One Quarter of Older Transgender Adults Contemplated Suicide

Twenty-six percent of transgender adults older than 50 years contemplated ending their lives in the previous year, according to a new study.

The study authors noted that this rate is higher than are estimates for suicidal ideation among the general adult population (4.7%) and among older adults (11%-17%).

Older transgender individuals experiencing serious psychological stress, scoring 12 or greater on the Kessler-6 Scale, are at the highest risk for suicidal ideation, reported the authors, Hugh Klein, PhD, of the Kensington Research Institute in Silver Spring, Maryland, and Thomas Alex Washington, of the California State University-Long Beach School of Social Work. They published their peer-reviewed, retrospective analysis online in Aging & Mental Health.

Also at high risk are those who experience any harassment, violence, or unequal treatment in the workplace, from healthcare and law enforcement professionals, and in housing and other public services; who experience threats to public safety; or who live in poverty, said the authors.

Jack Drescher, MD, clinical professor of psychiatry at New York’s Columbia University, said that it is well-known that transgender individuals, as members of a group discriminated against, have higher rates of anxiety, depression, and other mental health issues. The study is “trying to alert us that maybe the problem is bigger than we thought and requires further study,” Drescher told Medscape Medical News.

“The research supports the concept that this is a vulnerable patient population, and because it’s a vulnerable patient population you really need to think seriously about how much more research is needed to help them and what are the interventions might make a difference,” Drescher said.

Effects of Harassment and Discrimination

The researchers based their analysis on the 2015 US Transgender Survey, conducted by the National Center for Transgender Equality (NCTE). It collected data from 27,715 transgender individuals. Klein and Washington focused on the 3724 individuals who were aged 50 or older at the time of the survey interview.

The authors looked at responses about harassment, violence, and unequal treatment in five areas: the workplace; interactions with professionals; using public services; personal safety; and socioeconomic disadvantages. Respondents were asked, for instance, if they had lost a job for being transgender, were treated unequally or unprofessionally by an insurer or physician, were threatened or harassed for using a public restroom, had less than a college degree, or were living at or below the poverty line.

More than three quarters of the respondents (77%) said that they’d experienced at least some of these problems, with 5% saying they had experienced every single problem in every area. The latter had a more than doubling of their risk for suicidal ideation.

Forty percent said that they’d had workplace issues, whereas just under one half said that they’d had problems with a health insurer or received unequal or unprofessional treatment from a physician or healthcare provider or been treated badly by law enforcement or Transportation Security Administration officers.

Klein, Washington, and Drescher report no relevant financial relationships. There was no funding for the study.

Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in publications including JAMA and You can find her on X @aliciaault.

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