Prevalence and factors associated with gender incongruence in French healthcare professionals: results from a nationwide survey

Abstract

Objectives: The objective of this study was to explore gender incongruence among French healthcare professionals and its associated factors.

Study design: Nationwide online cross-sectional survey.

Methods: Healthcare professionals were recruited from May 2, 2021, to June 30, 2021, through social networks, professional networks, and email invitations. A multivariate regression model was used to analyze the association between gender incongruence and socio-demographic, professional, mental health, and addiction behavior factors.

Results: The study included 10,325 healthcare professionals, indicating a prevalence of gender incongruence at 2.6% (95% confidence interval [CI]: 2.3-2.9%). In multivariate analyses, we found that healthcare professionals with gender incongruence, when compared to their counterparts, exhibited the following characteristics: they were more frequently male (adjusted odds ratio [aOR] = 1.88, 95% CI: [1.42-2.48], p < 0.001), less frequently physicians (aOR = 0.18, 95%CI: [0.11-0.29], p < 0.001), health executives (aOR = 0.51 [0.34-0.77], p = 0.001), nurses (aOR = 0.47, 95%CI: [0.33-0.68], p < 0.001), and other allied professionals (aOR = 0.33, 95%CI [0.23-0.49], p < 0.001) than nurse assistants, they consumed antidepressants more frequently (aOR = 1.52, 95%CI: [1.02-2.26], p = 0.041) and were more likely to be tobacco smokers (aOR = 1.34 (1.02-1.77), p = 0.035). We did not observe any significant associations with age, hazardous drinking, sustained bullying at the work place, or sexual-orientation-based discrimination (all p > 0.05).

Conclusions: Gender incongruence should be taken into account at the management, colleague, or institution levels. We found that the professionals reporting gender incongruence consumed more antidepressants and smoked more, which may indicate a certain level of distress that warrants further investigation.

Protocol registration: IRB n°C08/21.01.06.93911, CNIL. The protocol was published DOI: 10.1016/j.encep.2021.06.001.

Trial and protocol registration: The protocol was published DOI: 10.1016/j.encep.2021.06.001.

Keywords: Diversity; Gender incongruence; Healthcare workers; Inclusion; Mental health.