An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults
Purpose Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and prote...
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| Veröffentlicht in: | Social Psychiatry and Psychiatric Epidemiology 2022, Vol.57 (1), p.195-205 |
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| container_title | Social Psychiatry and Psychiatric Epidemiology |
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| creator | Cramer, Robert J. Kaniuka, Andrea R. Yada, Farida N. Diaz-Garelli, Franck Hill, Ryan M. Bowling, Jessamyn Macchia, James M. Tucker, Raymond P. |
| description | Purpose
Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and protective factors.
Methods
This is a secondary analysis of the 2015 United States Transgender Health Survey, a comprehensive cross-sectional health assessment of a national sample of TGD adults (
N
= 27,658). Chi-square and Analysis of Variance (ANOVA) were used to identify bivariate correlates of 12-month and lifetime suicidal ideation (SI) and suicide attempt (SA). Logistic regression was employed to identify the strongest STB risk and protective factors across levels.
Results
Sexual minority identification, racial minority identification, and having a disability were lifetime STB risk factors. TGD identity, sexual minority identification, racial minority identification (SA only), lower education, lower income, military experience, having a disability, and being uninsured were 12-month STB risk factors. Psychological distress was the most robust STB risk factor. Workplace discrimination, family rejection, healthcare discrimination, and childhood bias-based victimization were lifetime STB risk factors. All forms of discrimination and victimization (with the exception of family rejection for SI) were 12-month STB risk factors. Family and coworker support were protective factors for lifetime SA (but not SI) and all 12-month STBs. Being less out about TGD identity was a protective factor for STBs (except for 12-month SI).
Conclusion
Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention. |
| doi_str_mv | 10.1007/s00127-021-02115-8 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2539524366</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A716432553</galeid><sourcerecordid>A716432553</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-a39232a4a048ef409d0c789e72dd7ea7d2eb79812ea4882b6f89f1da97bc4c163</originalsourceid><addsrcrecordid>eNp9kU9LHTEUxUOp1FftF-iiDLhxM5p_M0mWD2ltQeimbtyETHJnXmQmscmM4Lc3z_eqKFJCyE3u71xyOAh9JfiMYCzOM8aEihpTst2kqeUHtCKcsVpR2XxEK6xKLVTDD9HnnG8xxkwJ9gkdMk5wS2W7QjfrUJlgxofscxX7Ki_eemfGat7EZdjMuXRd1cHG3PuYym2KYajmZEIeIDhIT_196fw9pAyVccs452N00Jsxw5f9eYSuf3z_c_Gzvvp9-etifVVbzulcG6Yoo4YbzCX0HCuHrZAKBHVOgBGOQieUJBQMl5J2bS9VT5xRorPckpYdodPd3LsU_y6QZz35bGEcTYC4ZE0bphrKWbtFT96gt3FJxX6hWqKEbAUWL9RgRtA-9LH4tduhei1IyxltGlaos3eoshxM3sYAvS_vrwR0J7Ap5pyg13fJTyY9aIL1NlC9C1SXMPVToFoW0bf9j5duAvcs-ZdgAdgOyKUVBkgvlv4z9hELRamP</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2619786707</pqid></control><display><type>article</type><title>An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Cramer, Robert J. ; Kaniuka, Andrea R. ; Yada, Farida N. ; Diaz-Garelli, Franck ; Hill, Ryan M. ; Bowling, Jessamyn ; Macchia, James M. ; Tucker, Raymond P.</creator><creatorcontrib>Cramer, Robert J. ; Kaniuka, Andrea R. ; Yada, Farida N. ; Diaz-Garelli, Franck ; Hill, Ryan M. ; Bowling, Jessamyn ; Macchia, James M. ; Tucker, Raymond P.</creatorcontrib><description>Purpose
Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and protective factors.
Methods
This is a secondary analysis of the 2015 United States Transgender Health Survey, a comprehensive cross-sectional health assessment of a national sample of TGD adults (
N
= 27,658). Chi-square and Analysis of Variance (ANOVA) were used to identify bivariate correlates of 12-month and lifetime suicidal ideation (SI) and suicide attempt (SA). Logistic regression was employed to identify the strongest STB risk and protective factors across levels.
