An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults

Cramer, Robert J.; Kaniuka, Andréa R.; Yada, Farida N; Diaz-Garelli, Franck; Hill, Ryan M.; Bowling, Jessamyn; Macchia, James M; Tucker, Raymond P.

doi:10.1007/s00127-021-02115-8

Cited by 24 publications

(20 citation statements)

References 40 publications

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“…The significant relationship between distal gender minority stressors (i.e., identity invalidation, family rejection, and threat of harm) and psychological distress generally aligns with existing transgender research (Cramer et al, 2022; Testa et al, 2015; Timmins et al, 2017), affirming an understanding of deleterious trans mental health outcomes as inextricable from transphobic systems and experiences of oppression. Moreover, identity invalidation was the most impactful stressor (i.e., highest standardized β value), and the only stressor that remained significantly associated with psychological distress across most models.…”

Section: Discussionsupporting

confidence: 56%

Minority stressors and their associations with severe psychological distress among gender-diverse people.

Pease¹,

Williams²,

Iwamoto³

et al. 2022

American Journal of Orthopsychiatry

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People whose gender does not align with assigned sex often experience negative mental health outcomes related to cisnormative societal expectations and oppression, including familial rejection, threat of harm, and identity invalidation (e.g., misgendering). This study merged two crosssectional data sets of trans and gender-diverse people (N = 363; M age = 22.02) investigating how various types of distal minority stress experiences impact psychological distress. We tested the associations between three minority stressors (i.e., family rejection, threat of harm, and identity invalidation) and psychological distress using unadjusted and adjusted regression models, including gender-stratified models. In the overall unadjusted model, all three stressors were significantly, positively associated with psychological distress, with identity invalidation having the highest standardized β value. In the adjusted overall model, only identity invalidation was significantly associated with distress. Results varied in gender-stratified models. Additionally, participants who experienced any of the three stressors had predicted mean distress scores at or above the cutoff for severe psychological distress, while those who did not fell below that cutoff. Results highlight the differential impact of minority stress experiences on genderdiverse young adults and provide directions for clinical competency, interventions, and future research toward understanding mental health disparities for trans people. Public Policy Relevance StatementInvalidating the identity of gender-diverse (e.g., transgender, genderqueer, nonbinary) people is strongly associated with clinically notable levels of psychological distress. This study highlights the need for policies that increase inclusion and decrease invalidation of gender-diverse people in systems and society, as well as efforts that educate the public on trans issues to decrease interpersonal forms of harm and invalidation, which have strong potential to negatively impact mental health. aaa G ender-diverse people experience substantial deleterious mental health outcomes in the United States (U.S.), including anxiety, depression, general psychological distress, and suicidality (

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Section: Discussionsupporting

confidence: 56%

Minority stressors and their associations with severe psychological distress among gender-diverse people.

Pease¹,

Williams²,

Iwamoto³

et al. 2022

American Journal of Orthopsychiatry

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“…For example, in their longitudinal study of veterans of the U.S. military, Brown and Jones found that transgender veterans had a higher rate of “catastrophic disability” compared cisgender veterans (8% vs. 2.9%), and were two times as likely to have a service-connected disability (OR 2.08) [ 75 ]. Among studies that use the 2015 United States Transgender Health Survey ( n = 27,715 transgender, non-binary, and gender non-conforming participants) the rate of disability among transgender people is either 41.1% [ 47 ] or 28.47% [ 48 ], depending on how disability is operationalized. Downing and Przedworski compared transgender people to cisgender people on a variety of health-related outcomes using several years of the Behavioral Risk Factor Surveillance System, and found higher rates of disabilities among male-to-female people, female-to-male people, and gender non-conforming people compared to cisgender men and cisgender women [ 76 ].…”

Section: Discussionmentioning

confidence: 99%

“…When focusing on transgender populations, we find disability to be associated with stigma, discrimination, and psychosocial distress among transgender, non-binary, and gender non-conforming people. Disability is a risk factor for suicidal thoughts and behaviors among transgender and gender diverse adults [ 47 ]. In Australia, Leonard and Mann conducted an analysis of literature, policy, and survey data on the lived experiences of lesbian, gay, bisexual, transgender, and intersex (LGBTI) people with disability.…”

Section: Introductionmentioning

confidence: 99%

Gender Identity, Disability, and Unmet Healthcare Needs among Disabled People Living in the Community in the United States

Mulcahy

Streed

Wallisch

et al. 2022

IJERPH

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Disabled adults and transgender people in the United States face multiple compounding and marginalizing forces that result in unmet healthcare needs. Yet, gender identity among disabled people has not been explored, especially beyond binary categories of gender. Using cross-sectional survey data, we explored the rates of disability types and the odds of unmet healthcare needs among transgender people with disabilities compared to cisgender people with disabilities. The rates of disability type were similar between transgender and cisgender participants with two significant differences. Fewer transgender participants identified physical or mobility disability as their main disability compared to cisgender participants (12.31%/8 vs. 27.68/581, p < 0.01), and more transgender participants selected developmental disability as their main disability compared to cisgender participants (13.85%/9 vs. 3.67%/77, p < 0.001). After adjusting for sociodemographic characteristics, the odds of disabled transgender participants reporting an unmet need were higher for every unmet need except for preventative services.

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“…Prior research has examined differences in sociodemographic characteristics among transfeminine (TF), transmasculine (TM), and nonbinary(NB) people related to health care access, health care utilization, and health care discrimination (Kachen & Pharr, 2020). Cramer et al (2021) examined suicidal ideation and suicidal attempts among TGD people and how family support can serve as a protective factor for lifetime suicide attempts. Becerra et al (2021) examined how different sociodemographic characteristics are associated with suicidal thoughts, suicide attempts, and serious psychological distress among Asian American TGD people.…”

Section: Np21168mentioning

confidence: 99%

Transgender and Gender Diverse (TGD) Asian Americans in the United States: Experiences of Violence, Discrimination, and Family Support

Lerner

Lee

2021

J Interpers Violence

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Transgender and gender diverse (TGD) Asian Americans in the U.S. have multiple stigmatized identities, yet their experiences of violence and discrimination are not well understood. We utilized the 2015 United States Trans Survey, the largest survey to date with U.S. TGD people, to study the experiences of TGD Asian Americans. Our study included 699 TGD Asian Americans who experienced violence and discrimination in the form of unequal treatment, verbal harassment, and physical attack. We assessed how experiences differed by sociodemographic characteristics, including birthplace, income, age, education, disability, gender identity, and region. We also explored how family support was associated with experiences of violence in the sample. Bivariate analyses and multivariable regressions were used to understand how sociodemographic variables and family support are linked to experiences of violence and discrimination. Results indicated that income, age, disability, gender identity, and family support are significantly associated with violence and discrimination. As TGD Asian Americans currently experience high levels of violence and discrimination due to transphobia and a rapidly rising anti-Asian bias stemming from the COVID-19 pandemic, efforts to better understand factors that may increase vulnerability and identify how family support can mitigate those experiences are imperative.

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An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults

Cited by 24 publications

References 40 publications

Minority stressors and their associations with severe psychological distress among gender-diverse people.

Minority stressors and their associations with severe psychological distress among gender-diverse people.

Gender Identity, Disability, and Unmet Healthcare Needs among Disabled People Living in the Community in the United States

Transgender and Gender Diverse (TGD) Asian Americans in the United States: Experiences of Violence, Discrimination, and Family Support

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