Testing Predictors of Change in Suicidal Ideation Among Transgender and Non-Binary People

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Drobotenko, Natasha
Suicide , Transgender , Non-binary , Suicide ideation , Childhood abuse , Childhood maltreatment , Non-suicidal self-injury , Suicidal thoughts and behaviours , STBs , NSSI , Gender Minority Stress , Gender Minority Stress and Resilence , Self-injurious thoughts and behaviours
Suicide is a pressing public health concern and is among the top 10 leading causes of death. Although rates of suicidal thoughts and behaviours (STBs) are substantially elevated among transgender and non-binary (TGNB) people, risk factors for STBs are rarely tested in this group. Longitudinal research is thus needed to identify characteristics that specifically predict the escalation of STBs among TGNB people and ultimately, inform culturally competent care to curb preventable suffering and death in this high-risk community. The aim of the current study was to examine several contextual variables that contribute to suicide ideation in this population including childhood maltreatment, non-suicidal self-injury (NSSI), and gender minority stress (GMS), in a hypothesized mediation model. It was hypothesized that more severe childhood maltreatment would predict more frequent future suicide ideation, and that this effect would be mediated by increased rates of NSSI and more severe GMS. The current study included 182 gender-diverse individuals who completed an online survey at two timepoints spaced four months apart. At baseline, participants completed online questionnaires to assess gender identity (Alderson Sexuality Questionnaire, adapted; ASQ), childhood maltreatment (Childhood Trauma Questionnaire; CTQ), GMS (Gender Minority Stress and Resilience Questionnaire; GMSRQ), depression symptoms (Patient-Reported Outcomes Measurement Information System Depression scale; PROMIS-D), and a gold standard assessment of self-injurious thoughts and behaviours (Suicidal Thoughts and Behaviour Interview – Self-Report; SITBI-SR). Participants were readministered all measures at follow-up except for the CTQ. Contrary to my hypotheses, there was no direct or indirect effect of childhood maltreatment on ideation. However, there were several concurrent associations amongst all model variables consistent with previous literature using both cis- and trans-gender samples. Notably, more severe maltreatment was related to greater gender minority stress, specifically, external experiences of victimization. Additionally, there was a strong concurrent association between internalized stressors and ideation. Thus, putative risk factors for suicide ideation identified in prior studies using cisgender samples may not generalize to TGNB people under the same function. Community-specific context and correlates should be investigated further and cognitive-affective variables from leading suicide theories should be integrated to help clarify how gender diverse specific experiences may contribute to suicide risk.
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