Current and Military‐Specific Gender Minority Stress Factors and Their Relationship with Suicide Ideation in Transgender Veterans

Abstract

Research suggests the prevalence of suicide ideation and suicide attempts in the transgender veteran community may be upwards of 20 times higher than nontransgender veterans, who are known to be at increased risk than the general US population. This study aimed to understand the potential influence of external and internal minority stress experienced during and after military service on past-year and recent suicide ideation in a sample of 201 transgender veterans. Nonparametric bootstrapping analyses indicated past-year transgender-specific discrimination and rejection (external minority stress) indirectly predicted frequency of both past-year and past 2-week suicide ideation through past-year shame related to gender identity (internal minority stress). This result was significant when controlling for symptoms of depression and demographics. Similar patterns emerged when examining relationships among military external and internal minority stress on suicide outcomes. These results suggest that attempts to reduce both the experience and impact of minority stressors related to gender identity during and after military service may be an important avenue for suicide prevention.

Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals

“…Finally, a fourth study applying the PMF to 201 transgender veterans explored the influence of distal and proximal minority stressors experienced during and after military service on suicide ideation [ 33 ]. Authors found that distal stressors (i.e., past-year anti-transgender discrimination and rejection) indirectly predicted suicide ideation through feelings of shame related to gender identity (i.e., proximal stressor).…”

“…Summarizing, actual scientific literature reports evidence that both group-specific processes [ 5 , 31 , 33 ] and general psychological processes [ 32 ] mediate the relationship between external stressors and negative mental health outcomes, and that group-level coping mechanisms [ 5 ] buffer the effect of stressors on mental health. Notwithstanding that, no previous studies took into account the internal differentiation of internalized transphobia while analyzing its vertical and horizontal nature.…”

Gender Dysphoria in United States Veterans and Military Personnel: Historical Context and Current Policies

“…It is estimated that there are >150,000 transgender active duty service members, Veterans, and reservists (Ahuja et al, 2019). Although the future of transgender military policy remains to be seen, it is critical to understand that individuals who identify as transgender will continue to serve in the military, but some may conceal their gender identity during their time in the service due to fear of discrimination (Tucker et al, 2019). Nonetheless, transgender individuals will seek care at the VHA following their time in the military and should be supported in achieving optimum health outcomes.…”

“…Sociocultural factors, including social support (or lack thereof) and access to gender affi rmation care appear to infl uence trajectories among Veterans with gender dysphoria, with high levels of experienced discrimination associated with increases in suicidal ideation in this population (Carter et al, 2019;Tucker et al, 2019). Discrimination can be defi ned as "unfair treatment by outgroup members [i.e.…”

"We've been here all along" : the standpoint and collective resilience of transgender U.S. service members.

“…Furthermore, almost all participants recruited for this study indicated a binary gender identity. This is particularly salient as military policy requires service members (those who are allowed to continue serving) to comply with either male or female regulations and standards (DoD, 2016; (Tucker et al, 2018) and recommended efforts to reduce transgender veterans' exposure to minority stressors during and after service as a prevention strategy. Recent studies have also identified social support and connection as an important strategy for increasing resilience among transgender veterans (Carter et al, 2019).…”