Estimate and needs of the transgender adult population: the SPoT study

BACKGROUND

Despite the increasing interest in transgender health research, to date little is known about the size of the transgender and gender diverse (TGD) population.

METHODS

A web-based questionnaire survey was developed, including a collection of socio-demographic characteristics and disseminated online through social media. Gender incongruence was evaluated by using a 2-item approach assessing gender recorded at birth and gender identity. The primary objective of the present population-based study was to estimate the proportion of TGD people across ages among a large sample of people who answered a web-based survey. The secondary endpoints were to identify gender-affirming needs and possible barriers to healthcare access.

RESULTS

A total of 19,572 individuals participated in the survey, of whom 7.7% reported a gender identity different from the sex recorded at birth. A significantly higher proportion of TGD people was observed in the youngest group of participants compared with older ones. Among TGD people who participated in the study, 58.4% were nonbinary, and 49.1% experienced discrimination in accessing health care services. Nonbinary TGD participants reported both the need for legal name and gender change, along with hormonal and surgical interventions less frequently compared to binary persons.

CONCLUSIONS

Being TGD is not a marginal condition In Italy. A large proportion of TGD persons may not need medical and surgical treatments. TGD people often experience barriers to healthcare access relating to gender identity.

“Ma sei fuori?”: a path to awareness on mental health and stigma

 

Mental health issues, frequently associated with weirdness and danger, can easily derail the lives of the people who suffer from them, creating loneliness and isolation. Due to stigma, people with mental health disorders could experience limitation in their economic, social and cultural human rights. In the effort to fight stigma against mental health issues, Fondazione The Bridge promoted a contest called “Ma sei fuori?”, targeted to students from secondary school. “Ma sei fuori?” could be translated as “Are you off your rocker?” or, more simply, as “Are you crazy?”; this phrase has been adopted by our juvenile slang to identify a person who's generally considered “not in line”. To those who answered our public call, we sent the contest regulation and factsheets on schizophrenia and stigma, matched with a brief bibliography/filmography. Students involved had to develop a slogan on stigma linked with music and images; 140 classes competed. The best catchphrase had been voted by a jury composed of influencers, clinicians, policy makers, writers, patient associations and other KOLs; besides the winning class, the jury issued three special mentions. All the results had been broadcasted live on Facebook during a public event. The winning class, as prize, got access to financial resources for didactic use and its slogan will be the core of a TV spot. The project had been backed by a communication campaign on TikTok, Instagram, Facebook, with the involvement of the most famous italian tiktokers; just on TikTok the campaign reached 4.8 billion views. The project final scope was to raise young people's awareness about mental health issues and stigma, by stimulating a cultural shift. Students underlined another important result: working together online after school during the pandemic helped them filled the gap caused by the lack of socialization. Projects of this kind, easily replicable in other contests, could help creating a common language on the impact of stigma.

Key messages

Social stigma still has a great impact on the lives of people with mental issues and disorders. Tackling bias and discrimination is the first step to raise awareness and build a stronger community. As a community, we must promote a responsible behavior and a common language to tackle prejudice on mental health issues; starting from young people could be the key to boost a cultural shift.