Beyond identity categories: chronotype and mental health as correlates of sleep quality in transgender and gender-diverse adults - Report - MDSpire

Beyond identity categories: chronotype and mental health as correlates of sleep quality in transgender and gender-diverse adults

  • By

  • Paolo Meneguzzo

  • Alessio A. Gugliotta

  • Angela Favaro

  • Sara Montagnese

  • Marina Bonato

  • Alberto Scala

  • Marina Miscioscia

  • Andrea Garolla

  • July 3, 2026

  • 0 min

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Clinical Report: Exploring the Role of Chronotype and Mental Health in Sleep Quality

Overview

This study investigates sleep quality among transgender and gender-diverse adults, highlighting associations with chronotype and mental health. Findings indicate that eveningness correlates with poorer sleep quality, particularly in individuals undergoing gender-affirming hormone therapy.

Background

Sleep disturbances are prevalent among transgender and gender-diverse (TGD) individuals, impacting their overall well-being. This research contributes to the evidence on health disparities faced by TGD individuals.

Data Highlights

MeasureMean ± SDPercentage Scoring >5Percentage Scoring ≥8
PSQI6.31 ± 3.8454.9%31.5%

Key Findings

  • Mean PSQI score was 6.31 ± 3.84 among participants.
  • 54.9% of participants scored >5 on the PSQI, indicating poor sleep quality.
  • Eveningness was associated with poorer sleep quality, particularly among those receiving gender-affirming hormone therapy.
  • Lower mental health-related quality of life correlated with poorer sleep quality.
  • No association was found between the duration of hormone therapy and sleep quality.

Clinical Implications

Clinicians should consider the impact of chronotype and mental health on sleep quality when treating TGD individuals.

Conclusion

The findings indicate associations between sleep quality in TGD adults, chronotype, and mental health.

Related Resources & Content

  1. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 - PMC, 2022 -- Comprehensive guidelines for TGD care
  2. Sleep is essential to health: an American Academy of Sleep Medicine position statement - PMC, 2021 -- Position statement on sleep health
  3. Sex hormones, insomnia, and sleep quality: Subjective sleep in the first year of hormone use in transgender persons - ScienceDirect, 2023 -- Study on sleep quality and hormone use
  4. Intensive Care Medicine — Influence of Chronotype on Night Shift Fatigue, Sleepiness, and Psychomotor Performance in ICU Nurses
  5. Clinical Rheumatology — Morning Chronotype Observed in Individuals with Rheumatoid Arthritis
  6. European Journal of Preventive Cardiology — Night shift work and its interaction with sleep duration and chronotype, and risk of cardiovascular–kidney–metabolic diseases in the UK Biobank
  7. The Journal of Clinical Endocrinology & Metabolism — Sex Differences in Circadian Rhythm Alignment and Cardiometabolic Health in Adults with Overweight or Obesity
  8. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 - PMC
  9. Sleep is essential to health: an American Academy of Sleep Medicine position statement - PMC
  10. Sex hormones, insomnia, and sleep quality: Subjective sleep in the first year of hormone use in transgender persons - ScienceDirect
  11. Chronotype changes after sex hormone use: a prospective cohort study in transgender users of gender-affirming hormones | medRxiv
  12. 0812 Sleep Health Changes in Transgender Adults Initiating Gender-Affirming Hormone Therapy: A Systematic Review | SLEEP | Oxford Academic

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