Parental stress and mental health among transgender parents

Background: Parental stress impacts individual health and the development of the next generation, but there is a lack of comprehensive research on parental stress among transgender parents in China. This study is the first to investigate parental stress and mental health among transgender parents and identify potential influencing factors. Methods: We designed a cross-sectional survey that recruited a representative sample of 647 transgender parents. A validated questionnaire was used to investigate parental stress, depression, anxiety, and their associated factors, including parent factors (gender dysphoria, time of coming out, depression, and anxiety) and situational factors (family violence, partner violence, relationship with partner, discrimination and family income). Linear regression models were used to explore the influencing factors of parental stress among transgender parents, a structural equation model (SEM) was established to explore the possible pathways between these factors and parental stress, and network analysis was conducted to determine primary symptoms and central risk factors. Results: The average parental stress score was 50.4 ± 8.02. 92.7% of participants exhibited depressive tendencies and 73.7% showed anxiety tendencies. Lower family income (p < 0.001), coming out after having a child (Coefficient (Coef.) = 2.6, 95% confidential interval (CI) = 1.174 ∼ 4.027), family violence (Coef. = 3.582, 95%CI = 2.372 ∼ 4.791), partner violence (Coef. = 4.199, 95%CI = 2.998 ∼ 5.401), being discriminated during seeking of childbearing health care (Coef. = 3.29, 95%CI = 2.054 ∼ 4.526), poor relationship with partner (fair relationship: coef. = −3.205, 95%CI = −4.86∼−1.551; good relationship: coef. = −5.372, 95%CI = −6.886∼−3.858), depression (Coef. = 5.873, 95%CI = 3.557 ∼ 8.189), and anxiety (Coef. = 5.705, 95%CI = 4.368 ∼ 7.042) were significantly associated with higher parental stress. Through the pathway analysis, the direct or indirect effects of parent factors and situational factors on parental stress were observed. Additionally, network analysis revealed that gender dysphoria, family violence, psychological abuse, and various anxiety types as central risk factors, with two gender dysphoria symptoms showing the strongest direct relationship to stress. Conclusions: Transgender parents experience significant parental stress influenced by mental health, sociodemographic, transgender-specific, family, and socio-environmental factors. Enhanced family support and a more inclusive social environment are crucial for reducing stress and improving the well-being of transgender parents and their children.

本文关注中国跨性别父母的养育压力和心理健康，指出现有研究的不足，并首次探讨其养育压力、心理健康状况及可能的影响因素。

本文采用横断面调查方法，招募了具有代表性的647名跨性别父母样本。研究使用经过验证的问卷，调查养育压力、抑郁、焦虑及其相关因素，包括父母因素（性别焦虑、出柜时间、抑郁、焦虑）和情境因素（家庭暴力、伴侣暴力、与伴侣关系、歧视、家庭收入）。通过线性回归模型分析影响跨性别父母养育压力的因素，建立结构方程模型（SEM）探讨各因素与养育压力之间的潜在路径，并利用网络分析确定主要症状和核心风险因素。

本文发现跨性别父母普遍面临较高的养育压力，92.7%的参与者表现出抑郁倾向，73.7%表现出焦虑倾向。家庭收入较低、在生育后出柜、经历家庭或伴侣暴力、在生育保健中遭遇歧视、与伴侣关系不良、抑郁和焦虑均显著增加养育压力。通路分析表明，父母因素和情境因素对养育压力有直接或间接影响，网络分析进一步确认性别不安、家庭暴力、心理虐待和焦虑为核心风险因素。研究强调，改善跨性别父母的心理健康、增强家庭支持、促进社会包容性对减轻其养育压力和提升幸福感至关重要。