Exposure to anti-trans rhetoric, policies, and violence: associations with mental health outcomes in Australian trans and gender diverse communities

Background Despite escalations in anti-trans rhetoric, policies, and violence against trans and gender diverse (trans) people globally, little research has examined associated mental health outcomes. Methods A cross-sectional online survey of trans people aged ≥ 16 years living in Australia through May 2024, assessed frequency of seven different exposures in the previous month; anti-trans rhetoric in news media, online, and by Australian politicians and high-profile individuals, online bullying and harassment, anti-trans rallies and police violence against trans people in Australia, and international anti-trans legislation and violence. Modified Poisson logistic regression models were used to analyze associations between multiple times weekly exposure for each exposure type and mental health (anxiety, GAD-7; depression, PHQ-9; and self-reported past 12-month self-harm and suicidality). Results Amongst 807 respondents (median age 33 years), exposure multiple times weekly to all seven exposure types, were associated with significantly increased risk of anxiety and depression (adjusted prevalence ratio (aPRs) ranging 1.15 to 3.46). Six of the exposures were associated with significantly increased risk of suicide planning (aPRs ranging 1.39 to 2.42), four were associated with significantly increased risk of suicide ideation (aPRs ranging 1.47–2.02), and five were associated with significantly increased risk of self-harm ideation and/or behaviors (aPRs ranging 1.22 to 1.97). Conclusions Australian trans communities experience frequent exposure to anti-trans rhetoric, policies, and violence, with higher rates of exposure associated with higher risk of multiple adverse mental health outcomes. Urgent, multi-pronged collaborative responses are required from governments, news media outlets, and social media platforms to combat anti-trans mis/disinformation and discrimination.