Objective:

To investigate the association between bullying victimization, state gender-identity policy environments, and psychotic-like experiences among gender-diverse youths, specifically focusing on those assigned female at birth.

Key Findings:

• Mean psychotic-like experience score was 7.5 for the most gender-diverse youths compared to 2.0 for the least gender-diverse.
• Bullying victimization scores were 4.6 for the most gender-diverse compared to 2.8 for the least.
• The most gender-diverse group scored 0.78 standard deviations higher on psychotic-like experiences than the least gender-diverse group.
• Longitudinal analyses indicated that psychotic-like experiences increased over time among the most gender-diverse youths in low-support policy environments.

Interpretation:

The study suggests that bullying victimization and unsupportive state policies contribute to higher psychotic-like experiences in gender-diverse youths, highlighting the need for targeted mental health assessments and interventions.

Limitations:

• Observational study design limits causal conclusions.
• Participants excluded due to incomplete data may differ significantly from the broader cohort.
• The policy metric reflects overall legislative climate rather than individual laws.
• Potential biases in self-reporting may affect the accuracy of psychotic-like experience assessments.

Conclusion:

The findings emphasize the importance of considering social and political environments in the mental health care of gender-diverse youths, particularly in shaping supportive policies.