Results
Sexual minority identification, racial minority identification, and having a disability were lifetime STB risk factors. TGD identity, sexual minority identification, racial minority identification (SA only), lower education, lower income, military experience, having a disability, and being uninsured were 12-month STB risk factors. Psychological distress was the most robust STB risk factor. Workplace discrimination, family rejection, healthcare discrimination, and childhood bias-based victimization were lifetime STB risk factors. All forms of discrimination and victimization (with the exception of family rejection for SI) were 12-month STB risk factors. Family and coworker support were protective factors for lifetime SA (but not SI) and all 12-month STBs. Being less out about TGD identity was a protective factor for STBs (except for 12-month SI).
Conclusion
Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention.</description><identifier>ISSN: 0933-7954</identifier><identifier>EISSN: 1433-9285</identifier><identifier>DOI: 10.1007/s00127-021-02115-8</identifier><identifier>PMID: 34106286</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Adults ; Analysis ; Bivariate analysis ; Child ; Cross-Sectional Studies ; Discrimination ; Discrimination in medical care ; Employment discrimination ; Epidemiology ; Ethnic and Racial Minorities ; Gender Identity ; Humans ; Mediation ; Medicine ; Medicine & Public Health ; Mental health ; Military psychology ; Minority & ethnic groups ; Original Paper ; Psychiatry ; Psychological stress ; Public health ; Rejection ; Risk analysis ; Risk factors ; Set-top boxes ; Stress (Psychology) ; Suicidal behavior ; Suicidal Ideation ; Suicide ; Suicide prevention ; Suicides & suicide attempts ; Surveys ; Transgender people ; Transgender Persons ; United States - epidemiology ; Variance analysis ; Victimization</subject><ispartof>Social Psychiatry and Psychiatric Epidemiology, 2022, Vol.57 (1), p.195-205</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>2021. Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>COPYRIGHT 2022 Springer</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-a39232a4a048ef409d0c789e72dd7ea7d2eb79812ea4882b6f89f1da97bc4c163</citedby><cites>FETCH-LOGICAL-c442t-a39232a4a048ef409d0c789e72dd7ea7d2eb79812ea4882b6f89f1da97bc4c163</cites><orcidid>0000-0001-9105-5565</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00127-021-02115-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00127-021-02115-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34106286$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cramer, Robert J.</creatorcontrib><creatorcontrib>Kaniuka, Andrea R.</creatorcontrib><creatorcontrib>Yada, Farida N.</creatorcontrib><creatorcontrib>Diaz-Garelli, Franck</creatorcontrib><creatorcontrib>Hill, Ryan M.</creatorcontrib><creatorcontrib>Bowling, Jessamyn</creatorcontrib><creatorcontrib>Macchia, James M.</creatorcontrib><creatorcontrib>Tucker, Raymond P.</creatorcontrib><title>An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults</title><title>Social Psychiatry and Psychiatric Epidemiology</title><addtitle>Soc Psychiatry Psychiatr Epidemiol</addtitle><addtitle>Soc Psychiatry Psychiatr Epidemiol</addtitle><description>Purpose
Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and protective factors.
Methods
This is a secondary analysis of the 2015 United States Transgender Health Survey, a comprehensive cross-sectional health assessment of a national sample of TGD adults (
N
= 27,658). Chi-square and Analysis of Variance (ANOVA) were used to identify bivariate correlates of 12-month and lifetime suicidal ideation (SI) and suicide attempt (SA). Logistic regression was employed to identify the strongest STB risk and protective factors across levels.
Results
Sexual minority identification, racial minority identification, and having a disability were lifetime STB risk factors. TGD identity, sexual minority identification, racial minority identification (SA only), lower education, lower income, military experience, having a disability, and being uninsured were 12-month STB risk factors. Psychological distress was the most robust STB risk factor. Workplace discrimination, family rejection, healthcare discrimination, and childhood bias-based victimization were lifetime STB risk factors. All forms of discrimination and victimization (with the exception of family rejection for SI) were 12-month STB risk factors. Family and coworker support were protective factors for lifetime SA (but not SI) and all 12-month STBs. Being less out about TGD identity was a protective factor for STBs (except for 12-month SI).
