Intervenable factors associated with suicide risk in transgender persons: a respondent driven sampling study in Ontario, Canada.
Intervenable factors associated with suicide risk in transgender persons: a respondent driven sampling study in Ontario, Canada.
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DOI：
10.1186/s12889-015-1867-2
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发表时间：
2015-06-02
影响因子：
4.5
通讯作者：
Hammond R
中科院分区：
文献类型：
--
作者：
Bauer GR;Scheim AI;Pyne J;Travers R;Hammond R
在欧洲、加拿大和美国，22- 43%的跨性别者报告有自杀企图史。我们的目标是确定与降低过去一年自杀想法或企图风险相关的可干预因素（与社会包容、变性恐惧症或性别/性别转变相关），并量化潜在的人群健康影响。Trans PULSE响应驱动抽样（RDS）调查收集了加拿大安大略16岁以上跨性别者的数据，其中包括380名报告自杀结果的人。描述性统计和多变量logistic回归模型采用RDS II方法进行加权。使用模型标准化风险估计了反事实风险比和人群归因风险。在跨安大略省，35.1%（95%CI：27.6，42.5）严重考虑，11.2%（95%CI：6.0，16.4）企图，自杀在过去的一年。社会支持，减少变性恐惧症，并将任何个人身份证件更改为适当的性别指定与自杀风险的相对和绝对大幅降低相关，通过激素和/或手术（必要时）完成医疗过渡也是如此。父母对性别认同的支持与意念减少有关。较低的自我报告的跨性别恐惧症（第10百分位数与第90百分位数）与66%的意念减少相关（RR = 0.34，95% CI：0.17，0.67），并且在有意念的患者中，尝试次数额外减少76%（RR = 0.24; 95% CI：0.07，0.82）。这相当于每1,000名跨性别者中有160个想法，每1,000名跨性别者中有200个想法，这是基于跨性别恐惧症从目前水平减少到第10百分位数的假设。对可干预因素的这种对照分析观察到了较大的效应量，这表明增加社会包容性和获得医疗过渡的干预措施，以及减少跨性别恐惧症，有可能有助于大幅减少跨性别人群中自杀意念和企图的极高患病率。在人口一级采取这种干预措施可能需要改变政策。
Across Europe, Canada, and the United States, 22–43 % of transgender (trans) people report a history of suicide attempts. We aimed to identify intervenable factors (related to social inclusion, transphobia, or sex/gender transition) associated with reduced risk of past-year suicide ideation or attempt, and to quantify the potential population health impact. The Trans PULSE respondent-driven sampling (RDS) survey collected data from trans people age 16+ in Ontario, Canada, including 380 who reported on suicide outcomes. Descriptive statistics and multivariable logistic regression models were weighted using RDS II methods. Counterfactual risk ratios and population attributable risks were estimated using model-standardized risks. Among trans Ontarians, 35.1 % (95 % CI: 27.6, 42.5) seriously considered, and 11.2 % (95 % CI: 6.0, 16.4) attempted, suicide in the past year. Social support, reduced transphobia, and having any personal identification documents changed to an appropriate sex designation were associated with large relative and absolute reductions in suicide risk, as was completing a medical transition through hormones and/or surgeries (when needed). Parental support for gender identity was associated with reduced ideation. Lower self-reported transphobia (10th versus 90th percentile) was associated with a 66 % reduction in ideation (RR = 0.34, 95 % CI: 0.17, 0.67), and an additional 76 % reduction in attempts among those with ideation (RR = 0.24; 95 % CI: 0.07, 0.82). This corresponds to potential prevention of 160 ideations per 1000 trans persons, and 200 attempts per 1,000 with ideation, based on a hypothetical reduction of transphobia from current levels to the 10th percentile. Large effect sizes were observed for this controlled analysis of intervenable factors, suggesting that interventions to increase social inclusion and access to medical transition, and to reduce transphobia, have the potential to contribute to substantial reductions in the extremely high prevalences of suicide ideation and attempts within trans populations. Such interventions at the population level may require policy change.
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影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
影响因子：
4.9
作者：
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影响因子：
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作者：
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作者：
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Sinclair, KO