Non-Binary and Binary Gender Identity in Australian Trans and Gender Diverse Individuals
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ORIGINAL PAPER
Non‑Binary and Binary Gender Identity in Australian Trans and Gender Diverse Individuals Ada S. Cheung1 · Shalem Y. Leemaqz2 · John W. P. Wong3 · Denise Chew4 · Olivia Ooi1 · Pauline Cundill5 · Nicholas Silberstein5 · Peter Locke5 · Sav Zwickl1 · Ren Grayson5 · Jeffrey D. Zajac1 · Ken C. Pang4 Received: 15 March 2019 / Revised: 19 March 2020 / Accepted: 21 March 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Many trans and gender diverse (TGD) people have gender identities that are not exclusively male or female but instead fall in-between or outside of the gender binary (non-binary). It remains unclear if and how those with non-binary gender identity differ from TGD individuals with binary identities. We aimed to understand the sociodemographic and mental health characteristics of people with non-binary identities compared with binary TGD identities. We performed a retrospective audit of new consultations for gender dysphoria between 2011 and 2016 in three clinical settings in Melbourne, Australia; (1) Equinox Clinic, an adult primary care clinic, (2) an adult endocrine specialist clinic, and (3) the Royal Children’s Hospital, a child and adolescent specialist referral clinic. Age (grouped by decade), gender identity, sociodemographic, and mental health conditions were recorded. Of 895 TGD individuals, 128 (14.3%) had a non-binary gender. Proportions differed by clinical setting; 30.4% of people attending the adult primary care clinic, 7.4% attending the adult endocrine specialist clinic, and 8.0% attending the pediatric clinic identified as non-binary. A total of 29% of people in the 21–30-year-old age-group had a non-binary gender identity, higher than all other age-groups. Compared to TGD people with a binary gender identity, non-binary people had lower rates of gender-affirming interventions, and a higher prevalence of depression, anxiety, and illicit drug use. Tailoring clinical services to be inclusive of non-binary people and strategies to support mental health are required. Further research to better understand health needs and guide evidence-based gender-affirming interventions for non-binary people are needed. Keywords Transgender · Transsexualism · Gender identity · Gender dysphoria · Non-Binary
Introduction Gender variance, or gender nonconformity is an umbrella term used to describe gender identity, expression, or behavior that falls outside of culturally defined masculine or feminine * Ada S. Cheung [email protected] 1
Department of Medicine (Austin Health), The University of Melbourne, Studley Road, Heidelberg, VIC 3084, Australia
2
Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
3
Royal Melbourne Hospital, Parkville, VIC, Australia
4
Murdoch Children’s Research Institute and University of Melbourne (Department of Paediatrics), Royal Children’s Hospital, Parkville, VIC, Australia
5
Equinox Gender Diverse Health Centre, Thorne Harbour Health, Fitzroy, VIC, Australia
norms. In population-
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