The buffering role of social support on the associations among discrimination, mental health, and suicidality in a transgender sample

Abstract

INTRODUCTION Per the minority stress framework, trans individuals often experience psychological distress given the unique stress engendered by gender identity-related discrimination. Prior research has identified social support as particularly important for psychological distress and has suggested that social support may moderate this relationship. AIMS: The purpose of the current study was to explore the patterns of connections among discrimination, mental health, and suicidal ideation in trans individuals, and whether social support moderates these relationships. METHODS Participants (N = 78) completed measures of these constructs as part of a national online survey. RESULTS A series of simultaneous multiple regressions found that harassment/rejection discrimination was a unique positive predictor of mental health symptoms and suicidal ideation, with depression positively predicting suicidal ideation. A mediational model indicated that the association between harassment/rejection discrimination and suicidal ideation was fully mediated by depression. Three moderated meditational models were run, and one yielded a significant interaction, such that discrimination predicted suicidal ideation most strongly when participants had low social support from a significant other in comparison to moderate or high support. Further, conditional direct effects identified that discrimination led to ideation only for individuals with low support from friends or a significant other but not for those with moderate or high support. CONCLUSIONS Helping trans individuals cope with harassment and rejection, particularly by drawing on social support, may promote better mental health, which could help reduce suicidality in this population.

Minority stress and mental health among LGBT populations: an update on the evidence

“…was also chosen by staples et al 37 to assess distal trans stress, specifically considers discrimination in accessing health care services. in agreement with previous data, a crosssectional study by trujillo et al 38 involving 78 transgender participants reported a correlation between harassment and mental health problems like depression and eventually suicidal ideation.…”

“…Full-text papers were then screened for their relevance. For each paper finally included in the review, the following information was extracted ( Figure 1, table ii, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] iii, [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] iV ): first author, journal and year of publication, sample size, features of the population included, study design, clinical outcomes, and authors' conclusions.…”

“…-Characteristics of papers focusing on minority stress and suicidality included in the review [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]. Narrative analysis 35% of the overall sample had attempted suicide at least once and 25% had attempted suicide more than once…”

Non-binary and binary transgender youth: Comparison of mental health, self-harm, suicidality, substance use and victimization experiences

“…Future research should identify a universal method of identifying nonbinary gender identity with increased sensitivity and specificity, to enable comparisons across research studies to be made. Furthermore, the survey did not address "transitioning" status or types (Trujillo et al, 2017). For example, it is unknown what percentage of the sample were receiving cross-sex hormone therapy and research shows that hormone therapy can be associated with a reduction of mental health problems (Costa & Colizzi, 2016).…”

Exploring the Needs, Expectations, and Realities of Mental Healthcare for Transgender Adults: A Grounded Theory Study on Experiences in Sweden

“…There is currently a relatively rich body of literature exploring the mental health among transgender populations. 3 , 5–9 Reisner et al 9 asserted in the Lancet series on transgender global health that data “consistently showed that transgender adults are burdened by mental health concerns.” In the United States, a recent survey showed that transgender persons reported high rates of psychological distress issues such as “depression, anxiety, and suicidality at 39% compared with 5% for the general U.S. population; 40% had attempted suicide at some time in their life compared with 4.6% in the general population.” 4 Similarly, a study from 2015 in Australia indicated that 46% of transgender persons reported high to very high levels of psychological distress over the course of the previous year. 7 Researchers in Mexico attributed an underlying force for the high rates of mental health issues in this population that arose from a response to “discrimination, stigma, lack of acceptance, and abuse” experienced on a regular basis and not from inherent biological factors.…”