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BACKGROUND: This study aims to understand suicidal ideation and suicide attempts among transgender individuals through an in-depth analysis of a nation-wide population general survey in China. METHODS: Transgender Men (TM) and Women (TW) were investigated through a cross-sectional survey. A structured questionnaire was used to investigate participants' demographic information, perceived sexuality conflicts, childhood adversity and mental health conditions. Logistic regression models were utilized to investigate risk factors associated with suicidal ideation and suicide attempts in these groups. We also conducted a quasi-meta-analysis in order to compare the prevalence of suicidal ideation and attempted suicide between general and transgender populations in China. RESULTS: A total of 1309 participants across 32 provinces and municipalities in China took part in this survey, out of 2060 valid questionnaires. In this transgender population, the lifetime prevalence of suicidal ideation and an attempt at suicide were 56.4% and 16.1%, respectively. This estimated prevalence rate is far greater than in Chinese community samples. For all transgender people, disliking birth-assigned sex, seeking sex reassignment surgery, having intense conflicts with parents, lifetime history of suffering from major depressive disorder, a recent episode of depression, self-harm, and seeking mental health services were significantly associated with increased risk of suicidal ideation. An education level of high school or equivalent, being married and/or separated/divorced, having intense conflicts with parents, or self-harm and seeking mental health services were all significantly associated with increased risk of suicide attempt. Although most risk factors for TM and TW were equivalent across groups, differences were observed in both suicidal ideation and suicide attempt models. LIMITATIONS: The cross-sectional study design and lack of follow-up data are limitations of this study. CONCLUSIONS: This is the first study to examine suicide within a Chinese transgender population. The clinical implications of these findings for Chinese mental health professionals are discussed. Also, the evidence from this study can be used to inform the practices of suicide prevention workers, and policy makers working with the transgender population.

Original publication

DOI

10.1016/j.jad.2018.12.011

Type

Journal article

Journal

J Affect Disord

Publication Date

15/02/2019

Volume

245

Pages

1126 - 1134

Keywords

Chinese, Mental health, Suicidal ideation, Suicide attempt, Transgender, Adolescent, Adult, China, Cross-Sectional Studies, Depressive Disorder, Major, Educational Status, Family Conflict, Female, Humans, Logistic Models, Male, Mental Health Services, Parents, Patient Acceptance of Health Care, Prevalence, Risk Factors, Self-Injurious Behavior, Sexuality, Suicidal Ideation, Suicide, Attempted, Surveys and Questionnaires, Transgender Persons, Young Adult