MENTAL HEALTHCARE UTILIZATION AMONG TRANSGENDER AND GENDER-DIVERSE YOUTH AND THEIR CISGENDER SIBLINGS IN THE U.S. MILITARY HEALTHCARE SYSTEM

Purpose: Large population-based studies using administrative data sets indicate that transgender and gender diverse (TGD) adults are more likely to have a mental health diagnosis and higher use of mental health services compared to cisgender peers. Moreover, research suggests TGD youth may experience higher than expected rates of adverse mental health outcomes. However, these studies are limited by small sample sizes, self-reports, limited geographic area, and lack of control groups. This study's aim is to compare mental health service utilization ofTGD youth to a control group of cisgender siblings in a large healthcare system. Methods: TGD children and adolescents who received care in the military healthcare system 2010-2018 were identified by International Classification of Diseases (lCD) 9/10 codes; cisgender siblings were identified using the military parent's unique identifier. All included youths were dependents of a military parent enrolled in the TRICARE health plan and were