Mental Health
Trends in anxiety, depression, and flourishing among American college students by gender identity (2016-2024) Rachel Slimovitch* Rachel Slimovitch Anthony J. Rosellini Jaimie Gradus Sarah Lipson
Background:
Prior research has identified worsening mental health among both cisgender and transgender, nonbinary, and other gender minority (hereafter referred to as TNB) students through 2021, with TNB students experiencing significantly higher prevalence of anxiety and depression. However, trends by gender identity remain unexplored in the years after the emergence of COVID-19. This study expands on prior literature by exploring trends in anxiety, depression, and flourishing from 2016-2024 by gender identity.
Methods:
Using data from the Healthy Minds Study, we examined trends in depression (PHQ-9 ≥ 10), anxiety (GAD-7 ≥10), and flourishing (Flourishing Scale ≥ 48) from 2016-2024 among male, female, and TNB students. Joinpoint regression was used to estimate piecewise log-linear trends and annual percent change (APC) in the survey weighted prevalence estimates of depression, anxiety, and flourishing.
Results:
A total of 669,146 students (3.5% TNB) participated. After an increasing trend in prevalence of depression from 2016-2022 among male (APC 7.4%, 95% CI 6.0 to 10.3), female (APC 6.7%, 95% CI 5.1 to 11.0), and TNB students (APC 1.5, 95% CI 0.8 to 16.2), prevalence of depression decreased for each gender identity from 2022-2024. A similar trend was observed for anxiety among female and TNB students, with trends increasing from 2016-2022 (Female APC 7.1%, 95% CI 5.6 to 11.6; TNB APC 2.1, 95% CI 1.0 to 11.9) before decreasing from 2022-2024 (Female APC -4.7, 95% CI -9.8 to 1.6; TNB APC -3.4, 95% CI -6.4 to 0.1). Flourishing increased among TNB students from 2016-2024.
Discussion:
TNB students continue to experience elevated prevalence of depression and anxiety and lower flourishing compared to cisgender male and female students. However, since 2022, depression prevalence has decreased across all gender identities and anxiety has decreased among female and TNB students. Future research should examine what has been driving these promising recent trends.
