Prevalence and Correlates of Suicidal Ideation Among Transgender Youth in California: Findings From a Representative, Population-Based Sample of High School Students
Prevalence and Correlates of Suicidal Ideation Among Transgender Youth in California: Findings From a Representative, Population-Based Sample of High School Students
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DOI：
10.1016/j.jaac.2017.06.010
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发表时间：
2017-09-01
影响因子：
13.3
通讯作者：
Hatzenbuehler, Mark L.
中科院分区：
文献类型：
--
作者：
Perez-Brumer, Amaya;Day, Jack K.;Hatzenbuehler, Mark L.
目的：目前还没有针对美国青少年的代表性基于人口的研究来研究自杀念头中与性别认同相关的差异或导致这种差异的因素。为了解决这一问题，本研究检查了自杀意念流行率中与性别认同相关的差异;评估了既定的心理社会因素是否可以解释这些差异;并确定了所有青年中自杀意念的相关性，并按性别认同分层。方法：数据来自2013年至2015年加州健康儿童调查（CHKS; N = 621，189）和代表加州学生群体的加权子样本（两年一次的加州全州学生调查[CSS]，N = 28，856）。结果：跨性别青年过去12个月自我报告的自杀意念的患病率几乎是非跨性别青年的两倍（33.73%对18.85%;卡方（2）= 35.48，p < .001）。在代表性样本的完全调整模型中，与非变性青年相比，变性青年报告去年自杀意念的几率高2.99（95%CI 2.25-3.98）。在跨性别青少年中，只有抑郁症状（调整后的比值比5.44，95% CI 1.81-16.38）和受害（调整后的比值比2.66，95% CI 1.26-5.65）与完全调整模型中自杀意念的高几率显著相关。在多重中介分析中，抑郁使性别认同与自杀意念的关联减弱了17.95%，使受害感的关联减弱了14.71%。这项研究使用了美国第一个具有代表性的基于人口的青年样本，其中包括对性别认同的测量，以报告性别认同-相关的差异自杀意念，并确定潜在的机制，这种差异在一个有代表性的样本。
Objective: No representative population-based studies of youth in the United States exist on gender identity-related disparities in suicidal ideation or on factors that underlie this disparity. To address this, this study examined gender identity-related disparities in the prevalence of suicidal ideation; evaluated whether established psychosocial factors explained these disparities; and identified correlates of suicidal ideation among all youth and stratified by gender identity.Method: Data were derived from the 2013 to 2015 California Healthy Kids Survey (CHKS; N = 621,189) and a weighted subsample representative of the Californian student population (Biennial Statewide California Student Survey [CSS], N = 28,856).Results: Prevalence of past 12-month self-reported suicidal ideation was nearly twice as high for transgender compared with non-transgender youth (33.73% versus 18.85%; chi(2) = 35.48, p < .001). In fully adjusted models within the representative sample, transgender youth had 2.99 higher odds (95% CI 2.25-3.98) of reporting past-year suicidal ideation compared with non-transgender youth. Among transgender youth, only depressive symptoms (adjusted odds ratio 5.44, 95% CI 1.81-16.38) and victimization (adjusted odds ratio 2.66, 95% CI 1.26-5.65) remained significantly associated with higher odds of suicidal ideation in fully adjusted models. In multiple mediation analyses, depression attenuated the association between gender identity and suicidal ideation by 17.95% and victimization by 14.71%.Conclusion: This study uses the first representative population-based sample of youth in the United States that includes a measurement of gender identity to report on gender identity-related disparities in suicidal ideation and to identify potential mechanisms underlying this disparity in a representative sample.