John R Blosnich1,2,3, George R Brown4,5, Sybil Wojcio6, Kenneth T Jones4, Robert M Bossarte2,6. 1. 1 VA Pittsburgh Healthcare System , Center for Health Equity Research and Promotion, Pittsburgh, Pennsylvania. 2. 2 Department of Psychiatry, University of Rochester , Rochester, New York. 3. 3 Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania. 4. 4 Office of Health Equity , VA Central Office, Washington, D.C. 5. 5 Department of Psychiatry and Behavioral Sciences, East Tennessee State University , Johnson City, Tennessee. 6. 6 VISN2 Center of Excellence for Suicide Prevention, Canandaigua, New York.
Abstract
PURPOSE: The aims of this project were to document all-cause and suicide mortality among Veteran Healthcare Administration (VHA) utilizers with The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis consistent with transgender status. METHODS: The study population consisted of VHA patients identified as having any one of four diagnosis codes indicating transgender status (n=5,117) gathered from the VA National Patient Care Database. Mortality data were gathered from the National Death Index from 2000-2009 for 1,277 veterans with transgender-related ICD-9-CM diagnoses. The remaining 3,840 were not searched because they had VHA utilization after 2009 (indicating they were alive). Person-time at risk (person-years) for crude rates were calculated based on the time from an individual's index diagnosis to either death or the end of FY 2009. Causes of death were categorized using ICD-10 code groups. RESULTS: Approximately 9.3% (n=309) veterans with transgender-related ICD-9-CM diagnoses died across the study period. Although diseases of the circulatory system and neoplasms were the first and second leading causes of death, respectively, the other ranked causes of mortality differed somewhat from patterns for the US during the same time span. The crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses across the 10-year period was approximately 82/100,000 person-years, which approximated the crude suicide death rates for other serious mental illness in VHA (e.g., depression, schizophrenia). The average age of suicide decedents was 49.4 years. CONCLUSION: The crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses is higher than in the general population, and they may be dying by suicide at younger ages than their veteran peers without transgender-related ICD-9-CM diagnoses. Future research, such as age-adjusted rates or accounting for psychiatric co-morbidities, will help to better clarify if the all-cause and suicide mortality rates are elevated for veterans with transgender-related ICD-9-CM diagnoses.
PURPOSE: The aims of this project were to document all-cause and suicide mortality among Veteran Healthcare Administration (VHA) utilizers with The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis consistent with transgender status. METHODS: The study population consisted of VHA patients identified as having any one of four diagnosis codes indicating transgender status (n=5,117) gathered from the VA National Patient Care Database. Mortality data were gathered from the National Death Index from 2000-2009 for 1,277 veterans with transgender-related ICD-9-CM diagnoses. The remaining 3,840 were not searched because they had VHA utilization after 2009 (indicating they were alive). Person-time at risk (person-years) for crude rates were calculated based on the time from an individual's index diagnosis to either death or the end of FY 2009. Causes of death were categorized using ICD-10 code groups. RESULTS: Approximately 9.3% (n=309) veterans with transgender-related ICD-9-CM diagnoses died across the study period. Although diseases of the circulatory system and neoplasms were the first and second leading causes of death, respectively, the other ranked causes of mortality differed somewhat from patterns for the US during the same time span. The crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses across the 10-year period was approximately 82/100,000 person-years, which approximated the crude suicide death rates for other serious mental illness in VHA (e.g., depression, schizophrenia). The average age of suicide decedents was 49.4 years. CONCLUSION: The crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses is higher than in the general population, and they may be dying by suicide at younger ages than their veteran peers without transgender-related ICD-9-CM diagnoses. Future research, such as age-adjusted rates or accounting for psychiatric co-morbidities, will help to better clarify if the all-cause and suicide mortality rates are elevated for veterans with transgender-related ICD-9-CM diagnoses.
Authors: Ann P Haas; Andrew D Lane; John R Blosnich; Barbara A Butcher; Maggie G Mortali Journal: Am J Public Health Date: 2018-12-20 Impact factor: 9.308
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Authors: Ana M Progovac; Brian O Mullin; Emilia Dunham; Sari L Reisner; Alex McDowell; Maria Jose Sanchez Roman; Mason Dunn; Cynthia J Telingator; Frederick Q Lu; Aaron Samuel Breslow; Marshall Forstein; Benjamin Lê Cook Journal: Am J Prev Med Date: 2020-03-07 Impact factor: 5.043
Authors: Josephine Mak; Deirdre A Shires; Qi Zhang; Lucas R Prieto; Brian K Ahmedani; Leonardo Kattari; Tracy A Becerra-Culqui; Andrew Bradlyn; W Dana Flanders; Darios Getahun; Shawn V Giammattei; Enid M Hunkeler; Timothy L Lash; Rebecca Nash; Virginia P Quinn; Brandi Robinson; Douglas Roblin; Michael J Silverberg; Jennifer Slovis; Vin Tangpricha; Suma Vupputuri; Michael Goodman Journal: Am J Prev Med Date: 2020-08-12 Impact factor: 5.043
Authors: John R Blosnich; John Cashy; Adam J Gordon; Jillian C Shipherd; Michael R Kauth; George R Brown; Michael J Fine Journal: J Am Med Inform Assoc Date: 2018-07-01 Impact factor: 4.497