Despite many similarities, binary transgender and nonbinary individuals face distinct challenges warranting targeted interventions, with nonbinary adults showing poorer physical health, higher victimization rates, and less social support, while binary transgender adults more frequently reported unmet desires for parenthood.
Key Findings
Results
Nonbinary adults rated their general health as 'good' or better at substantially lower rates than binary transgender adults.
58.9% (95% CI 49.4–68.4) of nonbinary individuals rated their health as 'good' or better
78.4% (95% CI 69.9–86.8) of binary transgender participants rated their health as 'good' or better
Analysis used multivariable regression models controlling for age, sex assigned at birth, and employment
Data drawn from two companion national probability samples: Generations and TransPop
Results
Nonbinary adults reported functional limitations from physical or emotional problems at nearly twice the rate of binary transgender adults.
75.0% (95% CI 67.4–82.7) of nonbinary adults reported functional limitations from physical or emotional problems
41.4% (95% CI 31.6–51.2) of binary transgender adults reported such limitations
The difference represents a gap of approximately 33.6 percentage points between the two groups
Functional limitations were assessed as a distinct outcome from psychological distress
Results
Psychological distress levels were comparable between nonbinary and binary transgender adults.
Despite differences in physical health and functional limitations, psychological distress did not significantly differ between groups
This finding suggests physical and psychological health disparities do not necessarily track together across gender identity subgroups
Both groups are from national probability samples: binary transgender adults (n=159) and nonbinary adults (n=164)
Results
Nonbinary individuals had significantly higher odds of experiencing physical or sexual assault compared to binary transgender adults.
Adjusted odds ratio for physical or sexual assault among nonbinary individuals was aOR=2.03 (95% CI 1.08–3.81)
Models were adjusted for age, sex assigned at birth, and employment
This represents approximately double the odds of assault compared to binary transgender adults
Results
Nonbinary individuals had significantly higher odds of experiencing partner conflict compared to binary transgender adults.
Adjusted odds ratio for partner conflict among nonbinary individuals was aOR=2.74 (95% CI 1.29–5.82)
This represents nearly triple the odds of partner conflict compared to binary transgender adults
Both physical/sexual assault and partner conflict were examined as distinct victimization outcomes
Results
Binary transgender adults more frequently reported unmet desires for parenthood than nonbinary adults.
40.9% (95% CI 30.9–50.8) of binary transgender adults reported unmet desires for parenthood
18.0% (95% CI 10.7–25.3) of nonbinary adults reported unmet desires for parenthood
This represents one of the areas where binary transgender adults showed worse outcomes compared to nonbinary adults
Results
Nonbinary individuals reported poorer future outlook than binary transgender adults, while life satisfaction was comparable between groups.
Future outlook was significantly worse among nonbinary individuals compared to binary transgender adults
Life satisfaction did not differ significantly between the two groups
These findings suggest nuanced differences in psychosocial wellbeing dimensions that do not uniformly favor either group
Results
Friend support was lower among nonbinary individuals compared to binary transgender adults, while family support showed no significant differences between groups.
Nonbinary individuals reported significantly lower friend support than binary transgender adults
Family support levels were statistically comparable between nonbinary and binary transgender adults
Social support was examined as separate dimensions of friend and family support
Methods
The study used national probability samples to compare binary transgender and nonbinary adults, addressing a methodological gap in prior research.
Data came from two companion national probability samples: Generations and TransPop
Total sample included 159 binary transgender adults and 164 nonbinary adults
The authors note that existing research relies on convenience samples or combines gender-diverse individuals without examining subgroup differences
Multivariable regression models controlled for age, sex assigned at birth, and employment
What This Means
This research suggests that transgender and nonbinary people, while both facing significant health challenges, experience meaningfully different patterns of hardship. Using data from two national probability surveys (a more rigorous sampling method than most prior studies in this area), the researchers compared 159 binary transgender adults (transgender men and women) to 164 nonbinary adults. Nonbinary individuals were less likely to rate their health as good or better and were far more likely to report that physical or emotional problems limited their daily functioning. They also faced roughly double the odds of physical or sexual assault and nearly triple the odds of partner conflict compared to binary transgender adults. Additionally, nonbinary adults reported less friend support and a worse outlook on the future.
Binary transgender adults, on the other hand, were more likely to report that they wanted to be parents but had not been able to fulfill that desire — about 41% compared to 18% of nonbinary adults. Notably, psychological distress levels and life satisfaction were similar between both groups, suggesting that some dimensions of mental wellbeing may not differ as much as physical health and victimization outcomes do.
This research suggests that grouping all gender-diverse people together in health studies and policy may obscure important differences in what kinds of support or interventions each group needs. Nonbinary people appear to face particular vulnerabilities around physical health, violence, and social connection, while binary transgender people face distinct challenges related to family formation. The findings point to the value of developing targeted resources and interventions tailored to the specific experiences of different gender-diverse communities rather than treating them as a single uniform group.
Gina L. Scorpiniti, J. Kidd, Thomas Corbeil, Walter O. Bockting, Ilan H. Meyer. (2026). Health and psychosocial differences between binary transgender and nonbinary adults: A national probability sample analysis.. Psychiatry Research. https://doi.org/10.1016/j.psychres.2026.117183