{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:29:13Z","timestamp":1790364553480,"version":"4.1.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T00:00:00Z","timestamp":1653264000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["LGBT Health"],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>This study sought to expand on previous scholarship focused on gender-concordant identity documents (IDs) as a social determinant of health. We examined the association between barriers to legal gender recognition and the mental health of transgender and nonbinary people in Aotearoa\/New Zealand.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We used data from a 2018 nationwide community-based survey of trans and nonbinary people in Aotearoa (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u2009818). Variables of investigation included: gender-concordant IDs, mental health (past-month psychological distress, past-year nonsuicidal self-injury, past-year suicidality) and barriers to changing gender markers on a birth certificate or passport. Associations between gender-concordant IDs and mental health were determined using generalized linear regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In total, 34.8% reported the correct name on all of their IDs. The proportion with the correct gender marker on both birth certificates and passports was 16.0%. Participants with gender-concordant IDs were more likely to be older, have higher levels of income and education, and have had genital reconstruction. In addition, 68.7% of participants reported experiencing at least one barrier to changing gender markers on their IDs, and these participants had significantly higher average points of psychological distress scores (\n                      <jats:italic toggle=\"yes\">b<\/jats:italic>\n                      \u2009=\u20092.39) and greater odds of suicidal ideation (odds ratio\u2009=\u20092.02) than those with gender-concordant IDs, after adjusting for sociodemographic variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We present novel findings on higher levels of mental health problems among trans and nonbinary people who faced barriers in trying to obtain gender-concordant IDs compared with those with gender-concordant IDs. Removing barriers to legal gender recognition may be an effective way to improve mental health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lgbt.2021.0240","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T13:53:15Z","timestamp":1653313995000},"page":"401-410","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Barriers to Possessing Gender-Concordant Identity Documents are Associated with Transgender and Nonbinary People's Mental Health in Aotearoa\/New Zealand"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6831-7045","authenticated-orcid":false,"given":"Kyle K.H.","family":"Tan","sequence":"first","affiliation":[{"name":"Faculty of M\u0101ori and Indigenous Studies, University of Waikato, Hamilton, New Zealand."},{"name":"Transgender Health Research Lab, School of Psychology, University of Waikato, Hamilton, New Zealand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7824-7714","authenticated-orcid":false,"given":"Ryan J.","family":"Watson","sequence":"additional","affiliation":[{"name":"Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack L.","family":"Byrne","sequence":"additional","affiliation":[{"name":"Transgender Health Research Lab, School of Psychology, University of Waikato, Hamilton, New Zealand."},{"name":"TransAction, Auckland, New Zealand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9151-7413","authenticated-orcid":false,"given":"Jaimie F.","family":"Veale","sequence":"additional","affiliation":[{"name":"Transgender Health Research Lab, School of Psychology, University of Waikato, Hamilton, New Zealand."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,5,23]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1037\/sgd0000081"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-3223"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/trgh.2020.0025"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2019.0046"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2018.02.003"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13178-017-0289-6"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-1867-2"},{"key":"e_1_3_6_9_2","unstructured":"World Health Organization. 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