Conclusion
Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention.</description><subject>Adult</subject><subject>Adults</subject><subject>Analysis</subject><subject>Bivariate analysis</subject><subject>Child</subject><subject>Cross-Sectional Studies</subject><subject>Discrimination</subject><subject>Discrimination in medical care</subject><subject>Employment discrimination</subject><subject>Epidemiology</subject><subject>Ethnic and Racial Minorities</subject><subject>Gender Identity</subject><subject>Humans</subject><subject>Mediation</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental health</subject><subject>Military psychology</subject><subject>Minority & ethnic groups</subject><subject>Original Paper</subject><subject>Psychiatry</subject><subject>Psychological stress</subject><subject>Public health</subject><subject>Rejection</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Set-top boxes</subject><subject>Stress (Psychology)</subject><subject>Suicidal behavior</subject><subject>Suicidal Ideation</subject><subject>Suicide</subject><subject>Suicide prevention</subject><subject>Suicides & suicide attempts</subject><subject>Surveys</subject><subject>Transgender people</subject><subject>Transgender Persons</subject><subject>United States - epidemiology</subject><subject>Variance analysis</subject><subject>Victimization</subject><issn>0933-7954</issn><issn>1433-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU9LHTEUxUOp1FftF-iiDLhxM5p_M0mWD2ltQeimbtyETHJnXmQmscmM4Lc3z_eqKFJCyE3u71xyOAh9JfiMYCzOM8aEihpTst2kqeUHtCKcsVpR2XxEK6xKLVTDD9HnnG8xxkwJ9gkdMk5wS2W7QjfrUJlgxofscxX7Ki_eemfGat7EZdjMuXRd1cHG3PuYym2KYajmZEIeIDhIT_196fw9pAyVccs452N00Jsxw5f9eYSuf3z_c_Gzvvp9-etifVVbzulcG6Yoo4YbzCX0HCuHrZAKBHVOgBGOQieUJBQMl5J2bS9VT5xRorPckpYdodPd3LsU_y6QZz35bGEcTYC4ZE0bphrKWbtFT96gt3FJxX6hWqKEbAUWL9RgRtA-9LH4tduhei1IyxltGlaos3eoshxM3sYAvS_vrwR0J7Ap5pyg13fJTyY9aIL1NlC9C1SXMPVToFoW0bf9j5duAvcs-ZdgAdgOyKUVBkgvlv4z9hELRamP</recordid><startdate>2022</startdate><enddate>2022</enddate><creator>Cramer, Robert J.</creator><creator>Kaniuka, Andrea R.</creator><creator>Yada, Farida N.</creator><creator>Diaz-Garelli, Franck</creator><creator>Hill, Ryan M.</creator><creator>Bowling, Jessamyn</creator><creator>Macchia, James M.</creator><creator>Tucker, Raymond P.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9105-5565</orcidid></search><sort><creationdate>2022</creationdate><title>An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults</title><author>Cramer, Robert J. ; Kaniuka, Andrea R. ; Yada, Farida N. ; Diaz-Garelli, Franck ; Hill, Ryan M. ; Bowling, Jessamyn ; Macchia, James M. ; Tucker, Raymond P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-a39232a4a048ef409d0c789e72dd7ea7d2eb79812ea4882b6f89f1da97bc4c163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Adults</topic><topic>Analysis</topic><topic>Bivariate analysis</topic><topic>Child</topic><topic>Cross-Sectional Studies</topic><topic>Discrimination</topic><topic>Discrimination in medical care</topic><topic>Employment discrimination</topic><topic>Epidemiology</topic><topic>Ethnic and Racial Minorities</topic><topic>Gender Identity</topic><topic>Humans</topic><topic>Mediation</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental health</topic><topic>Military psychology</topic><topic>Minority & ethnic groups</topic><topic>Original Paper</topic><topic>Psychiatry</topic><topic>Psychological stress</topic><topic>Public health</topic><topic>Rejection</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Set-top boxes</topic><topic>Stress (Psychology)</topic><topic>Suicidal behavior</topic><topic>Suicidal Ideation</topic><topic>Suicide</topic><topic>Suicide prevention</topic><topic>Suicides & suicide attempts</topic><topic>Surveys</topic><topic>Transgender people</topic><topic>Transgender Persons</topic><topic>United States - epidemiology</topic><topic>Variance analysis</topic><topic>Victimization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cramer, Robert J.