Introduction:

Transgender and gender-diverse (TGD) individuals face health disparities and workplace discrimination, yet the job and health outcomes of TGD nurses remain underexplored.

Purpose:

To investigate how gender identity affects job and health outcomes.

Methods:

This cross-sectional observational study included 52,491 nurses (52,455 identifying as cisgender and 36 as TGD) in New York and Illinois surveyed in 2021. Job outcomes were burnout and job dissatisfaction. Health outcomes were depression, anxiety, and overall health ratings. Propensity score weighting was used to address confounding factors. Doubly robust methods were applied to refine estimates.

Results:

Compared with cisgender nurses, TGD nurses had higher odds of high burnout (adjusted odds ratio [aOR] = 2.60, p = .036), job dissatisfaction (aOR = 2.21, p = .044), poorer overall health (aOR = 3.98, p < .001), and more depressive (b = 0.82, p = .013) and anxiety symptoms (b = 0.76, p = .044).

Conclusions:

TGD nurses reported poorer job and health outcomes than cisgender nurses, underscoring the need to identify workplace factors associated with these disparities.