Sarah P Carter1,2, Kelly M Allred3, Raymond P Tucker4, Tracy L Simpson5,6,7, Jillian C Shipherd8,9,10, Keren Lehavot1,2,5,6. 1. 1 Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington. 2. 2 Department of Health Services, University of Washington, Seattle, Washington. 3. 3 VA Puget Sound Health Care System, Seattle, Washington. 4. 4 Department of Psychology, Louisiana State University, Baton Rouge, Louisiana. 5. 5 Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington. 6. 6 Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington. 7. 7 Center of Excellence in Substance Abuse Treatment and Education (CESATE), VA Puget Sound Health Care System, Seattle, Washington. 8. 8 LGBT Health Program, Department of Veterans Affairs, Washington, District of Columbia. 9. 9 Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts. 10. 10 Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts.
Abstract
PURPOSE: The aim was to examine social support and community connection as moderators of the relationship between discrimination and suicidal ideation (SI) in transgender veterans. METHODS: A national convenience sample of 298 transgender veterans completed an online cross-sectional survey from February to May 2014. Hierarchical regressions using nonparametric bootstrapping assessed associations among gender-related discrimination within the past year, two aspects of social support (social support, social connection) from four sources (family, friends, transgender/LGBT friends, and veterans), and SI in the past 2 weeks. RESULTS: Discrimination was positively associated with SI. Social support from transgender friends and social connection with LGBT and veteran communities moderated the relationship between discrimination and SI. At high and average levels of social support and connection, discrimination was associated with greater SI, whereas at low levels of these variables, SI was consistently elevated and unrelated to discrimination. CONCLUSION: Given that SI was consistently elevated when discrimination was high, these findings emphasize the need for additional research on how to mitigate the detrimental effects of discrimination, with consideration given to interventions targeting discrimination or responses to discrimination. In addition, given that high and average transgender social support and LGBT social connection were associated with reduced SI when discrimination was low, research would benefit from continued exploration of the potential protective elements of social support from a shared stigmatized community.
PURPOSE: The aim was to examine social support and community connection as moderators of the relationship between discrimination and suicidal ideation (SI) in transgender veterans. METHODS: A national convenience sample of 298 transgender veterans completed an online cross-sectional survey from February to May 2014. Hierarchical regressions using nonparametric bootstrapping assessed associations among gender-related discrimination within the past year, two aspects of social support (social support, social connection) from four sources (family, friends, transgender/LGBT friends, and veterans), and SI in the past 2 weeks. RESULTS: Discrimination was positively associated with SI. Social support from transgender friends and social connection with LGBT and veteran communities moderated the relationship between discrimination and SI. At high and average levels of social support and connection, discrimination was associated with greater SI, whereas at low levels of these variables, SI was consistently elevated and unrelated to discrimination. CONCLUSION: Given that SI was consistently elevated when discrimination was high, these findings emphasize the need for additional research on how to mitigate the detrimental effects of discrimination, with consideration given to interventions targeting discrimination or responses to discrimination. In addition, given that high and average transgender social support and LGBT social connection were associated with reduced SI when discrimination was low, research would benefit from continued exploration of the potential protective elements of social support from a shared stigmatized community.
Keywords:
discrimination; minority stress; social support; suicide ideation; transgender; veterans
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