Elevated Rates of Violence Victimization and Suicide Attempt Among Transgender and Gender Diverse Patients in an Urban, Safety Net Health System

Ana M. Progovac, Nathaniel M. Tran, Brian O. Mullin, Juliana De Mello Libardi Maia, Timothy B. Creedon, Emilia Dunham, Sari L. Reisner, Alex McDowell, Natalie Bird, María José Sánchez Román, Mason Dunn, Cynthia Telingator, Frederick Lu, Aaron Samuel Breslow, Marshall Forstein, Benjamin L.ê. Cook

Research output: Contribution to journalArticlepeer-review

Abstract

The extent to which violent victimization may explain higher rates of suicidality for transgender and gender diverse (TGD) populations is not well-understood. We identified likely-TGD patients using 2008–2019 electronic health record data and compared them with non-TGD patients to characterize differences in suicide attempt, ideation, and violent victimization. TGD patients (n = 916) had more suicide attempts (5.2 vs. 0.4 percent), ideation (20.5 vs. 1.8 percent), and violent victimization (5.4 vs. 1.7 percent, all p <.001) than non-TGDs (n = 511,026). Violent victimization and TGD cohort were independent predictors of suicide attempt (odds ratios [ORs], 7.23 and 10.84) and ideation (ORs, 6.83 and 11.03, all p <.001). We did not observe a differential impact of violent victimization for gender minorities. TGD patients are at higher baseline risk for suicidality, which is higher still for those experiencing violent victimization. Routine screening for both outcomes, including in primary care settings, may improve treatment.

Original languageEnglish (US)
Pages (from-to)176-198
Number of pages23
JournalWorld Medical and Health Policy
Volume13
Issue number2
DOIs
StatePublished - Jun 2021

Keywords

  • LGBTQ
  • electronic health record
  • suicide attempt
  • transgender and gender diverse
  • victimization

ASJC Scopus subject areas

  • Health Policy

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