1 Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington.
2 Department of Health Services, University of Washington, Seattle, Washington.
LGBT Health. 2019 Feb/Mar;6(2):43-50. doi: 10.1089/lgbt.2018.0239. Epub 2019 Feb 4.
The aim was to examine social support and community connection as moderators of the relationship between discrimination and suicidal ideation (SI) in transgender veterans.
A national convenience sample of 298 transgender veterans completed an online cross-sectional survey from February to May 2014. Hierarchical regressions using nonparametric bootstrapping assessed associations among gender-related discrimination within the past year, two aspects of social support (social support, social connection) from four sources (family, friends, transgender/LGBT friends, and veterans), and SI in the past 2 weeks.
Discrimination was positively associated with SI. Social support from transgender friends and social connection with LGBT and veteran communities moderated the relationship between discrimination and SI. At high and average levels of social support and connection, discrimination was associated with greater SI, whereas at low levels of these variables, SI was consistently elevated and unrelated to discrimination.
Given that SI was consistently elevated when discrimination was high, these findings emphasize the need for additional research on how to mitigate the detrimental effects of discrimination, with consideration given to interventions targeting discrimination or responses to discrimination. In addition, given that high and average transgender social support and LGBT social connection were associated with reduced SI when discrimination was low, research would benefit from continued exploration of the potential protective elements of social support from a shared stigmatized community.
本研究旨在探讨社会支持和社区联系是否可以调节 transgender 退伍军人中歧视与自杀意念（suicidal ideation，SI）之间的关系。
2014 年 2 月至 5 月，采用全国便利样本，对 298 名 transgender 退伍军人进行了在线横断面调查。使用非参数自举法的分层回归评估了过去一年中与性别相关的歧视、来自四个来源（家庭、朋友、跨性别/LGBT 朋友和退伍军人）的两种社会支持（社会支持、社会联系）以及过去两周的 SI 之间的关联。
歧视与 SI 呈正相关。来自跨性别朋友的社会支持和与 LGBT 社区及退伍军人社区的社会联系调节了歧视与 SI 之间的关系。在社会支持和联系水平较高和中等的情况下，歧视与更高的 SI 相关，而在这些变量水平较低的情况下，SI 持续升高且与歧视无关。
鉴于当歧视程度较高时 SI 始终升高，这些发现强调需要进一步研究如何减轻歧视的不利影响，同时考虑针对歧视的干预措施或对歧视的反应。此外，鉴于当歧视程度较低时，较高和中等水平的跨性别社会支持和 LGBT 社会联系与较低的 SI 相关，因此，需要继续探索来自共享污名化社区的社会支持的潜在保护因素，以进一步开展研究。
