Suicidality Among Transgender Youth: Elucidating the Role of Interpersonal Risk Factors

Austin, Ashley; Craig, Shelley L.; D'Souza, Sandra; McInroy, Lauren B.

doi:10.1177/0886260520915554

Cited by 106 publications

(87 citation statements)

References 57 publications

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“…Findings point to a range of factors that can influence transphobic violence, as well as its intensity and consequences due to sociocultural factors [37,[51][52][53][54][55][56][57][58][59]. This subsection is divided into two given the pertinence of these factors: internal factors, such as felt gender identity, sexuality, and self-perception, and external factors, such as circumstances and judgments.…”

Section: Risk Factorsmentioning

confidence: 99%

“…After suffering transphobic violence, certain sociocultural factors can impact how violence is internalized by victims, which is a common reaction to violence by TNBAY [53,59]. Enacted stigma has shown a higher risk of suffering eating disorders and engaging in unhealthy eating behaviors; supportive environments, caring friends, and family protection could act in such situations as protective factors [59].…”

Section: Felt Identity Sexuality and Self-perceptionmentioning

confidence: 99%

“…Enacted stigma has shown a higher risk of suffering eating disorders and engaging in unhealthy eating behaviors; supportive environments, caring friends, and family protection could act in such situations as protective factors [59]. Moreover, internalization is strongly related to and statistically significant for suicidality in the past 6 months, which demonstrates the great suffering to which TNBAY are exposed and the few tools that they can display to overcome the violence [53]. What can be truly transformative in this complex situation is the power of reporting and being heard by school personnel and relatives when transphobic violence takes place.…”

Section: Felt Identity Sexuality and Self-perceptionmentioning

confidence: 99%

“…Some of the research articles showed other factors regarding the educational centers and a familiar context as important markers of this kind of violence [53,54,58,59]. Emotional neglect and unsupportive family and caregivers have a significant weight, as they can add more distress to victims to such an extent that it can contribute to higher odds of lifetime suicidal attempts [53]. Emotional neglect, school belonging, and internalized self-stigma have a unique connection to a high level of distress to such a degree that it can contribute to suicidality in the past 6 months [53].…”

Section: External Circumstances and Judgmentsmentioning

confidence: 99%

“…Emotional neglect and unsupportive family and caregivers have a significant weight, as they can add more distress to victims to such an extent that it can contribute to higher odds of lifetime suicidal attempts [53]. Emotional neglect, school belonging, and internalized self-stigma have a unique connection to a high level of distress to such a degree that it can contribute to suicidality in the past 6 months [53]. Additionally, social support given to victims is statistically significant for the prevention of or contribution to unhealthy weight and eating behaviors as a form of leading with distress [59].…”

Section: External Circumstances and Judgmentsmentioning

confidence: 99%

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Transphobic Violence in Educational Centers: Risk Factors and Consequences in the Victims’ Wellbeing and Health

et al. 2021

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School violence and bullying re worrying problems due to their growing prevalence and severe consequences for adolescent and youth health and wellbeing. Sociocultural factors can contribute to, complicate, and increase the cases of violence in classrooms and spaces related to educational centers. Transphobic violence in this article is defined as the type of violence suffered by transgender and nonbinary adolescents and youth as a manifestation of the problem of discrimination and hate against gender and sexual diversity. This work intends to study the complex sociocultural dynamics of violence detected in educational contexts affecting transgender and nonbinary adolescents and youth identified by recent high- impact studies. At the same time, we aim to fill the gap in the scientific literature on transphobic violence and articulate successful strategies to prevent and combat it. In this review, transphobic violence is defined as the violence affecting transgender adolescents and youth, continuous in time, influenced by peers, and taking place in spaces or realities related to educational centers. The reviewed studies point at the complexity of this kind of violence due to the combination of socio-personal factors and its variety in manifestations. Furthermore, we study the consequences of transphobic violence for the wellbeing and health of transgender and nonbinary adolescents and youth to deepen the knowledge of their mental health repercussions. We end by providing suggestions for how this problem can be prevented in educational environments, grounded on scientific evidence in the materialization of a transformative approach.

