Prevalence and Correlates of Suicidal Ideation and Suicide Attempt Among Transgender Men in San Francisco

Abstract

Data on unmet mental health needs is limited for transgender men. This analysis aims to determine the prevalence and correlates of lifetime suicidal ideation and suicide attempt among transgender men in San Francisco. Between 2014 and 2015, 122 transgender men aged ≥18 years from the San Francisco Bay Area were recruited using a hybrid venue- and peer referral-based sampling method (starfish sampling) to participate in a survey that included mental health indicators. Multivariable Poisson regression models determined associations of lifetime suicidal ideation and lifetime suicide attempt, separately, with demographic, substance use, and psychosocial factors. Mean age of participants was 29.6 years (range 18–56); 22% identified as transgender men of color (6 Asian, 8 Black/African American, 4 Hispanic/Latinx, and 9 other/mixed race); 52% reported ever receiving a depression diagnosis. Overall, 81% (n = 98) reported suicidal ideation, of whom 48% (n = 47) reported suicide attempt. Identification as a transgender man of color (adjusted prevalence ratio [PR] 1.23, p = .03) and prior depression diagnosis (PR 1.46, p < .01) were associated with lifetime suicidal ideation. Perceived social support was associated with a decreased risk of suicidal ideation (PR 0.82, p = .02). Prior depression diagnosis (PR 2.23, p < .01) and low to moderate (≤3 episodes vs. none) binge alcohol use in the last 6 months (PR 1.60, p = .03) were correlates of lifetime suicide attempt. Suicidal behaviors were highly prevalent among this community-derived sample of transgender men. Targeted mental health-focused interventions, specifically among ethnic minorities, may help to address these disparities in this underserved group.