United Nations Development Programme, Bangkok, Thailand.
British Columbia Centre On Substance Use, St. Paul's Hospital, Vancouver, BC, Canada.
Soc Psychiatry Psychiatr Epidemiol. 2022 Oct;57(10):1987-1997. doi: 10.1007/s00127-022-02292-0. Epub 2022 May 23.
Thailand has one of the highest suicide rates in Southeast Asia; yet, little is known about suicidality among lesbian, gay, bisexual, trans, queer, intersex, and other gender and sexually diverse (LGBTQI +) people living in the region, who may experience elevated risk for suicide. We sought to identify the prevalence of lifetime suicidal attempts and ideation among a nationally recruited sample of LGBTQI + people in Thailand. We further examined the relationship between levels of sexual/gender stigma and suicidal attempt and ideation.
Data were derived from a national online survey of Thai LGBTQI + individuals between January and March 2018. Multivariable logistic regression was used to examine the relationship between sexual/gender stigma scales, adapting a previously validated instrument, and suicide attempt and ideation.
Among 1,290 LGBTQI + participants, the median age was 27 years. The prevalence of suicide attempt and ideation was 16.8% and 50.7%, respectively. In multivariable analyses, after adjusting for potential confounders, experiences of perceived and enacted sexual/gender stigma were independently and positively associated with suicide attempt (adjusted odds ratio [AOR] = 1.25; 95% confidence interval CI:1.10-1.41 and AOR = 1.31; 95% CI:1.11-1.55, respectively) and ideation (AOR = 1.30; 95% CI:1.17-1.43 and AOR = 1.34; 95% CI:1.14-1.58, respectively).
One-sixth of the sample reported a suicide attempt, while a half reported ever contemplating suicide. Both experiences of perceived and enacted sexual/gender stigma were associated with lifetime suicide attempt and ideation. Multi-level interventions are needed to decrease stigma and in turn suicide among LGBTQ + people in Thailand, including anti-discrimination policies and support for mental health and well-being.
泰国是东南亚自杀率最高的国家之一；然而，对于生活在该地区的女同性恋、男同性恋、双性恋、跨性别者、酷儿、间性人和其他性别与性多样化（LGBTQI+）人群的自杀情况知之甚少，他们可能面临更高的自杀风险。我们试图确定在泰国全国招募的 LGBTQI+人群中，一生中尝试自杀和有自杀念头的比例。我们进一步研究了性/性别污名与自杀企图和念头之间的关系。
数据来自于 2018 年 1 月至 3 月期间针对泰国 LGBTQI+个体的一项全国性在线调查。多变量逻辑回归用于研究性/性别污名量表与自杀企图和念头之间的关系，该量表改编自一个经过验证的工具。
在 1290 名 LGBTQI+参与者中，中位数年龄为 27 岁。自杀企图和念头的发生率分别为 16.8%和 50.7%。在多变量分析中，调整潜在混杂因素后，感知到的和经历到的性/性别污名与自杀企图（调整后的优势比[OR]为 1.25；95%置信区间[CI]为 1.10-1.41 和 OR 为 1.31；95%CI 为 1.11-1.55）和念头（OR 为 1.30；95%CI 为 1.17-1.43 和 OR 为 1.34；95%CI 为 1.14-1.58）独立且呈正相关。
六分之一的样本报告有自杀企图，而一半的样本报告曾有过自杀念头。感知到的和经历到的性/性别污名都与一生中的自杀企图和念头有关。需要采取多层次的干预措施来减少泰国 LGBTQ+人群中的污名和自杀现象，包括反歧视政策以及对心理健康和福祉的支持。
