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Suicide Attempts by Gender Among Veterans Experiencing Housing Instability
Abby Mulcahy1,2, John R Blosnich3,4, Aerin deRussy5
1Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR 97239, United States.
Military Medicine
|July 30, 2026
Summary
Transgender and gender diverse (TGD) veterans with housing instability face higher suicide attempt risks. Cisgender women veterans showed increased attempts over time, while social services linked to higher attempts in cisgender men.
Area of Science:
- Veterans Health Administration
- Mental Health
- Suicidology
Background:
- Military veterans exhibit higher suicide rates than the general population.
- Housing instability is a prevalent risk factor for suicide among veterans.
- Gender significantly moderates suicide risk and attempts.
Purpose of the Study:
- To investigate suicide attempt risk factors at the intersection of gender and housing instability in veterans.
- To analyze gender differences in suicide attempts among housing-unstable veterans.
- To identify specific risk correlates within different gender groups.
Main Methods:
- Utilized Veterans Health Administration electronic health records (2013-2017) for 659,987 housing-unstable veterans.
- Defined gender by recorded sex (male/female) and identified transgender and gender diverse (TGD) status via ICD-10 codes.
- Employed discrete-time survival analysis to examine suicide attempt correlates over time across cisgender men, cisgender women, and TGD veterans.
Main Results:
- Transgender and gender diverse (TGD) veterans had 2-3 times higher suicide attempt prevalence than cisgender men and women.
- Cisgender women veterans showed higher suicide attempts during follow-up compared to baseline.
- Suicidal ideation and social service utilization were significant predictors of suicide attempts across groups, with social services linked to higher attempts in cisgender men.
Conclusions:
- TGD veterans with housing instability experience the highest prevalence of suicide attempts.
- Further research is needed to ensure VA suicide prevention efforts effectively reach TGD veterans.
- Social service programs may signal acute risk, especially for cisgender men, suggesting a need for better integration with suicide prevention strategies.
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