Immediate Release
September 10, 2019
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Rachel Dowd
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New analysis of data from the 2015 U.S. Transgender Survey found that over half (51.2%) of respondents who had experienced four instances of anti-transgender discrimination and violence in the past year reported attempting suicide in that year. Nearly all (97.7%) had seriously thought about suicide.
Respondents who had experienced losing a job, eviction, homelessness, and physical attack in the past year were ten times more likely to have reported suicide attempts in that year compared to those who experienced none of these.
“Experiences of discrimination and serious psychological distress go hand-in-hand, and both are associated with suicide thoughts and attempts among transgender people,” said lead author Jody L. Herman, scholar of public policy at the Williams Institute. “Public policies that aim to reduce discrimination against transgender people are suicide prevention efforts.”
Previous research has found that transgender people have many of the same risk factors for suicidality as the U.S. general population, such as depression, substance abuse, poor health, and homelessness. However, the current study finds that transgender people also face additional risk factors, such as discrimination, family rejection, and lack of access to gender-affirming health care.
Key Findings
Respondents who experienced discrimination were more likely to report suicide thoughts and attempts. Transgender people who had been denied equal treatment because they are transgender were twice as likely to report past-year suicide attempts as those who had not experienced such treatment (13.4% compared to 6.3%).
Respondents who experienced family rejection were also more likely to report attempting suicide. Respondents who were rejected by their family of origin were twice as likely to report past-year suicide attempts compared to those who had not experienced such rejection (10.5% compared to 5.1%).
Being a victim of violence was related to an elevated prevalence of suicide thoughts and attempts. Over 30% of those who were physically attacked in a place of public accommodation reported attempting suicide in the past year, compared to 7% of respondents who were not similarly attacked.
Access to gender-affirming medical care is associated with lower prevalence of suicide thoughts and attempts. Respondents who wanted and subsequently received gender-affirming surgical care were less likely to report suicide attempts in the past year compared to those who wanted it but had not received it (5.1% vs 8.5%).
“Our analysis suggests that, along with improving access to quality gender-affirming health services, suicide prevention efforts must target the social structures and institutions that stigmatize transgender people and lead to the pervasive discrimination and violence they report,” said study author Ann P. Haas, Professor Emerita in the Department of Health Sciences, Lehman College of the City University of New York.
The 2015 U.S. Transgender Survey (USTS), conducted by the National Center for Transgender Equality, surveyed 28,000 transgender adults and is currently the largest survey of transgender people in the U.S.
excerpt
GENERAL RISK FACTORS
Transgender people have many of the same risk factors for suicidality as found in the U.S. general population, such as depression, substance use, and housing instability. Similar to these trends in the U.S. general population, we found an elevated prevalence of suicide thoughts and attempts among USTS respondents who
Experienced serious psychological distress and reported heavy alcohol or illicit drug use (excluding marijuana);
Reported poor general health compared to those who reported excellent health (19.9% versus 3.6% past year suicide attempts);
Reported having a disability, experienced homelessness in the past year, or had ever been arrested for any reason.
UNIQUE RISK FACTORS
In addition to general risk factors, transgender people have additional risk factors, such as experiences of discrimination, stigma, family rejection, and lack of access to gender-affirming health care. Findings regarding these unique factors include the following:
Experiencing discrimination or mistreatment in education, employment, housing, health care, in places of public accommodations, or from law enforcement is associated with higher prevalence of suicide thoughts and attempts. For example, the prevalence of past-year suicide attempts by those who reported that they had been denied equal treatment in the past year because they are transgender was more than double that of those who had not experienced such treatment (13.4% compared to 6.3%).
Those who reported that their spouses, partners, or children rejected them because they are transgender reported higher prevalence of lifetime and past-year suicide attempts. Those who reported rejection by their family of origin, for example, reported twice the prevalence of past-year suicide attempts compared to those who had not experienced such rejection (10.5% compared to 5.1%).
Respondents who had been rejected by their religious communities or had undergone conversion therapy were more likely to report suicide thoughts and attempts. For instance, 13.1 percent of those who had experienced religious rejection in the past year had attempted suicide in the past year; by contrast, 6.3 percent of respondents who had experienced religious acceptance in the past year attempted suicide in the past year.
Experiences of violence, including intimate partner violence (IPV) are associated with higher prevalence of suicide thoughts and attempts. Over 30 percent of those who were physically attacked in a place of public accommodation reported attempting suicide in the past year, which is over four times the prevalence among respondents who were not similarly attacked.
Those who had “de-transitioned” at some point, meaning having gone back to living according to their sex assigned at birth, were significantly more likely to report suicide thoughts and attempts, both past-year and lifetime, than those who had never “de-transitioned.” Nearly 12 percent of those who “de-transitioned” attempted suicide in the past year compared to 6.7 percent of those who have not “de-transitioned.”
People who are not viewed by others as transgender and those who do not disclose to others that they are transgender reported lower prevalence of suicide thoughts and attempts. For instance, 6.3 percent of those who reported that others can never tell they are transgender attempted suicide in the past year compared to 12.2 percent of those who reported that others can always tell they are transgender.
The cumulative effect of minority stress is associated with higher prevalence of suicidality. For instance, 97.7 percent of those who had experienced four discriminatory or violence experiences in the past year (being fired or forced to resign from a job, eviction, experiencing homelessness, and physical attack) reported seriously thinking about suicide in the past year and 51.2 percent made a suicide attempt in the past year.