Gender Development and Suicidality among Transgender and Gender Non-Conforming Youth and Young Adults

In the largest, most geographically representative sample of transgender adults to date, 41% of participants reported a history of suicide attempt (Grant et al., 2011). However, the extent to which empirically supported theories of suicidality apply to transgender and gender nonconforming (TGNC) populations has not yet been examined. The present study collected information on the suicide-related thoughts and experiences of TGNC youth and young adults (age 14 to 30; N=1,965) using an affirming, interpersonally focused, and developmentally informed approach. Within the sample, measures of Gender-Related Support and Gender-Related Self-Concept relevant to the youth and young adult TGNC population were first developed and validated. General social support from family and friends, Gender-Related Support, victimization (sexual orientation related, gender related), and Gender-Related Self-Concept were each associated with unique variance in both measures of suicidality. Consistent with the Interpersonal theory of suicide, a small but significant interaction was also found between Gender-Related Support and gender-related victimization in the prediction of past year suicide severity but not past year suicide ideation frequency. Consistent with the Escape from Self theory of suicidality, depression and self concept positivity functioned as mediators of the relationship between interpersonal factors and suicidality. Further, when accounting for all interpersonal influences, desire for gender affirming medical care was also associated with higher levels of both suicidality outcomes. However, these relationships were no longer significant once access to gender affirming medical care was considered. Taken together, results support the perspective that both general and minority specific interpersonal and intrapersonal stress processes influence the mental health of the TGNC population and assist in identifying critical prevention and intervention targets.