与澳大利亚跨性别成年人自杀未遂相关的因素。
Factors associated with suicide attempts among Australian transgender adults.
机构信息
Trans Health Research Group, Department of Medicine (Austin Health), The University of Melbourne, Melbourne, Victoria, 3084, Australia.
College of Medicine and Public Health, Flinders University, Adelaide, South Australia, 5042, Australia.
出版信息
BMC Psychiatry. 2021 Feb 8;21(1):81. doi: 10.1186/s12888-021-03084-7.
BACKGROUND
Transgender, including gender diverse and non-binary people, henceforth referred to collectively as trans people, are a highly marginalised population with alarming rates of suicidal ideation, attempted suicide and self-harm. We aimed to understand the risk and protective factors of a lifetime history of attempted suicide in a community sample of Australian trans adults to guide better mental health support and suicide prevention strategies.
METHODS
Using a non-probability snowball sampling approach, a total of 928 trans adults completed a cross-sectional online survey between September 2017 and January 2018. The survey assessed demographic data, mental health morbidity, a lifetime history of intentional self-harm and attempted suicide, experiences of discrimination, experiences of assault, access to gender affirming healthcare and access to trans peer support groups. Logistic regression was used to examine the risk or protective effect of participant characteristics on the odds of suicide.
RESULTS
Of 928 participants, 85% self-reported a lifetime diagnosis of depression, 63% reported previous self-harm, and 43% had attempted suicide. Higher odds of reporting a lifetime history of suicide attempts were found in people who were; unemployed (adjusted odds ratio (aOR) 1.55 (1.05, 2.29), p = 0.03), had a diagnosis of depression (aOR 3.70 (2.51, 5.45), p < 0.001), desired gender affirming surgery in the future (aOR 1.73 (1.14, 2.61), p = 0.01), had experienced physical assault (aOR 2.01 (1.37, 2.95), p < 0.001) or experienced institutional discrimination related to their trans status (aOR 1.59 (1.14, 2.23), p = 0.007).
CONCLUSION
Suicidality is associated with barriers to gender affirming care, gender based victimisation and institutionalised cissexism. Interventions to increase social inclusion, reduce transphobia and enable timely access to gender affirming care, particularly surgical interventions, are potential areas of intervention.
背景
跨性别者，包括性别多样化和非二元性别者，此后统称跨性别者，是一个高度边缘化的群体，其自杀意念、自杀企图和自残的发生率令人震惊。我们旨在了解澳大利亚跨性别成年人社区样本中自杀未遂的终身风险和保护因素，以更好地提供心理健康支持和预防自杀策略。
方法
使用非概率雪球抽样方法，共有 928 名跨性别成年人在 2017 年 9 月至 2018 年 1 月期间完成了一项横断面在线调查。该调查评估了人口统计学数据、心理健康发病率、一生中的故意自我伤害和自杀企图的经历、歧视经历、攻击经历、获得性别肯定的医疗保健和获得跨性别同伴支持小组的情况。使用逻辑回归来检查参与者特征对自杀几率的风险或保护效应。
结果
在 928 名参与者中，85%自我报告有一生中的抑郁症诊断，63%报告有以前的自我伤害，43%有自杀企图。在以下人群中，报告自杀未遂的终身史的几率更高：失业者（调整后的优势比（aOR）为 1.55（1.05，2.29），p=0.03）、患有抑郁症（aOR 为 3.70（2.51，5.45），p<0.001）、未来希望进行性别肯定手术（aOR 为 1.73（1.14，2.61），p=0.01）、经历过身体攻击（aOR 为 2.01（1.37，2.95），p<0.001）或经历过与跨性别身份相关的机构歧视（aOR 为 1.59（1.14，2.23），p=0.007）。
结论
自杀意念与获得性别肯定护理的障碍、基于性别的受害和制度化的顺性别主义有关。增加社会包容性、减少跨性别恐惧症以及使人们能够及时获得性别肯定护理，特别是手术干预，是潜在的干预领域。
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