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Section: Risk Factorsmentioning

confidence: 99%

Section: Felt Identity Sexuality and Self-perceptionmentioning

confidence: 99%

Section: Felt Identity Sexuality and Self-perceptionmentioning

confidence: 99%

Section: External Circumstances and Judgmentsmentioning

confidence: 99%

Section: External Circumstances and Judgmentsmentioning

confidence: 99%

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Transphobic Violence in Educational Centers: Risk Factors and Consequences in the Victims’ Wellbeing and Health

et al. 2021

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Early Access to Testosterone Therapy in Transgender and Gender-Diverse Adults Seeking Masculinization

Nolan,

Zwickl,

Locke

et al. 2023

JAMA Netw Open

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ImportanceTestosterone treatment is a necessary component of care for some transgender and gender-diverse individuals. Observational studies have reported associations between commencement of gender-affirming hormone therapy and improvements in gender dysphoria and depression, but there is a lack of data from randomized clinical trials.ObjectiveTo assess the effect of testosterone therapy compared with no treatment on gender dysphoria, depression, and suicidality in transgender and gender-diverse adults seeking masculinization.Design, Setting, and ParticipantsA 3-month open-label randomized clinical trial was conducted at endocrinology outpatient clinics and primary care clinics specializing in transgender and gender-diverse health in Melbourne, Australia, from November 1, 2021, to July 22, 2022. Participants included transgender and gender-diverse adults aged 18 to 70 years seeking initiation of testosterone therapy.InterventionsImmediate initiation of testosterone commencement (intervention group) or no treatment (standard care waiting list of 3 months before commencement). This design ensured no individuals would be waiting longer than the time to standard care.Main Outcomes and MeasuresThe primary outcome was gender dysphoria, as measured by the Gender Preoccupation and Stability Questionnaire. Secondary outcomes included the Patient Health Questionnaire-9 (PHQ-9) to assess depression and the Suicidal Ideation Attributes Scale (SIDAS) to assess suicidality. Questionnaires were undertaken at 0 and 3 months. The evaluable cohort was analyzed.ResultsSixty-four transgender and gender-diverse adults (median [IQR] age, 22.5 [20-27] years) were randomized. Compared with standard care, the intervention group had a decrease in gender dysphoria (mean difference, −7.2 points; 95% CI, −8.3 to −6.1 points; P &lt; .001), a clinically significant decrease in depression (ie, change in score of 5 points on PHQ-9; mean difference, −5.6 points; 95% CI, −6.8 to −4.4 points; P &lt; .001), and a significant decrease in suicidality (mean difference in SIDAS score, −6.5 points; 95% CI, −8.2 to −4.8 points; P &lt; .001). Resolution of suicidality assessed by PHQ-9 item 9 occurred in 11 individuals (52%) with immediate testosterone commencement compared with 1 (5%) receiving standard care (P = .002). Seven individuals reported injection site pain/discomfort and 1 individual reported a transient headache 24 hours following intramuscular administration of testosterone undecanoate. No individual developed polycythemia.Conclusions and RelevanceIn this open-label randomized clinical trial of testosterone therapy in transgender and gender-diverse adults, immediate testosterone compared with no treatment significantly reduced gender dysphoria, depression, and suicidality in transgender and gender-diverse individuals desiring testosterone therapy.Trial RegistrationANZCTR Identifier: ACTRN1262100016864

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Gender‐affirming healthcare: Where are the risks?

Walters¹

2023

Child Adolescent Behavior

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Every major medical organization involved in providing health care to youth, including the American Medical Association, the American Academy of Pediatrics, and the American Psychiatric Association, supports gender‐affirming care for youth. However, states advancing bans on gender‐affirming care also promote the view that this approach is medically unproven, potentially dangerous, and in some views, a form of child abuse.

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Suicidality Among Transgender Youth: Elucidating the Role of Interpersonal Risk Factors

Cited by 106 publications

References 57 publications

Transphobic Violence in Educational Centers: Risk Factors and Consequences in the Victims’ Wellbeing and Health

Transphobic Violence in Educational Centers: Risk Factors and Consequences in the Victims’ Wellbeing and Health

Early Access to Testosterone Therapy in Transgender and Gender-Diverse Adults Seeking Masculinization

Gender‐affirming healthcare: Where are the risks?

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