To investigate the contributions of chronotype, mental health, and gender-affirming hormone therapy (GAHT) to sleep quality in transgender and gender-diverse (TGD) adults.
Approach:
Study Design: Cross-sectional study involving 222 TGD adults attending a specialized gender clinic in Padova, Italy.
Data Collection: Participants completed the Pittsburgh Sleep Quality Index (PSQI), Morningness–Eveningness Questionnaire (MEQ), and SF-12.
Statistical Analysis: Multivariable linear regression was used to examine associations between sleep quality and various factors including chronotype and mental health.
Key Findings:
Mean PSQI score was 6.31 ± 3.84; 54.9% scored >5 and 31.5% ≥8.
Poorer sleep quality was independently associated with greater eveningness, lower mental health-related quality of life, younger age, and current GAHT.
The association between eveningness and poorer sleep quality was stronger among participants receiving GAHT.
No association was found between duration of GAHT and PSQI scores.
Interpretation:
Poor sleep quality is common among TGD adults and is linked to circadian preference and psychological well-being, with variations based on GAHT status.
Limitations:
Cross-sectional design limits causal inferences.
Sample size may not be representative of all TGD individuals.
Conclusion:
Longitudinal studies are needed to further explore the relationships between chronotype, mental health, and sleep quality in TGD populations.
