A Comparison of Post-Traumatic Stress and Depressive Symptoms by Suicidal Ideation Among Black Transgender Women

Black transgender women in the United States (US) report a significant burden of minority stress contributing to high post-traumatic stress disorder (PTSD) and depressive symptom severity and suicidality. Literature suggests Black Americans are less likely than White peers to report suicidal ideation (SI) but more likely to attempt suicide in the last year. Limited research exists to identify specific symptoms that may indicate increased risk of suicidality among Black transgender women who do not disclose SI-limiting clinicians' ability to identify those at risk of suicidality. Our study aimed to compare the prevalence and severity of PTSD and depressive symptoms among Black transgender women who endorse or do not endorse SI. We analyzed cross-sectional online survey data from a convenience sample of Black transgender women in the US (N = 153). Symptoms were measured using the PTSD Symptom Checklist - DSM-V version and the Beck Depression Inventory-II. Statistical analyses included Wilcoxon Rank Sum Tests, Fischer's Exact Tests, and logistic regression. Worthlessness, changes in appetite, and severity of total Beck Depression Inventory II (BDI-II) scores were consistently significantly higher or more prominent in those endorsing SI compared to those who did not. Findings highlight those two symptoms and the total depressive symptom score as potential indicators of suicidality, which highlights opportunities for providers to further assess for SI and consider safety planning even in the absence of SI disclosure. More research is needed with larger samples of gender-expansive people to further explore these findings.