{
  "abstract": "BackgroundAdolescent mental health after the COVID-19 pandemic has been a major public health concern. Studies covering the post-pandemic period remain scarce and rarely include gender-diverse youth. We examined trends in mental health among cisgender, transgender, and nonbinary youth during the pandemic and through 2025.\n\nMethodsParticipants (N=636,201) were adolescents in grades 8-11 from the Finnish School Health Promotion study between 2019 and 2025, a repeated cross-sectional classroom survey.\n\nValidated questionnaires were used to assess clinical levels of depressive, generalized anxiety and social anxiety symptoms, as well as mental well-being.\n\nResultsIn 2025 there were 81,145 (48.6%) cisgender girls, 1137 (0.7%) transgender boys, 78,898 (47.2%) cisgender boys, 449 (0.3%) transgender girls, and 4658 (2.8%) nonbinary youth. Clinically significant depressive and generalized anxiety symptoms remained more prevalent in 2025 (reference) compared with pre-pandemic levels across all groups (ORs for 2019, 0.48-0.86; p<0.01). Compared with other groups, symptoms were most prevalent among transgender boys and nonbinary youth. Among cisgender youth, generalized anxiety symptoms increased across the post-pandemic period (ORs for 2021 and 2023, 0.81-0.95; p<0.0001). Nonbinary youth were the only group to show a recovery pattern in depressive, generalized anxiety, and social anxiety symptoms (ORs for 2021, 1.36-1.52; p<0.0001) and demonstrated improved mental well-being after the pandemic (beta for 2021, -0.68; p<0.0001).\n\nConclusionsThe results indicate that the elevated levels of mental health problems among adolescents associated with the COVID-19 pandemic have not subsided. They also reveal persistent disparities by gender identity and call for targeted policy action.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Healthcare and Social Welfare, Finnish Institute for Health and Welfare"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "O. Kiviruusu"
    },
    {
      "name": "S. Therman"
    },
    {
      "name": "J. Lehtonen"
    },
    {
      "name": "E. Ystrom"
    },
    {
      "name": "A. Butwicka"
    },
    {
      "name": "T. Halldorsdottir"
    },
    {
      "name": "H. Ask"
    },
    {
      "name": "J. Suvisaari"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fjtq7809nhy3r.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.06.26362161",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.06.26362161v1.full",
  "id": "fjtq7809nhy3r",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.06.26362161v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "psychiatry and clinical psychology"
    ],
    [
      "openalex",
      "3203|COVID-19 and Mental Health"
    ]
  ],
  "openalex": "W7212256545",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.06.26362161v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-06",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/fjtq7809nhy3r.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:18Z",
      "native_id": "10.64898/2026.09.06.26362161",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.06.26362161v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:psychiatry and clinical psychology",
      "subfield": "psychiatry"
    }
  ],
  "title": "Mental health before, during, and after COVID-19 (through 2025) in boys, girls, and gender-diverse youth",
  "title_text": "Mental health before, during, and after COVID-19 (through 2025) in boys, girls, and gender-diverse youth",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:18Z",
  "url": "https://research.draconitic.com/paper/fjtq7809nhy3r",
  "venue": "medRxiv",
  "versions": []
}