Psychosocial mediators of perceived stigma and suicidal ideation among transgender women

Krishna Kiran Kota; Laura F Salazar; Rachel E Culbreth; Richard A Crosby; Jamal Jones

doi:10.1186/s12889-020-8177-z

Psychosocial mediators of perceived stigma and suicidal ideation among transgender women

BMC Public Health. 2020 Jan 29;20(1):125. doi: 10.1186/s12889-020-8177-z.

Authors

Krishna Kiran Kota¹, Laura F Salazar², Rachel E Culbreth³, Richard A Crosby^{4

5}, Jamal Jones¹

Affiliations

¹ Department of Health Policy & Behavioral Science, School of Public Health, Georgia State University, PO Box 3984, Atlanta, GA, 30302-3984, USA.
² Department of Health Policy & Behavioral Science, School of Public Health, Georgia State University, PO Box 3984, Atlanta, GA, 30302-3984, USA. lsalazar1@gsu.edu.
³ Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA.
⁴ Department of Health Promotion, College of Public Health, University of Kentucky, Lexington, KY, USA.
⁵ Kinsey Institute for Research on Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.

Abstract

Background: Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation.

Methods: Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact of gender minority status, and substance use behaviors as potential mediators for the relationship between perceived stigma and suicidal ideation. All models were controlled for age, race, education, and homelessness.

Results: Suicidal ideation was reported by 33% (N = 30) of the study participants. In multivariable analysis, suicidal ideation was associated with sexual abuse (AOR = 3.17, 95% CI = 1.10-9.30), anxiety (AOR = 1.74, 95% CI = 1.10-2.73), family verbal abuse (AOR = 2.99, 95% CI = 1.10-8.40), stranger verbal abuse (AOR = 3.21, 95% CI = 1.02-10.08), and psychosocial impact of gender minority status (AOR = 3.42, 95% CI = 1.81-6.46). Partner support was found to be the protective factor for suicidal ideation (AOR = 0.34, 95% CI = 0.13-0.90). In the mediation analysis, the psychosocial impact of gender minority status mediated the relationship between perceived stigma and suicidal ideation. The estimated conditional indirect effect was 0.46, (95% CI = 0.12-1.11).

Conclusion: Interventions that aim to reduce suicidal behaviors among TGW should address stigma, psychosocial impact of gender minority status, and different forms of violence and abuse.

Keywords: Perceived stigma; Psychosocial impact of gender minority status; Sexual abuse; Suicidal ideation; Transgender women.

MeSH terms

Adolescent
Adult
Aged
Cross-Sectional Studies
Female
Georgia
Humans
Male
Middle Aged
Risk Factors
Social Stigma*
Suicidal Ideation*
Transgender Persons / psychology*
Transgender Persons / statistics & numerical data
Young Adult