Varied Reports of Adult Transgender Suicidality: Synthesizing and Describing the Peer-Reviewed and Gray Literature

Abstract

Purpose: This article reports on the findings of a meta-synthesis undertaken on published gray transgender suicidality literature, to determine the average rate of suicidal ideation and attempts in this population. Methods: Studies included in this synthesis were restricted to the 42 that reported on 5 or more Canadian or U.S. adult participants, as published between 1997 and February 2016 in either gray or peer-reviewed health literature. Results: Across these 42 studies an average of 55% of respondents ideated about and 29% attempted suicide in their lifetimes. Within the past year, these averages were, respectively, 51% and 11%, or 14 and 22 times that of the general public. Overall, suicidal ideation was higher among individuals of a male-to-female (MTF) than female-to-male (FTM) alignment, and lowest among those who were gender non-conforming (GNC). Conversely, attempts occurred most often among FTM individuals, then decreased for MTF individuals, followed by GNC individuals. Conclusion: These findings may be useful in creating targeted interventions that take into account both the alarmingly high rate of suicidality in this population, and the relatively differential experience of FTM, MTF, and GNC individuals. Future research should examine minority stress theory and suicidality protection/resilience factors, particularly transition, on this population.

Keywords: marginalization; suicide; transgender.

FIG. 1.

A PRISMA flow chart showing the literature reviewed for this assessment of transgender suicidality and the process of narrowing its scope to those North American studies that reported original transgender suicidality data, were published since 1997, and included five or more participants who were majority 18 years of age or older (50% +1).

FIG. 2.

Suicidality among transgender adults in studies that measured this across the lifetime, or “ever,” as compared by gender identities. The numbers in brackets represent, first, the number of studies that recorded ideation statistics and second, the number that recorded attempt statistics. The label “All” indicates the figure for suicidality in studies that measured this among all participants, irregardless of gender identity. CD, cross-dresser; FTM, female-to-male; GNC, gender non-conforming; MTF, male-to-female.

FIG. 3.

Suicidality among transgender adults in studies that measured this in the past year, compared with those that measured this before transition. The numbers in brackets represent, first, the number of studies that recorded ideation statistics and second, the number that recorded attempt statistics. Studies that measured suicidality in “the past year” and “past 12 months” were combined. Little information was available for suicidality before transition (three studies total, two each for ideation and attempts) and the category is a combination of before treatment, when participants first felt trans, and before transition.