University of Birmingham Suicidal ideation and attempted suicide amongst Chinese transgender persons

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 (FTM) and Women (MTF) 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 idation and attempted suicide between general and transgender population in China. There were a total of 1309 participants out of 2060 valid questionnaires across 32 provinces and municipalities in China took part in this survey. 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 biological sexuality, seeking sex reassignment surgery, having intense conflicts with parents, lifetime history of suffering from major depressive disorder, 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 FTM and MTF were equivalent across groups, differences were observed in both suicidal ideation and suicide attempt models. Cross-secitonal study design and lack of follow-up data for the comparison are limitatons of this study. This is the first study to examine suicide within a Chinese transgender population. The clinical implication of these findings for Chinese mental health professionals are discussed. Also, the evidences from this study can be used to inform the practices of suicide prevention worker, policy maker working with transgender population. Abstract 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. 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. The cross-sectional study design and lack of follow-up data are limitations of this study. 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.