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Publications

Journal Article Epublish

PubMed: 42490988 DOI: 10.3389/fpsyt.2026.1872006

Beyond identity categories: chronotype and mental health as correlates of sleep quality in transgender and gender-diverse adults.

Front Psychiatry 17:1872006

Authors: Paolo Meneguzzo, Alessio A Gugliotta, Angela Favaro, Sara Montagnese, Marina Bonato, Alberto Scala, Marina Miscioscia, Andrea Garolla

Affiliations

  • Department of Neuroscience, University of Padova, Padova, Italy.
  • Padova Neuroscience Center, University of Padova, Padova, Italy.
  • Regional Reference Center for Gender Incongruence, Azienda Ospedale-Università di Padova, Padova, Italy.
  • Department of Medicine, University of Padova, Padova, Italy.
  • Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy.
  • Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy.

Abstract

BACKGROUND

Sleep disturbance is frequently reported among transgender and gender-diverse (TGD) adults, yet the relative contribution of circadian preference, mental health, and gender-affirming hormone therapy (GAHT) remains unclear.

METHODS

In this cross-sectional study, 222 TGD adults (mean age = 26.9 ± 9.3 years; 15.3% non-binary) attending a specialized gender clinic in Padova (Italy) completed the Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), and SF-12. Multivariable linear regression examined associations between sleep quality and chronotype, mental health-related quality of life, age, sex assigned at birth, gender identity, and current GAHT. An exploratory model tested the interaction between chronotype and GAHT status.

RESULTS

Mean PSQI 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. Within the GAHT subgroup, treatment duration was not associated with PSQI scores.

CONCLUSIONS

Poor sleep quality is common in TGD adults and appears primarily associated with circadian preference and psychological well-being. Findings suggest that the relationship between chronotype and sleep quality may vary by GAHT status, although no linear association with treatment duration was observed. Longitudinal studies are needed to clarify these relationships.

MeSH

Quality Of Life, Sleep, Duration Of Therapy, Therapeutics, Mental Health