Runsen Chen1, Xuequan Zhu2, Lucy Wright3, Jack Drescher4, Yue Gao2, Lijuan Wu5, Xin Ying6, Ji Qi6, Chen Chen7, Yingjun Xi2, Lanxin Ji8, Huichun Zhao9, Jianjun Ou10, Matthew R Broome11. 1. Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Chinese National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, China; Chinese National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China; The National Clinical Research Center for Mental Disorders & Beijing key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China; Department of Psychiatry, University of Oxford, UK. 2. The National Clinical Research Center for Mental Disorders & Beijing key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China. 3. Department of Psychiatry, University of Oxford, UK. 4. Department of Psychiatry, New York Medical College, New York, NY, USA; Center for Psychoanalytic Training and Research, Columbia University, NY, USA; New York University Postdoctoral Program in Psychotherapy and Psychoanalysis, New York, NY, USA. 5. Department of Sociology, Peking University, Beijing, China. 6. Beijing LGBT Center, China. 7. Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China. 8. Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China. 9. Central Univerity of Finance and Economics, Beijing, China. 10. Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Chinese National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, China; Chinese National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China. Electronic address: oujianjun@csu.edu.cn. 11. Department of Psychiatry, University of Oxford, UK; Institute for Mental Health, University of Birmingham, Birmingham, UK.
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. 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.
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.
Authors: Kyle K H Tan; Sonja J Ellis; Johanna M Schmidt; Jack L Byrne; Jaimie F Veale Journal: Int J Environ Res Public Health Date: 2020-04-21 Impact factor: 3.390
Authors: Sav Zwickl; Alex Fang Qi Wong; Eden Dowers; Shalem Yiner-Lee Leemaqz; Ingrid Bretherton; Teddy Cook; Jeffrey D Zajac; Paul S F Yip; Ada S Cheung Journal: BMC Psychiatry Date: 2021-02-08 Impact factor: 3.630