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Lower levels of social support are associated with risk for future suicide attempts in a clinical sample of transgender and gender diverse adults

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Abstract

Purpose

Transgender and gender diverse (TGD) adults are disproportionately affected by suicide. Social support and connection to the broader TGD community may help lower TGD adults’ odds of having a suicide attempt (SA). The current study examined whether baseline levels of social support and community connectedness were associated with TGD adult’s prospective odds of having a SA over 12 months of follow-up.

Methods

Longitudinal data for the current study came from a patient cohort of TGD adults enrolled in the LEGACY Project. Descriptive statistics and an attrition analysis were used to examine characteristics of the cohort and missingness over time. Logistic generalized estimating equation models were used to examine factors associated with patients’ odds of having a past 6-month SA at 6- or 12-month follow-up.

Results

During the 12-month follow-up period, a total of 26 patients (3.1%; N = 830) reported having a SA. The 6-month incidence of SAs was approximately 2% at both 6- and 12-months of follow-up (6 months: N = 830; 12 months: N = 495). Baseline factors associated with increased odds of a future SA included gender identity (transfeminine vs. transmasculine: adjusted odds ratio [aOR] = 3.73, 95% confidence interval [CI] = 1.26–11.08; nonbinary vs. transmasculine: aOR = 3.09, 95% CI = 1.03–9.21), having a prior SA (aOR = 6.44, 95% CI = 2.63–15.79), and having moderate vs. high perceived social support (aOR = 4.25, 95% CI = 1.65–10.90).

Conclusion

Lower levels of social support are associated with risk for future suicide attempts among TGD adults. Findings may inform screening practices for future suicide risk and the development of interventions to improve mental health outcomes for TGD adults.

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Acknowledgements

We would like to thank our Community Advisory Board, Scientific Advisory Board, and Research Support Coalition for their invaluable contributions to this project. We would also like to thank members of the LEGACY team for their significant contributions to the overarching project, including Kenneth Mayer, Madeline Deutsch, Jennifer Potter, Alex Gonzales, Chris Grasso, Juwan Campbell, Andrew Asquith, Dana Pardee, Alexander Harris, and Meg Quint. Finally, we would like to thank the participants of this study for lending their voices and experiences. Without them, this work would not be possible.

Funding

This work was supported by the Patient-Centered Research Outcomes Institute (PCORI), grant number [AD-2017C1-6569] (PI: Reisner). The content is solely the responsibility of the authors and does not necessarily represent the official views of PCORI. The funder was not involved in the collection, analysis, or interpretation of study data.

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Authors and Affiliations

  1. Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S. Main St., Providence, RI, 02903, USA

    David R. Pletta & Jaclyn M. W. Hughto

  2. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    David R. Pletta, S. Bryn Austin & Jarvis T. Chen

  3. The Fenway Institute, Fenway Health, Boston, MA, USA

    David R. Pletta, Alex S. Keuroghlian, Jaclyn M. W. Hughto & Sari L. Reisner

  4. Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA

    S. Bryn Austin

  5. Callen-Lorde Community Health Center, New York City, NY, USA

    Asa E. Radix

  6. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Alex S. Keuroghlian

  7. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Alex S. Keuroghlian

  8. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA

    Jaclyn M. W. Hughto

  9. Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA

    Sari L. Reisner

  10. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Sari L. Reisner

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  1. David R. Pletta
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Contributions

DRP developed the initial analysis plan, conducted all analyses, and wrote the manuscript. SBA, JTC, and SLR contributed to revisions of the analysis plan and provided extensive feedback on drafts of the manuscript. AER and SLR devised the primary study and oversaw data collection. JMWH and ASK provided feedback on drafts of the manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to David R. Pletta.

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Pletta, D.R., Austin, S.B., Chen, J.T. et al. Lower levels of social support are associated with risk for future suicide attempts in a clinical sample of transgender and gender diverse adults. Soc Psychiatry Psychiatr Epidemiol (2024). https://doi.org/10.1007/s00127-023-02606-w

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