Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China; Public Health Research Institute of Jiangsu Province, Nanjing 210009, China.
Department of Public Health Sciences, College of Health and Human Services, University of North Carolina Charlotte, Charlotte 28262, USA.
J Affect Disord. 2020 Dec 1;277:869-874. doi: 10.1016/j.jad.2020.09.002. Epub 2020 Sep 7.
To measure prevalence and risk factors of poor mental health, suicidal ideation, and suicide attempt among transgender women in Jiangsu province, China.
We surveyed 250 transgender women with mean age of 27.9 years from July 2018 to May 2019 in Jiangsu province, China. Logistic regression analysis characterized risk factors for mental health, suicidal ideation, and suicide attempt.
Many transgender women experienced discrimination, including verbal abuse (56.0%), physical abuse (32.0%), and sexual violence (32.0%) during their lifetime. Classification by the Kessler Psychological Distress Scale found 32.4%% to be in good mental health, while 24.0%, 16.8%, and 26.8% had mild, moderate, and severe psychological distress respectively. In multivariable logistic regression, severe psychological distress was correlated with bisexual orientation (vs. gay/lesbian, aOR = 2.9, 95%CI = 1.5-5.8), being unsure of sexual orientation (vs. gay/lesbian, aOR = 4.7, 95%CI = 1.8-12.8), experience of verbal abuse (aOR = 1.8, 95%CI = 1.1-3.1), and less severe with alcohol use (aOR = 0.6, 95%CI = 0.3-0.9) (P< 0.05). Many transgender women also reported suicidal ideation (22.0%) and prior suicide attempt (25.6%). Compared to no suicidal ideation, moderate (aOR = 4.9, 95%CI = 1.6-15.2) or severe psychological distress (aOR = 38.6) were associated with prior suicide attempt (P< 0.05). Residing in Jiangsu province (vs. not residing in Jiangsu, aOR = 0.3, 95%CI = 0.1-0.6) and higher income (vs. lower income, aOR = 0.6, 95%CI = 0.4-0.9) were protective factors for suicide attempt (P< 0.05).
Chinese transgender women experience high levels of discrimination, abuse, poor mental health, suicidal ideation, and suicide attempts in Jiangsu province. Society-wide interventions need to be developed to mitigate transphobic discrimination among transgender women in China.
在中国江苏省测量跨性别女性的心理健康不良、自杀意念和自杀企图的流行率和风险因素。
我们于 2018 年 7 月至 2019 年 5 月调查了 250 名平均年龄为 27.9 岁的跨性别女性。Logistic 回归分析描述了心理健康、自杀意念和自杀企图的风险因素。
许多跨性别女性在其一生中经历过歧视，包括言语虐待（56.0%）、身体虐待（32.0%）和性暴力（32.0%）。按照 Kessler 心理困扰量表分类，32.4%的人心理健康状况良好，而 24.0%、16.8%和 26.8%的人分别有轻度、中度和重度心理困扰。在多变量逻辑回归中，严重心理困扰与双性恋取向（与同性恋/双性恋相比，aOR=2.9，95%CI=1.5-5.8）、性取向不确定（与同性恋/双性恋相比，aOR=4.7，95%CI=1.8-12.8）、言语虐待经历（aOR=1.8，95%CI=1.1-3.1）和酒精使用较少严重（aOR=0.6，95%CI=0.3-0.9）（P<0.05）相关。许多跨性别女性也报告了自杀意念（22.0%）和既往自杀企图（25.6%）。与没有自杀意念相比，中度（aOR=4.9，95%CI=1.6-15.2）或重度心理困扰（aOR=38.6）与既往自杀企图相关（P<0.05）。与不在江苏省居住（aOR=0.3，95%CI=0.1-0.6）和收入较低（aOR=0.6，95%CI=0.4-0.9）相比，居住在江苏省（aOR=0.3，95%CI=0.1-0.6）和收入较高是自杀企图的保护因素（P<0.05）。
中国江苏省的跨性别女性经历了高水平的歧视、虐待、心理健康不良、自杀意念和自杀企图。需要制定全社会干预措施，以减轻中国跨性别女性的跨性别歧视。
