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Intervenable factors associated with suicide risk in transgender persons: a respondent driven sampling study in Ontario, Canada
Journal article   Open access   Peer reviewed

Intervenable factors associated with suicide risk in transgender persons: a respondent driven sampling study in Ontario, Canada

Greta R Bauer, Ayden I Scheim, Jake Pyne, Robb Travers and Rebecca Hammond
BMC public health, v 15(1), pp 525-525
02 Jun 2015
DOI: https://doi.org/10.1186/s12889-015-1867-2
PMID: 26032733
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-015-1867-2View
Published, Version of Record (VoR) Open
url
https://doi.org/10.1186/s12889-015-1867-2View
Published, Version of Record (VoR) Open

Abstract

Adult Female Gender Identity Humans Logistic Models Male Ontario - epidemiology Parents Prejudice - psychology Prevalence Sampling Studies Self Report Social Isolation - psychology Social Support Suicidal Ideation Suicide - psychology Suicide - statistics & numerical data Suicide, Attempted - psychology Suicide, Attempted - statistics & numerical data Transgender Persons - psychology Transgender Persons - statistics & numerical data Transsexualism - psychology United States ESI Highly Cited Paper (Incites)
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 (10(th) versus 90(th) 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 10(th) 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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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#5 Gender Equality
#3 Good Health and Well-Being

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Highly Cited Paper 
Collaboration types
Domestic collaboration
Web of Science research areas
Public, Environmental & Occupational Health
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