@article{ref1,
title="An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults",
journal="Social psychiatry and psychiatric epidemiology",
year="2021",
author="Cramer, Robert J. and Kaniuka, Andrea R. and Yada, Farida N. and Diaz-Garelli, Franck and Hill, Ryan M. and Bowling, Jessamyn and Macchia, James M. and Tucker, Raymond P.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
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. <br><br>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. <br><br>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). <br><br>CONCLUSION: Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention.<p /> <p>Language: en</p>",
language="en",
issn="0933-7954",
doi="10.1007/s00127-021-02115-8",
url="http://dx.doi.org/10.1007/s00127-021-02115-8"
}