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Identifying Intersecting Factors Associated With Suicidal Thoughts and Behaviors Among Transgender and Gender Diverse
Amelia M Stanton1,2, Lauren A Trichtinger3, Norik Kirakosian4
1Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States.
Journal of Medical Internet Research
|April 11, 2025
Summary
Transgender and gender diverse (TGD) individuals face higher risks for suicidal thoughts and behaviors (STBs). Key risk factors include age, race, sexual orientation, psychiatric distress, and discrimination, highlighting the need for targeted interventions.
Area of Science:
- Public Health
- Mental Health Research
- Sociology
Background:
- Transgender and gender diverse (TGD) individuals experience disproportionately high rates of suicidal thoughts and behaviors (STBs).
- Intersecting demographic and psychosocial factors may exacerbate STB disparities within the TGD population.
Purpose of the Study:
- To identify intersecting factors associated with increased risk for suicidal ideation, intent, plan, and attempts in US TGD adults.
- To determine the age of onset for these outcomes using conditional inference trees (CITs).
Main Methods:
- Utilized data from the US Transgender Population Health Survey (N=274).
- Employed conditional inference trees (CITs) to identify risk factors and age of onset for STBs.
- Compared CIT results with logistic regressions and Cox proportional hazards models, analyzing both EMR-available and expanded variable sets.
Main Results:
- Younger adults and specific racial/ethnic minority groups (Black, Latine, multiracial) showed higher risks for ideation and planning.
- Sexual minority identity was linked to increased risk for ideation and planning.
- Psychiatric distress, healthcare stereotype threat, and everyday discrimination were associated with increased risk for ideation, intent, and attempts.
- Age of onset for ideation and attempts varied by gender identity (transgender women, transgender men, nonbinary individuals).
- CITs outperformed traditional regression models for age of onset outcomes.
Conclusions:
- Suicidal risk in TGD adults is influenced by a complex interplay of age, racial identity, sexual minority status, psychiatric distress, healthcare stereotype threat, and discrimination.
- Identifying these intersecting factors is crucial for early risk detection and intervention among TGD individuals.
- Further validation of the CIT approach using larger-scale EMR data is recommended to improve service provision for TGD individuals at high risk for STBs.
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