1 GENder Education and Care Interdisciplinary Support (GENECIS) Program, Department of Endocrinology, Children's Health Texas , Dallas, Texas.
2 Department of Psychiatry, University of Texas Southwestern , Dallas, Texas.
LGBT Health. 2018 Oct;5(7):391-400. doi: 10.1089/lgbt.2017.0259. Epub 2018 Oct 2.
Rates of suicide ideation and attempt appear to be particularly high in the transgender and gender nonconforming (TGNC) population, yet little is known about which factors are the most salient contributors for TGNC young people and how these contributors vary across suicide-related outcomes.
Within the largest sample of TGNC young people to date (N = 1896; ages 14-30), we examined the contribution of demographics (age, assigned sex, gender identity, sexual orientation identity, race/ethnicity, and socioeconomic status), minority stress (gender-related affirmation, gender-related self-concept, victimization, and gender-affirming medical treatment desire/access), social support (from family and friends), and depressive symptoms in the cross-sectional prediction of three suicide-related outcomes: past-year attempt, past-year ideation, and a composite measure of suicide risk.
Each set of factors explained significant variance in each outcome; however, only several predictors remained significant in each of the full models. Gender-related victimization and depressive symptoms were independent predictors for all three outcomes. Additional predictors varied across outcome. Age, male identity, sexual orientation-based victimization, and friend support were associated with suicide attempt. Age, queer identity, gender-related self-concept negativity, and family support were associated with suicide ideation, and pansexual identity and gender-related self-concept negativity were associated with positive suicide risk screen.
Prevention and intervention efforts aimed at building support and positive self-concept, decreasing victimization, and treating depression are likely to partially reduce suicide ideation and attempt in TGNC adolescents and young adults. Comprehensive interventions with younger adolescents are particularly critical.
自杀意念和自杀企图的发生率在跨性别和性别不一致（TGNC）人群中似乎特别高，但对于哪些因素是 TGNC 年轻人最突出的贡献因素以及这些贡献因素如何因自杀相关结果而异，我们知之甚少。
在迄今为止最大的 TGNC 年轻人样本中（N=1896；年龄 14-30 岁），我们研究了人口统计学因素（年龄、分配性别、性别认同、性取向认同、种族/族裔和社会经济地位）、少数群体压力（与性别相关的肯定、与性别相关的自我概念、受害和性别肯定治疗的愿望/获得）、社会支持（来自家庭和朋友）以及抑郁症状在预测三个与自杀相关的结果中的交叉作用：过去一年的尝试、过去一年的想法以及自杀风险的综合衡量标准。
每一组因素都在每个结果中解释了显著的差异；然而，只有几个预测因素在每个完整模型中仍然具有统计学意义。与性别相关的受害和抑郁症状是所有三个结果的独立预测因素。在每个结果中，不同的预测因素也存在差异。年龄、男性认同、基于性取向的受害以及朋友支持与自杀企图有关。年龄、酷儿认同、与性别相关的自我概念的消极性以及家庭支持与自杀意念有关，而泛性认同和与性别相关的自我概念的消极性与积极的自杀风险筛查有关。
旨在建立支持和积极的自我概念、减少受害和治疗抑郁的预防和干预措施可能会部分减少 TGNC 青少年和年轻人的自杀意念和企图。针对年轻青少年的综合干预措施尤为关键。
