LAUSR

A growing body of research indicates that transgender and gender-diverse (TGD) youth experience considerable mental health disparities when compared with their cisgender peers, including higher rates of depression, anxiety, and suicidality. 1 These disparities have been attributed to two processes: gender dysphoria and gender minority stress. 1 Gender dysphoria refers to distress related to one’s body developing in a way that is incongruent with one’s gender identity. It is important to note that not all TGD youth experience gender dysphoria, but that this can be a substantial source of distress for many. Gender minority stress refers to the ways in which society’s mistreatment of TGD people negativelyimpactsmentalandphysicalhealth. 1 Thegenderminoritystressmodeloutlinesbothdistal “external” factors (experiences of discrimination, rejection, and violence on the basis of gender identity) as well as subsequent proximal “internal” factors (expectations of rejection, concealment of one’s gender identity, and internalized transphobia). of the multifactorial contributions to disparities for TGD youth, reducing these disparities requires a multipronged approach, working on both gender dysphoria and gender minority stress. In this issue of JAMA Network Open we find two excellent studies—one examining the treatment of physical gender dysphoria through gender-affirming medical care, and a second that aims to lessen stigma against TGD youth, with the greater goal of lessening the impact of gender minority stress.