An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults
An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults
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DOI：
10.1007/s00127-021-02115-8
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发表时间：
2021-06-09
影响因子：
4.4
通讯作者：
Tucker, Raymond P.
中科院分区：
文献类型：
--
作者：
Cramer, Robert J.;Kaniuka, Andrea R.;Tucker, Raymond P.
目的 对于跨性别者和性别多样化 (TGD) 人士来说，自杀想法和行为 (STB) 仍然是一个紧迫的公共卫生问题。本研究的目标是应用社会生态和少数群体压力框架来确定个人和人际层面 TGD 特定的 STB 风险和保护因素。方法 这是对 2015 年美国跨性别健康调查的二次分析，该调查是对全国 TGD 成年人样本 (N = 27,658) 的全面横断面健康评估。卡方和方差分析 (ANOVA) 用于确定 12 个月和终生自杀意念 (SI) 和自杀企图 (SA) 的双变量相关性。采用逻辑回归来确定各个级别中最强的 STB 风险和保护因素。结果性少数群体认同、种族少数群体认同和残疾是终生STB危险因素。 TGD 身份、性少数群体身份、种族少数群体身份（仅限南澳）、较低教育程度、较低收入、军事经验、残疾和没有保险是 12 个月的 STB 风险因素。心理困扰是最重要的STB危险因素。工作场所歧视、家庭拒绝、医疗保健歧视和基于童年偏见的受害是终生性传播疾病的危险因素。所有形式的歧视和受害（因 SI 引起的家庭排斥除外）都是 12 个月的 STB 风险因素。家庭和同事的支持是终生 SA（但不是 SI）和所有 12 个月 STB 的保护因素。较少关注 TGD 身份是 STB 的一个保护因素（12 个月 SI 除外）。结论 研究结果支持社会生态和少数群体应激性 STB 风险框架。为预防 TGD 自杀的综合方法提供了建议。
Purpose Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and protective factors. Methods This is a secondary analysis of the 2015 United States Transgender Health Survey, a comprehensive cross-sectional health assessment of a national sample of TGD adults (N = 27,658). Chi-square and Analysis of Variance (ANOVA) were used to identify bivariate correlates of 12-month and lifetime suicidal ideation (SI) and suicide attempt (SA). Logistic regression was employed to identify the strongest STB risk and protective factors across levels. Results Sexual minority identification, racial minority identification, and having a disability were lifetime STB risk factors. TGD identity, sexual minority identification, racial minority identification (SA only), lower education, lower income, military experience, having a disability, and being uninsured were 12-month STB risk factors. Psychological distress was the most robust STB risk factor. Workplace discrimination, family rejection, healthcare discrimination, and childhood bias-based victimization were lifetime STB risk factors. All forms of discrimination and victimization (with the exception of family rejection for SI) were 12-month STB risk factors. Family and coworker support were protective factors for lifetime SA (but not SI) and all 12-month STBs. Being less out about TGD identity was a protective factor for STBs (except for 12-month SI). Conclusion Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention.