Imputation methods for missing failure times in recurrent-event survival analysis: Application to suicide attempts in the transgender population

Suicide risk among transgender populations is an important public health issue. In a project evaluating association between gender affirmation and suicide attempts in the US Transgender Survey, we evaluated the relationship between gender affirmation and risk for suicide attempts. One of the challenges is that the age at suicide attempts was only collected for the […]

Suicidal ideation disparities among transgender and gender diverse compared to cisgender community health patients

Background Transgender and gender diverse (TGD) individuals experience more severe psychological distress and may be at higher risk for suicide compared to cisgender individuals. The existing literature largely consists of small-sample studies that do not assess subgroup differences. Objective To examine rates of self-reported suicidal ideation among four TGD groups compared to cisgender individuals. Design […]

Understanding past experiences of suicidal ideation and behavior in the life narratives of transgender older adults

Transgender people (collectively referred to here as trans) experience disproportionate rates of suicidal ideation and behavior (plans and attempts) attributed to complex constellations of structural and individual factors. Interpretive methods in suicide research elucidate and contextualize intricate patterns of risk factors and strategies for recovery. The life narratives of trans older adults offer unique insights […]

Proximal correlates of suicidal ideation among transgender and gender diverse people: A preliminary test of the three-step theory

Introduction Transgender and gender diverse (TGD) people experience higher rates of suicidal ideation than their cisgender peers; however, very little is known about factors that proximally relate to suicidal ideation in this population. This limited understanding may be due to the lack of theory-guided studies that are capable of testing proximal correlates of suicidal ideation […]

Self-injury in young bisexual people: A microlongitudinal investigation (SIBL) of thwarted belongingness and self-esteem on non-suicidal self-injury

Background Bisexual people are at an elevated risk for non-suicidal self-injury (NSSI). Psychological factors including self-esteem and thwarted belongingness may help explain this risk. The aim of the current study was to investigate associations between self-esteem, thwarted belongingness and NSSI urges and behavior in young bisexual people. Methods Participants aged 16–25 from 25 countries took […]

Experiences of hospitalization for suicide ideation and suicide attempt in gender diverse adults

Introduction This study sought to investigate general perceptions of suicide-related hospital-based care that Transgender/Gender Diverse (TGD) adults have experienced as well as correlates of their perceived usefulness of this care. Methods Data were collected via a cross-sectional online survey of N = 3718 self-identified TGD individuals. Single-item self-report measures of all constructs of interest were used. Results A […]

Transgender-based disparities in suicidality: A population-based study of key predictions from four theoretical models

Introduction Numerous studies have reported a high prevalence of suicidality among transgender individuals. Yet few studies have reported results from population-based samples, leaving open questions about the generalizability of existing findings. Factors proposed to explain transgender individuals’ elevated risk of suicidality derive from several theoretical models (i.e., clinical model, interpersonal model, minority stress model, and […]

Factors that drive mental health disparities and promote well- being in transgender and nonbinary people

Transgender (or trans) is an umbrella term for individuals who experience their gender differently from what is associated with the sex they were assigned at birth. Individuals who are nonbinary experience their gender outside binary conceptions of gender. Although research has predominantly focused on negative mental health outcomes for transgender and non-binary (TNB) individuals, an […]

Syndemic relationship of depressive symptoms, substance use, and suicidality in transgender youth: A cross‑sectional study using the U.S. youth risk behavior surveillance system

Purpose Syndemics are co-occurring epidemics that cluster within populations due to shared socio-structural factors and are often in populations with intersecting forms of vulnerability. Suicide, depression, and substance use all disproportionately affect transgender and gender diverse (TGD) youth. In this study, we test a syndemic model of the relationship between these three mental health conditions […]

Dialectical behaviour therapy (DBT) for high-risk transgender and gender diverse (TGD) youth: A qualitative study of youth and mental health providers’ perspectives on intervention relevance

Objectives Despite the significant mental health challenges and unique treatment needs of transgender and gender diverse (TGD) youth, research on the acceptability of evidence-based treatments for these youth is limited. To address this gap, the current study explored the perceived relevance of dialectical behaviour therapy (DBT) for high-risk TGD youth. Methods Qualitative data were collected […]

Being safe, being me 2019: Results of the Canadian trans and non-binary youth health survey

In 2014, Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC) conducted a bilingual survey to learn about the health of transgender youth in Canada. It was the first and largest of its kind in Canada, with 923 young people responding. From this report, recommendations—such as developing safe, more inclusive schools and providing support for families […]

