性少数和跨性别青少年的自杀倾向：加拿大全国代表性青少年人群研究。
Suicidality among sexual minority and transgender adolescents: a nationally representative population-based study of youth in Canada.
机构信息
School of Epidemiology and Public Health (Kingsbury, Hammond, Colman), University of Ottawa, Ottawa, Ont.; Wisdom2Action (Johnstone), Halifax, NS; Centre for Fertility and Health (Colman), Norwegian Institute of Public Health, Oslo, Norway.
School of Epidemiology and Public Health (Kingsbury, Hammond, Colman), University of Ottawa, Ottawa, Ont.; Wisdom2Action (Johnstone), Halifax, NS; Centre for Fertility and Health (Colman), Norwegian Institute of Public Health, Oslo, Norway
出版信息
CMAJ. 2022 Jun 6;194(22):E767-E774. doi: 10.1503/cmaj.212054.
BACKGROUND
Very little research has described risk of suicidal ideation and suicide attempt among transgender youth using high-quality, nationally representative data. We aimed to assess risk of suicidality among transgender and sexual minority adolescents in Canada.
METHODS
We analyzed a subsample of adolescents aged 15-17 years from the 2019 Canadian Health Survey on Children and Youth, a nationally representative, cross-sectional survey. We defined participants' transgender identity (self-reported gender different from sex assigned at birth) and sexual minority status (self-reported attraction to people of the same gender) as exposures, and their self-reported previous-year suicidal ideation and lifetime suicide attempt as outcomes.
RESULTS
We included 6800 adolescents aged 15-17 years, including 1130 (16.5%) who indicated some degree of same-gender attraction, 265 (4.3%) who were unsure of their attraction and 50 (0.6%) who reported a transgender identity. Compared with cisgender, heterosexual adolescents, transgender adolescents showed 5 times the risk of suicidal ideation (95% confidence interval [CI] 3.63 to 6.75; 58% v. 10%) and 7.6 times the risk of suicide attempt (95% CI 4.76 to 12.10; 40% v. 5%). Among cisgender adolescents, girls attracted to girls had 3.6 times the risk of previous-year suicidal ideation (95% CI 2.59 to 5.08) and 3.3 times the risk of having ever attempted suicide (95% CI 1.81 to 6.06), compared with their heterosexual peers. Adolescents attracted to multiple genders had 2.5 times the risk of suicidal ideation (95% CI 2.12 to 2.98) and 2.8 times the risk of suicide attempt (95% CI 2.18 to 3.68). Youth questioning their sexual orientation had twice the risk of having attempted suicide in their lifetime (95% CI 1.23 to 3.36).
INTERPRETATION
We observed that transgender and sexual minority adolescents were at increased risk of suicidal ideation and attempt compared with their cisgender and heterosexual peers. These findings highlight the need for inclusive prevention approaches to address suicidality among Canada's diverse youth population.
背景
使用高质量、全国代表性数据描述跨性别青年出现自杀意念和自杀企图的风险的研究很少。我们旨在评估加拿大跨性别和性少数青少年的自杀风险。
方法
我们分析了 2019 年加拿大儿童和青少年健康调查的一个 15-17 岁青少年亚组，这是一项全国代表性的横断面调查。我们将参与者的跨性别身份（自我报告的性别与出生时分配的性别不同）和性少数群体地位（自我报告的对同性别的吸引力）定义为暴露因素，并将其自我报告的前一年自杀意念和终生自杀企图作为结果。
结果
我们纳入了 6800 名 15-17 岁的青少年，其中 1130 名（16.5%）表示有一定程度的同性吸引，265 名（4.3%）不确定自己的吸引力，50 名（0.6%）报告自己是跨性别者。与顺性别、异性恋青少年相比，跨性别青少年出现自杀意念的风险高 5 倍（95%置信区间 [CI] 3.63 至 6.75；58% v. 10%），自杀企图的风险高 7.6 倍（95% CI 4.76 至 12.10；40% v. 5%）。在顺性别青少年中，与异性恋同龄人相比，女孩对女孩的吸引力使前一年出现自杀意念的风险增加了 3.6 倍（95% CI 2.59 至 5.08），自杀企图的风险增加了 3.3 倍（95% CI 1.81 至 6.06）。对多种性别的吸引力使自杀意念的风险增加了 2.5 倍（95% CI 2.12 至 2.98），自杀企图的风险增加了 2.8 倍（95% CI 2.18 至 3.68）。对自己的性取向有疑问的青少年一生中自杀的风险增加了一倍（95% CI 1.23 至 3.36）。
解释
我们发现，与顺性别和异性恋同龄人相比，跨性别和性少数青少年出现自杀意念和企图的风险更高。这些发现突出表明，需要采取包容性的预防措施来解决加拿大多样化青年群体的自杀问题。
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