Mental health among trans adults: a meta-analysis estimates high prevalence rates, with substantial variation

A global synthesis of 207 studies

The researchers searched three scientific databases for studies published between January 1, 1990 and April 7, 2026. Their analysis examines the prevalence of mental disorders, suicidal thoughts and suicide attempts, as well as nonsuicidal self-injury among trans and gender-diverse adults.

Most narrowly defined or highly selected subpopulations were excluded, but samples drawn from gender-affirming care settings were retained. This distinction matters: the recruitment setting can influence estimates, and the abstract does report variations by setting.

Results that must be read alongside their measurement methods

The estimated pooled prevalence of depression is 40.1%, with a 95% confidence interval ranging from 35.6 to 44.8%. It is 29.8% for anxiety and 23.6% for post-traumatic stress disorder. These figures combine clinical diagnoses with symptoms exceeding the thresholds of screening tools validated in the general population. They therefore do not represent diagnosed disorders alone.

Over the past twelve months, estimates reach 43.1% for suicidal thoughts, 9.3% for suicide attempts and 26.1% for nonsuicidal self-injury. These findings are based on participants’ self-reports. Suicidal thoughts, suicide attempts and self-injury remain distinct indicators and should not be conflated.

Limited data suggest higher prevalence rates among nonbinary participants. This finding requires greater caution than the overall estimates.

A need for care, not an explanation of causes

The authors report high prevalence rates compared with reference estimates for the general population. However, the abstract does not detail these comparisons: it does not allow the gap to be quantified precisely or the comparability of the populations to be verified.

This synthesis documents the extent of the difficulties observed but does not establish their causes. In particular, it does not allow these difficulties to be attributed to gender identity itself. The authors highlight the need for accessible mental health care that respects gender identity, although this analysis does not assess the effectiveness of any particular intervention.

What we can take away

The most useful finding is the substantial need for mental health care in the populations studied. Pooled averages do not predict an individual’s situation and do not provide a causal explanation.