High impact of sleeping problems on quality of life in transgender individuals: A cross-sectional multicenter study

Introduction

Studies in the general
population suggest that determinants of QoL are often sex-dependent. Sex-dependent
analyses of QoL in transgender populations have not been performed so far.

Methods

In
this cross-sectional multicentre study including 82 transwomen (TW) and 72
transmen (TM) at different treatment stages, we investigated potential
determinants for QoL, assessed by the  Short
Form (36) Health Survey (SF-36), focusing on the impact of mood (BDI, STAI-X),
sleep quality (PSQI), chronic pain (GPQ), body image (FBeK) and social support
(SSS).

Results

The
age-adjusted SF-36 total score and its subscales did not significantly differ
between TM and TW. Using a multivariate regression analysis approach, we
identified common but also sex-dependent determinants for QoL (Adjusted R2 = 0.228; 0.650 respectively).
Accounting for general characteristics such as age, BMI and treatment status, sleep
quality according to the PSQI was an independent and strong determinant of QoL
in both sexes (β = -0.451, p =0.003 TM; β = -0.320; p = 0.0029 TW). Chronic
pain was a significant independent predictor of QoL in TM (β = -0.298; p =
0.042) but not in TW. In contrast, anxiety (β= - 0.451; p< 0.001) being
unemployed (β= -0.206; p = 0.020) and insecurity about the own appearance
(FBeK) (β= -0.261; p = 0.01) were independent predictors of QoL in TW. The rate
of those reporting high sleep disturbances (PSQI ≥5) was high with 79.2% in TW
and 81.2% in TM. Accordingly, age-adjusted QoL was also significantly lower in
those reporting poor sleep in both sexes.

Conclusions

Sleep
strongly affected QoL in both gender, while other factors, like pain and body
image, seem to be gender specific in transgender individuals.