Mental Health Care Utilization, Unmet Care Needs, and Barriers to Receiving Care in Adolescence Among Transgender and Nonbinary Young Adults.

Purpose: Few studies have explored mental health needs and barriers to accessing care among transgender and nonbinary (TNB) individuals during adolescence. The purpose of this study was to explore TNB young adults' mental health care utilization, unmet care needs, and barriers to receiving care in adolescence.

Methods: A 42-item cross-sectional survey was administered to TNB individuals aged 18-20 years. Chi² and Fisher's exact tests were used to identify differences in receipt of mental health care by demographics. Post-hoc pairwise comparisons were conducted using the Bonferroni correction for multiple comparisons when indicated.

Results: Of 286 participants, approximately half (42.3%) were women and 50.7% reported being "out" to at least one parent before the age of 18. More than half (55.2%) reported having seen a mental health provider in adolescence; however, only 10.1% indicated that they had received enough mental health support. Significant differences were found in having seen a mental health provider by gender identity (p = 0.02) and outness to parents during adolescence (p < 0.001). The most common barriers included confidentiality (59.9%), unsupportive parents (58.0%), and uncertainty about where to get care (52.9%).

Conclusions: These findings provide a better understanding of the mental health care utilization and needs among TNB individuals in adolescence. Further research focused on ways to support TNB adolescents and how parents can support their TNB adolescents' mental health is warranted.