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Suicidal ideation and attempted suicide amongst Chinese transgender persons: National population study.
J Affect Disord. 2019 02 15; 245:1126-1134.JA

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.

Authors+Show Affiliations

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.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.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.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 Sociology, Peking University, Beijing, China.Beijing LGBT Center, China.Beijing LGBT Center, China.Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, 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.Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China.Central Univerity of Finance and Economics, Beijing, China.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.Department of Psychiatry, University of Oxford, UK; Institute for Mental Health, University of Birmingham, Birmingham, UK.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30699856

Citation

Chen, Runsen, et al. "Suicidal Ideation and Attempted Suicide Amongst Chinese Transgender Persons: National Population Study." Journal of Affective Disorders, vol. 245, 2019, pp. 1126-1134.
Chen R, Zhu X, Wright L, et al. Suicidal ideation and attempted suicide amongst Chinese transgender persons: National population study. J Affect Disord. 2019;245:1126-1134.
Chen, R., Zhu, X., Wright, L., Drescher, J., Gao, Y., Wu, L., Ying, X., Qi, J., Chen, C., Xi, Y., Ji, L., Zhao, H., Ou, J., & Broome, M. R. (2019). Suicidal ideation and attempted suicide amongst Chinese transgender persons: National population study. Journal of Affective Disorders, 245, 1126-1134. https://doi.org/10.1016/j.jad.2018.12.011
Chen R, et al. Suicidal Ideation and Attempted Suicide Amongst Chinese Transgender Persons: National Population Study. J Affect Disord. 2019 02 15;245:1126-1134. PubMed PMID: 30699856.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Suicidal ideation and attempted suicide amongst Chinese transgender persons: National population study. AU - Chen,Runsen, AU - Zhu,Xuequan, AU - Wright,Lucy, AU - Drescher,Jack, AU - Gao,Yue, AU - Wu,Lijuan, AU - Ying,Xin, AU - Qi,Ji, AU - Chen,Chen, AU - Xi,Yingjun, AU - Ji,Lanxin, AU - Zhao,Huichun, AU - Ou,Jianjun, AU - Broome,Matthew R, Y1 - 2018/12/11/ PY - 2018/08/14/received PY - 2018/11/18/revised PY - 2018/12/08/accepted PY - 2019/2/1/entrez PY - 2019/2/1/pubmed PY - 2019/4/4/medline KW - Chinese KW - Mental health KW - Suicidal ideation KW - Suicide attempt KW - Transgender SP - 1126 EP - 1134 JF - Journal of affective disorders JO - J Affect Disord VL - 245 N2 - 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. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/30699856/Suicidal_ideation_and_attempted_suicide_amongst_Chinese_transgender_persons:_National_population_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(18)31792-0 DB - PRIME DP - Unbound Medicine ER -