0826 Sleep Duration and Short Sleep Disparities Among Transgender Adults: A Nationally Representative Analysis of BRFSS 2022

Abstract Introduction Sexual and gender minority populations experience stress, discrimination, and barriers to healthcare access yet data on sleep duration is limited. We analyzed the 2022 Behavioral Risk Factor Surveillance System (BRFSS) to compare sleep duration and short sleep prevalence across transgender female-to-male (Trans F-to-M), transgender male-to-female (Trans M-to-F), gender non-conforming, and non-transgender adults, and to evaluate whether differences persisted after adjustment for age. Methods Cross-sectional analysis of 2022 BRFSS data was analyzed using R version 4.5.1 and the survey package to account for complex sampling design. Sleep duration was assessed using SLEPTIM1 and short sleep was defined as < 7 hours. Gender identity (TRNSGNDR) was categorized as gender non-conforming, Trans F-to-M, Trans M-to-F, or not transgender (reference). Short sleep prevalence and standard errors were estimated and regression with age modeled. Odds ratios (OR) and 95% confidence intervals (CI) were calculated from exponentiated model coefficients. Results Data includes 436,194 adults, of whom 0.19% (≈499) identified as gender non-conforming, 0.20% (≈515) as Trans F-to-M, and 0.22% (≈589) as Trans M-to-F, while 97.9% (≈430,000) reported not being transgender. Weighted mean sleep duration was 6.74 ± 0.18 hours among Trans F-to-M adults, 6.89 ± 0.15 hours among Trans M-to-F adults, 7.00 ± 0.16 hours among gender non-conforming individuals, and 6.95 ± 0.01 hours among non-transgender adults. Short sleep prevalence was highest among Trans F-to-M adults (46.1%, SE 3.97%), followed by gender non-conforming (40.0%, SE 3.32%) and Trans M-to-F adults (39.7%, SE 4.26%), compared with 35.7% (SE 0.20%) among non-transgender adults. In age-adjusted models, Trans F-to-M adults had significantly higher odds of short sleep (OR 1.52; 95% CI 1.11–2.08; p = 0.009), whereas gender non-conforming (OR 1.19; 95% CI 0.90–1.57) and Trans M-to-F adults (OR 1.16; 95% CI 0.80–1.67) were not statistically different. Short sleep increased across early and mid-adulthood, peaking at ages 30–64 (OR range 1.27–1.40, all p < 0.001), and declined after age ≥65. Conclusion Transgender female-to-male adults experience a significantly higher burden of short sleep independent of age, while other transgender identity groups demonstrate sleep patterns similar to non-transgender adults. Support (if any)