But good healthcare experiences appeared to be protective, according to the national survey.
Trans and gender-diverse Australians reported at least twice rate of suicidal ideation and suicide attempts in the past year compared to the cis-gendered LGBQ population.
Good experiences in healthcare were protective though, according to the article in Suicide and Life-Threatening Behavior.
Around 1500 trans or gender diverse adults were surveyed about their suicidality over the last 12 months, as part of the larger 2020 Private Lives 3 national survey that tracks the health and wellbeing of lesbian, gay, bisexual, transgender, intersex and queer people.
A staggering two in three trans participants reported suicidal ideation, and one in 10 reported a suicide attempt. These are twice the rates reported by cisgender participants in the same survey (37.2% and 3.9%, respectively).
Both groups have substantially higher rates of suicidality than the general population. According to 2009 data, suicidal ideation was experienced by 2.3% or the population and suicide attempts by 0.4% of the population in the preceding 12 months.
“The reported levels of suicidal ideation and suicide attempts in the past 12 months among trans people in this sample are alarmingly high when compared [with] both their cisgender LGBQ peers and the general population in Australia,” Dr Adam Hill, a public health sociologist at La Trobe University, and colleagues wrote.
The healthcare experiences of trans and gender-diverse adults proved to be significant.
“Trans participants who felt that their gender identity was affirmed when accessing a mainstream health service in the past 12 months were one-third less likely to report suicidal ideation,” the authors reported.
“[This] demonstrates the important protective role that gender-affirming care can play in healthcare services.”
The perennial problem of access to health services which are trans-inclusive and culturally informed about gender-affirming care was highlighted by the results.
“It is important to note, however, that the development and expansion of LGBTQ-accredited mainstream health services inclusive of trans people should be made in parallel with the expansion of LGBTQ community-controlled health service providers that cater exclusively to the needs of LGBTQ people, which also play an important role in suicide prevention in these populations,” the authors wrote.
“It is therefore important to expand dedicated services that are also provided, where possible, by trans professionals in order to attend to the specific health and wellbeing needs of this group.”
TMR has previously reported on the positive outcomes experienced by trans and gender-diverse patients attending primary care services facilitated by peer navigators.
“It is of note that peer support around suicide is challenging and re-traumatising for people who have experienced suicidal ideation themselves or of people they know,” the authors warned.
“Peer support leaders may therefore need adequate supervision and training.”
The researchers also found that the likelihood of suicidal ideation was higher for younger participants (18-24 years), and lower for those with a postgraduate degree, or who felt accepted by family or work.
The likelihood of suicide attempts was greater for younger participants, or those who had recently experienced sexual harassment based on their sexual orientation or gender identity. It was lower for those who identified as non-binary.
“These findings have potential implications for health providers, governments, and suicide prevention services,” the authors concluded.
“Taken together, these findings highlight an urgent need to provide suicide prevention programming and related strategies that tackle stigma, support the mental health of trans people, and enable culturally safe, gender-affirming care in health and medical settings.”
Suicide and Life-Threatening Behavior 2023, online 14 February
