Evidence mapPaperPMID 39804641Full record

ArticleJAMA network open2025

Mental Health Utilization Among Transgender Veterans.

Joy L Lee, Adam Hirsh, Archana Radhakrishnan, Guneet K Jasuja, Stanley Taylor, Stephanie Dickinson, Jocelyn Mineo, Jennifer Carnahan, Michael Weiner

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Joy L LeeVA Center for Health Information and Communication, US Department of Veterans Affairs, Veterans Health Administration, Health Systems Research CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana.
Adam HirshDepartment of Psychology, Indiana University Indianapolis, Indianapolis.
Archana RadhakrishnanDepartment of Internal Medicine, University of Michigan, Ann Arbor.
Guneet K JasujaVA Center for Healthcare Optimization and Implementation Research, US Department of Veterans Affairs, Veterans Health Administration, VA Bedford Healthcare System, Bedford, Massachusetts.
Stanley TaylorVA Center for Health Information and Communication, US Department of Veterans Affairs, Veterans Health Administration, Health Systems Research CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana.
Stephanie DickinsonDepartment of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington.
Jocelyn MineoDepartment of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington.
Jennifer CarnahanVA Center for Health Information and Communication, US Department of Veterans Affairs, Veterans Health Administration, Health Systems Research CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana.
Michael WeinerVA Center for Health Information and Communication, US Department of Veterans Affairs, Veterans Health Administration, Health Systems Research CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Compared with cisgender (CG) individuals, transgender and gender-diverse (TGD) individuals experience substantial social and economic disparities that can result in adverse mental health consequences. It is critical to understand potential barriers to care and to address the causes of the disparities in the future. Objective: To characterize mental health care utilization among TGD veterans with depression. Design, Setting, and Participants: This cohort study used electronic health record data from the US Department of Veterans Affairs (VA) to create a 1:3 age group-matched and VA facility-matched nationwide cohort of TGD and CG veterans with documentation of depression during 2018 to 2020. Data analysis was performed from January to November 2023. Exposure: TGD identity was ascertained by diagnosis of a gender identity disorder. Main Outcomes and Measures: The primary outcome was mental health care utilization, including counts of outpatient (in specialty care and primary care settings), telehealth, emergency department, and inpatient visits in this cohort. Descriptive statistics were used to characterize counts of mental health utilization, and statistically significant differences between TGD and CG veterans were tested using χ2 and Fisher exact tests. Wilcoxon rank-sum tests were used to test for differences in utilization between the 2 groups. Adjusted logistic regression, controlling for age group, administrative sex, race, Charlson Comorbidity Index, and number of mental health medications (eg, antidepressant, antipsychotic, and anxiolytic medications), was also used to compare utilization between TGD and CG veterans. Results: Among 10 564 veterans with depression (mean [SD] age, 46.4 [15.2] years; 8050 male [76.2%]), 2643 TGD veterans were matched with 7921 CG veterans. TGD veterans had 6 more specialty mental health visits per year than CG veterans (mean [SD], 13.93 [20.08] vs 8.46 [14.96] visits a year; median [range], 7.14 [0.00-246.30] vs 3.76 [0.00-202.38] visits per year). In adjusted models, compared with CG veterans, TGD veterans were 2.6 times more likely to have an outpatient mental-health visit (odds ratio, 2.60; 95% CI, 2.16-3.15). Conclusions and Relevance: In this cohort study of veterans with depression, TGD veterans had significantly higher utilization of mental health services compared with CG veterans, even after adjusting for several relevant health factors. Different health system resources may be required to meet the needs of this population. Further studies are needed to understand the determinants of these disparities and subsequently how to address them.

Indexed as

DepressionMental Health ServicesPatient Acceptance of Health CareTransgender PersonsVeteransAdultCohort StudiesFemaleHumansMaleMiddle AgedUnited StatesUnited States Department of Veterans Affairs

Identifiers

PMID39804641
PMCPMC11731220

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.