</creatorcontrib><creatorcontrib>Kaniuka, Andrea R.</creatorcontrib><creatorcontrib>Yada, Farida N.</creatorcontrib><creatorcontrib>Diaz-Garelli, Franck</creatorcontrib><creatorcontrib>Hill, Ryan M.</creatorcontrib><creatorcontrib>Bowling, Jessamyn</creatorcontrib><creatorcontrib>Macchia, James M.</creatorcontrib><creatorcontrib>Tucker, Raymond P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Social Psychiatry and Psychiatric Epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cramer, Robert J.</au><au>Kaniuka, Andrea R.</au><au>Yada, Farida N.</au><au>Diaz-Garelli, Franck</au><au>Hill, Ryan M.</au><au>Bowling, Jessamyn</au><au>Macchia, James M.</au><au>Tucker, Raymond P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults</atitle><jtitle>Social Psychiatry and Psychiatric Epidemiology</jtitle><stitle>Soc Psychiatry Psychiatr Epidemiol</stitle><addtitle>Soc Psychiatry Psychiatr Epidemiol</addtitle><date>2022</date><risdate>2022</risdate><volume>57</volume><issue>1</issue><spage>195</spage><epage>205</epage><pages>195-205</pages><issn>0933-7954</issn><eissn>1433-9285</eissn><abstract>Purpose
Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and protective factors.
Methods
This is a secondary analysis of the 2015 United States Transgender Health Survey, a comprehensive cross-sectional health assessment of a national sample of TGD adults (
N
= 27,658). Chi-square and Analysis of Variance (ANOVA) were used to identify bivariate correlates of 12-month and lifetime suicidal ideation (SI) and suicide attempt (SA). Logistic regression was employed to identify the strongest STB risk and protective factors across levels.
Results
Sexual minority identification, racial minority identification, and having a disability were lifetime STB risk factors. TGD identity, sexual minority identification, racial minority identification (SA only), lower education, lower income, military experience, having a disability, and being uninsured were 12-month STB risk factors. Psychological distress was the most robust STB risk factor. Workplace discrimination, family rejection, healthcare discrimination, and childhood bias-based victimization were lifetime STB risk factors. All forms of discrimination and victimization (with the exception of family rejection for SI) were 12-month STB risk factors. Family and coworker support were protective factors for lifetime SA (but not SI) and all 12-month STBs. Being less out about TGD identity was a protective factor for STBs (except for 12-month SI).
Conclusion
Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34106286</pmid><doi>10.1007/s00127-021-02115-8</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9105-5565</orcidid></addata></record> |
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| identifier | ISSN: 0933-7954 |
| ispartof | Social Psychiatry and Psychiatric Epidemiology, 2022, Vol.57 (1), p.195-205 |
| issn | 0933-7954 1433-9285 |
| language | eng |
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| subjects | Adult Adults Analysis Bivariate analysis Child Cross-Sectional Studies Discrimination Discrimination in medical care Employment discrimination Epidemiology Ethnic and Racial Minorities Gender Identity Humans Mediation Medicine Medicine & Public Health Mental health Military psychology Minority & ethnic groups Original Paper Psychiatry Psychological stress Public health Rejection Risk analysis Risk factors Set-top boxes Stress (Psychology) Suicidal behavior Suicidal Ideation Suicide Suicide prevention Suicides & suicide attempts Surveys Transgender people Transgender Persons United States - epidemiology Variance analysis Victimization |
| title | An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults |
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