Past-year suicidal ideation among transgender individuals in the United States

This study assessed potential correlates to past-year suicide ideation among a national sample of transgender adults in the United States. A secondary analysis of the 2015 Transgender Survey was conducted. The 2015 Transgender Survey is the first and largest survey assessing health behaviors among transgender individuals living in the United States. Participants were recruited by […]

Associations between minority stress, depression, and suicidal ideation and attempts in transgender and gender diverse (TGD) individuals: Systematic review and meta-analysis

Minority stress theory posits that transgender and gender diverse (TGD) individuals exhibit greater rates of depression and suicidality due to internal (proximal) and external (distal) stressors related to their TGD identity. Yet, the magnitude of the relationship between minority stress processes and mental health outcomes has not been quantitatively summarized. The current research meta-analyzed the relationship between […]

Heterogeneity in gender dysphoria in a Brazilian sample awaiting gender-affirming surgery: A data-driven analysis

Background Population heterogeneity and the lack of clinical and sociodemographic information in transgender individuals with gender dysphoria (GD) remains a challenge for specialized services in mental health and surgical procedures. It aimed to identify and describe profiles in a sample waiting for gender-affirming surgery. Methods A sample of 100 outpatients with GD was assessed through […]

Predictors of self-harm and suicide in LGBT youth: The role of gender, socio-economic status, bullying and school experience

Background Lesbian, gay and bisexual (LGB) young people’s increased risk of self-harm, suicidal attempts and suicide compared with heterosexual youth is well established. The current study sought to examine whether these findings also apply to the trans (T) population and which factors act as additional risk or protective factors. Methods In a national cross-sectional survey, […]

Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care

Objective  To investigate changes in mental health over the first year of receiving gender-affirming care and whether initiation of puberty blockers (PBs) and gender-affirming hormones (GAHs) was associated with changes in depression, anxiety, and suicidality. Design, Setting, and Participants  This prospective observational cohort study was conducted at an urban multidisciplinary gender clinic among TNB adolescents and young […]

Examining the mental health presentations of treatment‑seeking transgender and gender nonconforming (TGNC) youth

Recent research suggests that transgender and/or gender nonconforming (TGNC) youth present with heightened levels of mental health problems compared to peers. This study seeks to examine the mental health needs of a large sample of treatment-seeking TGNC youth by comparing them to cisgender males and females. Participants were 94,804 children and youth ages 4–18 years […]

Associations between minority stress, depression, and suicidal ideation and attempts in transgender and gender diverse (TGD) individuals: Systematic review and meta-analysis

Minority stress theory posits that transgender and gender diverse (TGD) individuals exhibit greater rates of depression and suicidality due to internal (proximal) and external (distal) stressors related to their TGD identity. Yet, the magnitude of the relationship between minority stress processes and mental health outcomes has not been quantitatively summarized. The current research meta-analyzed the […]

Association of gender-affirming hormone therapy with depression, thoughts of suicide, and attempted suicide among transgender and nonbinary youth

Purpose: There are no large-scale studies examining mental health among transgender and nonbinary youth who receive gender-affirming hormone therapy (GAHT). The purpose of this study is to examine associations among access to GAHT with depression, thoughts of suicide, and attempted suicide among a large sample of transgender and nonbinary youth. Methods: Data were collected as […]

An analysis of suicidal thoughts and behaviors among transgender and gender diverse adults

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-specifc STB risk and protective factors. Methods This is a secondary analysis of the 2015 United States Transgender […]

Responsible journalism, imitative suicide, and transgender populations: A systematic review of UK newspapers

Purpose: The risk of suicide is high in the transgender population. Imitative suicide occurs when excess suicidal behavior is observed following news media coverage of suicide. The purpose of this study is to evaluate how often UK newspapers adhere to suicide reporting guidelines designed to minimize imitative suicide when they report the suicides of transgender […]

Gender-diverse: A spotlight on the health of trans and non-binary young people in BC. Results of the 2018 BC Adolescent Health Survey

This report provides a profile of the health of gender-diverse youth in British Columbia (BC). The report uses data from the 2018 BC Adolescent Health Survey (BC AHS). The BC AHS is the most reliable, comprehensive health survey of adolescents ages 12–19 in public schools in BC. Repeated every five years since 1992, the survey […]

Peer support as a protective factor against suicide in trans populations: A scoping review

Rationale There is a growing body of research involving transgender (trans) individuals that foregrounds elevated rates of suicidality in trans populations. Although peer support is increasingly studied as a protective factor against suicide among trans persons, the scholarship in this area continues to be limited and has yet to be synthesized and appraised. Objective In this paper, […]