Garthe Rachel C, Blackburn Allyson M, Kaur Amandeep, Sarol Jesus N, Goffnett Jacob, Rieger Agnes, Reinhart Crystal, Smith Doug C
School of Social Work, University of Illinois at Urbana-Champaign (UIUC), Urbana, Illinois, USA.
Department of Psychology, University of Illinois at Urbana-Champaign (UIUC), Urbana, Illinois, USA.
Transgend Health. 2022 Oct 7;7(5):416-422. doi: 10.1089/trgh.2021.0055. eCollection 2022 Oct.
Suicide is a leading public health concern among transgender and gender expansive adolescents, although little research has examined mechanisms through which gender identity is associated with suicidal ideation. This study examined the indirect effects of peer victimization, dating violence, substance use (SU), SU problems, and depressive symptoms in the relationship between gender identity and suicidal ideation.
Secondary data analysis was conducted from a 2018 statewide survey, including 4464 adolescents who identified as male, female, transgender, or gender expansive (=1116 per gender). The sample was frequency matched on grade, race, geographic region, and free/reduced lunch status. Mediation analyses were performed.
Reports of suicidal ideation were highest among transgender (49.29%) and gender expansive (41.31%) adolescents compared with male (10.82%) and female adolescents (19.08%). Using the Karlson, Holm, and Breen approach, 50.45% of the effect of being transgender on suicidal ideation was mediated through peer victimization, dating violence, and depressive symptoms, and 39.29% through SU, SU problems, and depressive symptoms. The mediation through the same pathways for being gender expansive was 46.37% and 39.89%, respectively. Across both models, depressive symptoms predominately accounted for the mediating effect.
Transgender and gender expansive youth are at alarming risk for suicidal ideation, which illustrates the critical need for suicide prevention within this population. Programs that promote mental health and work to prevent bullying, dating violence, SU, and SU problems are crucial; although longitudinal research is needed, targeting these mechanisms may play a critical role in reducing suicidal ideation and risk.
自杀是跨性别和性别认同扩展青少年中一个主要的公共卫生问题，尽管很少有研究探讨性别认同与自杀意念相关的机制。本研究考察了同伴受害、约会暴力、物质使用（SU）、SU问题和抑郁症状在性别认同与自杀意念关系中的间接影响。
对2018年全州范围的一项调查进行二次数据分析，包括4464名自我认同为男性、女性、跨性别或性别认同扩展的青少年（每个性别=1116名）。样本在年级、种族、地理区域和免费/减价午餐状况方面进行了频率匹配。进行了中介分析。
与男性青少年（10.82%）和女性青少年（19.08%）相比，跨性别青少年（49.29%）和性别认同扩展青少年（41.31%）的自杀意念报告率最高。采用卡尔森、霍尔姆和布林方法，跨性别对自杀意念影响的50.45%通过同伴受害、约会暴力和抑郁症状介导，39.29%通过SU、SU问题和抑郁症状介导。性别认同扩展通过相同途径的中介作用分别为46.37%和39.89%。在两个模型中，抑郁症状在中介效应中占主导地位。
跨性别和性别认同扩展的青少年有令人担忧的自杀意念风险，这表明在这一人群中预防自杀至关重要。促进心理健康以及努力预防欺凌、约会暴力、SU和SU问题的项目至关重要；尽管需要纵向研究，但针对这些机制可能在降低自杀意念和风险方面发挥关键作用。
