Minority Stress Across Proximal Contexts and Suicide in Transgender Young Adults: A Critical Scoping Review.

Suicide disproportionately affects transgender and gender-diverse (TGD) young adults. Experiences of minority stress are associated with poor mental health and suicide outcomes. However, this research in TGD communities is still emerging and little attention has been given to the uniquely sensitive stage of young adulthood. Furthermore, to adequately address health inequities, careful consideration of the environments in which people are situated is needed. Minority stress research often lacks account of socioenvironmental contexts. Even among the broader lesbian, gay, bisexual, transgender, and queer (LGBTQ) population, evidence is inconsistent in the measurement of minority stress experiences, the socioenvironmental contexts in which they occur, and suicide outcomes. A scoping, critical literature review was conducted to synthesize the existing evidence on minority stress experiences across proximal environmental contexts and suicide outcomes in TGD young adults. PubMed, PsycINFO, and CINAHL were searched for articles within the past 5 years that examined contextual minority stress and suicide in TGD groups; articles were included if the sample included individuals of young adult age (defined as 18-30 years old) from the United States. Iterative searches using context keywords "family," "school," "religious/spiritual community," and "work" enabled identification of 21 publications. Findings are discussed through an integrated minority stress and socioecological framework. Through identifying weaknesses and inconsistencies in the literature, innovative recommendations are provided for future research directions. Results highlight the need for investigation of multiple socioenvironmental contexts through which minority stress experiences occur and suicide in TGD young adults to better inform upstream intervention strategies.