State-level pro- and anti-transgender and gender-diverse (TGD) legislation and mental health among TGD young adults in the United States.

Overall state-level anti-TGD legislation was marginally associated with greater suicidal ideation among TGD young adults.

• Data were drawn from the Healthy Minds Study from Spring 2022 to Spring 2023
• The sample included 8,149 TGD participants from 38 U.S. states
• Multilevel modeling was used to examine relationships between state-level legislation passed in 2023 and individual-level mental health variables
• The association was described as 'marginal' rather than statistically robust

Sports-related anti-TGD laws predicted higher suicidal ideation in TGD young adults within affected states.

• Sports-related anti-TGD laws were examined as a specific legislative subcategory
• The relationship was found at the state level, meaning it applied to TGD individuals residing in states with such laws
• This was identified as a statistically significant predictor distinct from the overall anti-TGD legislation index
• The finding was identified within the multilevel modeling framework

Bathroom-related anti-TGD laws predicted more suicide attempts among TGD young adults within their respective states.

• Bathroom-related laws restricting access to public facilities were examined as a distinct legislative subcategory
• The outcome measure was suicide attempts, distinct from suicidal ideation
• This represents a behavioral outcome (attempts) rather than only ideation, suggesting a potentially more severe mental health impact
• The relationship was identified through multilevel modeling controlling for other variables

Pro-TGD legislation was not associated with improved mental health outcomes among TGD young adults.

• The study examined both pro- and anti-TGD legislation to assess bidirectional relationships with mental health
• Pro-TGD legislation categories may have included antibullying and nondiscrimination protections
• The null finding for pro-TGD legislation contrasts with prior research suggesting protective laws reduce poor outcomes
• The authors note this finding despite prior literature demonstrating that protective laws generally reduce poor mental health outcomes for TGD individuals

The United States has seen sharp increases in anti-TGD state legislation including limits on gender-affirming care, public facility restrictions, and constraints on public gender expression.

• Legislative categories examined included limits on access to gender-affirming care, restrictions on access to public facilities, and constraints on public gender expression and presentation
• Legislation passed in 2023 was specifically examined in the multilevel models
• The study spans Spring 2022 to Spring 2023, capturing a period of accelerating legislative activity
• Prior research cited demonstrates that structural stigma generally leads to poorer mental health outcomes for TGD individuals

The authors conclude that findings signal the potential devastating impact of newer anti-TGD federal policies on TGD suicide.

• The authors explicitly extrapolate from state-level findings to potential federal policy impacts
• The discussion emphasizes the importance of advocacy and civic engagement among clinicians working with TGD populations
• The authors frame the findings as demonstrating 'the harm of anti-TGD state laws on TGD mental health'
• Structural changes are identified as necessary to improve TGD mental health