Suicide in Transgender Veterans: Prevalence, Prevention, and Implications of Current Policy

Transgender adults serve in the U.S. military at 2 to 3 times the rate of the general adult population. Unfortunately, transgender veterans die by suicide at twice the rate of their cisgender veteran peers and approximately 5.85 times the rate of the general population. This article reviews the literature regarding the prevalence of suicidal thoughts and behaviors in transgender veterans. Suicide risk and resilience factors are reviewed, and future areas of study are detailed that incorporate findings from the broader suicide-prevention literature and research on transgender mental-health disparities. Individual services and broader prevention considerations are discussed, including the adaptation of evidence-based suicide-specific psychological interventions, national transgender health-training resources, and relevant veteran suicide-prevention initiatives. Finally, U.S. Department of Defense and U.S. Department of Veterans Affairs policies regarding transgender service and health care are reviewed. State-level policies relevant to transgender veteran suicide such as firearm ownership and nondiscrimination laws are also reviewed, and their implications for suicide prevention are discussed. The aim of this article is to provide a broad review of research findings from multiple fields of study to assist health-care providers, researchers, and policymakers in their efforts to prevent transgender veteran suicide.