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The Nexus of Sex Trading, Psychological Distress, and Suicidal Ideation Among Transgender Adults: Results from a Large National Study

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Abstract

Very little research has been undertaken to examine the prevalence of sex-trading behaviors among transgender adults, and even less is known about how engaging in this behavior affects sex-trading individuals. This paper examines the nexus of sex trading and psychological distress and suicidal ideation. Data from the 2015 U.S. National Transgender Survey were used to examine the factors associated with sex trading in a sample of 27,715 transgender Americans aged 18 or older. The Kessler-6 scale was used to measure psychological distress and a dichotomous measure of suicidal ideation during the past year was the other main outcome measure. Covariates in the multivariate analysis included sociodemographic measures, numerous measures of anti-transgender harassment, discrimination, and violence, and several transition milestones. Approximately one person in six had engaged in sex-trading behaviors. Multivariate analysis revealed that sex trading was related to psychological distress and to an increased risk of suicidal ideation. Structural equation analysis showed that sex trading had both a direct impact upon suicidal ideation and an indirect effect through its influence on psychological distress, which was the strongest predictor of suicidal ideation. Although sex trading is relatively uncommon among transgender persons, it is much more common in this population than it is in the population-at-large. Among persons who engage in this practice, though, there is a greatly elevated risk for suffering from psychological distress and suicidal ideation.

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Notes

  1. Persons aged 40–49 were excluded from these “younger” and “older” classifications so as to facilitate clean comparisons between the groups. Had this not been done and, alternatively, had the sample been divided into persons aged 18–44 and persons aged 45 and older, there would have been a risk that people literally one year apart from one another age-wise would have been classified differently from one another. Using the 18–39 versus 50 + classification, the comparison groups are discrete.

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The authors declare that no funds, grants, or other support was received during the preparation of this manuscript. The authors have no relevant financial or nonfinancial interests to disclose.

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  1. Kensington Research Institute, Silver Spring, MD, USA

    Hugh Klein

  2. California State University Long Beach, Long Beach, CA, USA

    Hugh Klein & Thomas A. Washington

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  1. Hugh Klein
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  2. Thomas A. Washington
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Material preparation, data analysis, literature review, and initial writing of the first draft of this manuscript were performed by Hugh Klein. Review of the manuscript, editorial changes to the text, and final approval of the submitted version of the manuscript were given by both Hugh Klein and Thomas A. Washington.

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Correspondence to Hugh Klein.

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All of the research protocols for the collection of the data used in this study were approved by the Institutional Review Board at University of California—Los Angeles. This included the completion and submission of formal written consent prior to beginning the questionnaire. Prior to releasing the data to the present authors for access, analysis, and publication, the present authors received approval from the Institutional Review Board at California State University—Long Beach.

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Klein, H., Washington, T.A. The Nexus of Sex Trading, Psychological Distress, and Suicidal Ideation Among Transgender Adults: Results from a Large National Study. Sexuality & Culture 28, 1067–1084 (2024). https://doi.org/10.1007/s12119-023-10166-z

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