Correlates of psychotic experiences in gender-diverse youth in Ireland: A population-based survey

Epidemiological studies have shown that psychotic disorders are more prevalent in transgender and non-binary (TR/NB) individuals compared to their cisgender (i.e., male & female) counterparts (CIS). Despite this, little research exists that examines the association between gender diversity and psychotic episodes (PEs), with implications for public health policy. This study examines the prevalence of, and the factors associated with, PEs in both CIS and TR/NB adolescents in Ireland. The study is a cross-sectional analysis of the 2021 Planet Youth survey completed by secondary school students in Cavan, Monaghan and North Dublin. The outcome of interest was self-reported episodes experienced by students at least once over their lifespan, using the 7-item Adolescent Psychotic-like Symptom Screener. Of 4406 students who completed the questionnaire, 3877 identified as CIS and 169 identified as TR/NB. TR/NB cohorts reported higher levels of PEs (M = 4.6, SE = .206, CI = 4.2, 5.0) than CIS (M = 2.6, SE = .027, CI = 2.5, 2.6), z = -6.393, p < .0001). In both cohorts, PEs positively correlated with the incidence of serious arguments with parents (CIS: rs = .210, p < .0001; TR/NB: rs = .202, p = .0374), being bullied (CIS: rs = .227, p < .0001; TR/NB: rs = .360, p = .0002) and the occurrence (CIS: rs = .288, p < .0001; TR/NB: rs = .303, p = .0016) and disclosure (CIS: rs = .208, p < .0001; TR/NB: rs = .305, p = .0015) of suicidal thoughts. Additionally, PEs were negatively correlated with feelings of safety at home, school and in the neighbourhood (CIS: rs = -.283, p < 0001; TR/NB: rs = -.279, p = .0037). These findings indicate that further research is needed to examine how psychosocial stressors may operate as trauma and contribute to clinical symptoms in TR/NB youth. Results from the Planet Youth survey suggest that more attention needs to be paid to the mental health needs of gender diverse youth and policy makers must be cognisant of this. KEY MESSAGES: • Gender diverse youth in Ireland report a higher prevalence of psychotic symptoms compared to cisgender youth. • Gender diverse youth reported feeling less safe at home, at school and in the neighbourhood compared to their cisgender counterparts.