An intersectional approach to transgender and/or nonbinary college student mental health: The role of gender identity, race/ethnicity, socioeconomic status, and campus policy

NIH Pandemic-Era Grants

Pandemic Era Grants

2024

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Principal Investigator: Even  Paglisotti
Organization: HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH
Fiscal Year: 2024
Award: $38,151
Funding agency: National Institute of Mental Health

PROJECT SUMMARY
PAR-22-172 Mental Health Research Dissertation Grant to Enhance Workforce Diversity (R36): Transgender
and/or nonbinary (TNB) college students (those whose gender is incongruent with their sex assigned at birth)
are at substantially higher risk for mental health concerns (e.g. suicidality, depression) than their cisgender
peers (whose gender aligns with sex assigned at birth). Students of color and students of lower socioeconomic
status (SES) similarly experience disparities in mental health outcomes. However, no quantitative studies of
TNB college students have examined mental health outcomes across intersecting social positions of gender
identity, race/ethnicity, and SES, a notable gap in mental health equity research. Additionally, while a growing
body of literature connects state-level protective policies with improved TNB mental health, little research has
examined the role of TNB-supportive campus policies (e.g. insurance coverage for gender affirming
healthcare, TNB-competent counseling training) in TNB student mental health. Further, no studies have
investigated the impact of these policies collectively. In light of an increasingly anti-TNB sociopolitical climate in
the US and the aforementioned scientific gaps, further research on protective policy environments for TNB
students across intersecting social positions is urgently needed. To address these gaps, this project will draw
on Intersectionality, Minority Stress, and Ecosocial frameworks. Leveraging data from the largest national
study of US college mental health, the Healthy Minds Study, including new data on TNB-supportive campus
policies from 323 campuses, this project's objective is to use rigorous social epidemiologic methods to
examine the role of TNB-supportive campus policy environments in intersectional TNB mental health
disparities. The project's aims are to: 1) estimate mental health outcomes (depression and suicidality) across
intersectional groups defined by gender, race/ethnicity, and SES; 2) empirically categorize campuses into
distinct classes of TNB-supportive policy environments; 3) characterize the degree to which policy
environments impact TNB mental health outcomes across intersectional groups of race/ethnicity and SES.
These aims are consistent with priorities stated in the NIMH Strategic Plan (Goal 4 Objective 4.3) and the NIH
FY 2021–25 Strategic Plan to Advance Research on the Health & Well-Being of Sexual & Gender Minorities.
The project is innovative in its novel application of quantitative intersectional methods to advance health equity
in TNB mental health research. The proposed project is significant in that it will generate a nuanced
understanding of the role of TNB-supportive campus policy environments in college student mental health
across intersecting social positions, with the goal of informing campus policy interventions to improve TNB
mental health. Support for this project would lay the groundwork for future studies in the investigator's career
as a scientist researching equitable policy solutions for TNB mental health.

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