Prevalence of neurodevelopmental and psychiatric disorders among transgender and gender non-conforming youth and adults in a U.S. healthcare system between 2019 and 2023

To examine the sociodemographic characteristics and rates of prevalent neurodevelopmental and mental health disorders among Transgender and Gender Non-Conforming (TGNC) individuals within a healthcare system in the United States. Data were obtained between 2019 and 2023 from a large medical healthcare system and included academic and non-academic ambulatory and inpatient clinical encounters. Cisgender patients were randomly sampled at a 2:1 ratio to TGNC patients for a final dataset of 12,504 individuals ages 12 and older. Age-adjusted rates for physical, neurodevelopmental, and mental health disorders, as well as an overall comorbidity index, were computed among gender identity groups. The study sample included 4168 individuals who self-identified as TGNC individuals. The comorbidity index was significantly higher for gender non-conforming (2.22) and transgender (2.05) individuals compared to cisgender individuals (1.81), and TGNC individuals had significantly higher rates of neurodevelopmental disorders (e.g., autism spectrum disorder, attention deficit deficit/hyperactivity disorder), severe mental health disorders (e.g., schizophrenia, bipolar disorders), suicidality, eating disorders, sleep disorders, substance use disorders (including alcohol and nicotine use), posttraumatic stress disorder, obsessive compulsive disorder, depressive disorders, and anxiety disorders. The elevated rates of neurodevelopmental and mental health disorders faced by TGNC individuals highlight the necessity for enhanced training among healthcare providers and the development of more inclusive, affirming interventions within clinical settings. Future research should aim to unpack the intersectionality of mental health challenges and the societal pressures uniquely experienced by the TGNC community. • Psychiatric diagnoses are more prevalent in gender diverse individuals. • Neurodevelopmental disorders are more prevalent in gender diverse individuals. • Morbidity/Mortality risks are elevated in gender diverse individuals. • Prevalance of disorders vary between transgender and gender non-conforming people.