................................ 13

     Aim 2………………………………………….........................................…………………………............................... 13

     Aim 3......................................................................................………………………….................................. 14

Discussion……………………………………………..……………….............................……………………...….........…..... 15

     Implications…………………………………………………………….…................…………………….……………........... 16

     Limitations………………………………………………………….………….................…………………………................ 18

     Directions for Future Research……………………………......................................………………......................... 19

     Conclusion…………………………………………………….........................................………………....................... 23

References…………………………………………………………................................……………………….....….….…...... 24

Appendix……………………………………………………………......................................……….…………......….…...…. 36

     Table 1………………....................................……………………...................................................................... 36

     Table 2………………….....................................…………………….................................................................. 37

     Table 3………………………….................................……………………............................................................. 37

     Table 4…………………………...................................……………………........................................................... 38

     Table 5…………………………...............................……………………............................................................... 39

     Table 6………………………….............................……………………................................................................. 40

     Figure 1………………….........................................……………………............................................................. 41

Supplemental Materials…………..........................…………………….................................................................. 42

    Supplemental Table 1…………………...........……………………........................................................................ 42

    Supplemental Table 2…………………................……………………................................................................... 42

    Supplemental Figure 1.........................…………………………........................................................................ 43

About this Honors Thesis

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School	Emory College
Department	Psychology
Subfield / Discipline	Clinical Psychology
Degree	B.A.
Submission	Honors Thesis
Language	English
Research Field	Gender Studies Women's Studies Psychology, Clinical
Keyword	afab postnatal depression ftm reproduction nonbinary pregnancy LGBTQ seahorse parenting birthing parent gender dysphoria female-to-male gender expansive transgender parenting transgender obstetrics LGBT reproductive healthcare LGBTQ+ pregnancy perinatal depression transgender reproductive care reproductive care nonbinary gender non-conforming ftm seahorse parent transgender reproduction gender incongruence gender affirming obstetrics queer parenting obstetrician gender nonconformity LGBTQIA+ female-to-male healthcare childbirth transgender pregnancy
Committee Chair / Thesis Advisor	Sherryl H. Goodman, Emory University
Committee Members	Andrew M. Kazama, Emory University Elizabeth A. Wilson, Emory University

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