Clinical Scorecard: Exploring the Role of Chronotype and Mental Health in Sleep Quality Among Transgender and Gender-Diverse Individuals

At a Glance

Key Highlights

• Poor sleep quality is highly prevalent among transgender and gender-diverse adults.
• Chronotype and mental health-related quality of life are the strongest correlates of sleep quality.
• Eveningness is associated with poorer sleep quality, particularly among individuals receiving gender-affirming hormone therapy.
• No association was found between duration of hormone therapy and sleep quality.
• Sleep disturbances may reflect multidimensional vulnerability rather than identity-specific effects.

Guideline-Based Recommendations

Diagnosis

• Utilize the Pittsburgh Sleep Quality Index (PSQI) for assessing sleep quality.

Management

• Consider mental health-related quality of life in managing sleep disturbances.

Monitoring & Follow-up

• Monitor sleep quality in relation to chronotype and GAHT status.

Risks

• Identify psychological distress as a contributing factor to sleep disturbances.

Patient & Prescribing Data

Transgender and gender-diverse adults attending a specialized gender clinic.

Current gender-affirming hormone therapy is associated with poorer sleep quality, particularly in those with evening chronotype.

Clinical Best Practices

• Assess chronotype and mental health when evaluating sleep quality in TGD individuals.
• Address psychological distress as part of the treatment plan for sleep disturbances.

Related Resources & Content

• Study on sleep quality and mental health in TGD individuals