Elevated Rates of Violence Victimization and Suicide Attempt Among Transgender and Gender Diverse Patients in an Urban, Safety Net Health System

Ana M. Progovac; Nathaniel M. Tran; Brian O. Mullin; Juliana De Mello Libardi Maia; Timothy B. Creedon; Emilia Dunham; Sari L. Reisner; Alex McDowell; Natalie Bird; María José Sánchez Román; Mason Dunn; Cynthia Telingator; Frederick Lu; Aaron Samuel Breslow; Marshall Forstein; Benjamin L.ê. Cook

doi:10.1002/wmh3.403

Elevated Rates of Violence Victimization and Suicide Attempt Among Transgender and Gender Diverse Patients in an Urban, Safety Net Health System

Ana M. Progovac, Nathaniel M. Tran, Brian O. Mullin, Juliana De Mello Libardi Maia, Timothy B. Creedon, Emilia Dunham, Sari L. Reisner, Alex McDowell, Natalie Bird, María José Sánchez Román, Mason Dunn, Cynthia Telingator, Frederick Lu, Aaron Samuel Breslow, Marshall Forstein, Benjamin L.ê. Cook

Psychiatry and Behavioral Sciences

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

The extent to which violent victimization may explain higher rates of suicidality for transgender and gender diverse (TGD) populations is not well-understood. We identified likely-TGD patients using 2008–2019 electronic health record data and compared them with non-TGD patients to characterize differences in suicide attempt, ideation, and violent victimization. TGD patients (n = 916) had more suicide attempts (5.2 vs. 0.4 percent), ideation (20.5 vs. 1.8 percent), and violent victimization (5.4 vs. 1.7 percent, all p <.001) than non-TGDs (n = 511,026). Violent victimization and TGD cohort were independent predictors of suicide attempt (odds ratios [ORs], 7.23 and 10.84) and ideation (ORs, 6.83 and 11.03, all p <.001). We did not observe a differential impact of violent victimization for gender minorities. TGD patients are at higher baseline risk for suicidality, which is higher still for those experiencing violent victimization. Routine screening for both outcomes, including in primary care settings, may improve treatment.

Original language	English (US)
Pages (from-to)	176-198
Number of pages	23
Journal	World Medical and Health Policy
Volume	13
Issue number	2
DOIs	https://doi.org/10.1002/wmh3.403
State	Published - Jun 2021

Keywords

LGBTQ
electronic health record
suicide attempt
transgender and gender diverse
victimization

ASJC Scopus subject areas

Health Policy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/wmh3.403

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Progovac, A. M., Tran, N. M., Mullin, B. O., De Mello Libardi Maia, J., Creedon, T. B., Dunham, E., Reisner, S. L., McDowell, A., Bird, N., Sánchez Román, M. J., Dunn, M., Telingator, C., Lu, F., Breslow, A. S., Forstein, M., & Cook, B. L. Ê. (2021). Elevated Rates of Violence Victimization and Suicide Attempt Among Transgender and Gender Diverse Patients in an Urban, Safety Net Health System. World Medical and Health Policy, 13(2), 176-198. https://doi.org/10.1002/wmh3.403

Progovac, AM, Tran, NM, Mullin, BO, De Mello Libardi Maia, J, Creedon, TB, Dunham, E, Reisner, SL, McDowell, A, Bird, N, Sánchez Román, MJ, Dunn, M, Telingator, C, Lu, F, Breslow, AS, Forstein, M & Cook, BLÊ 2021, 'Elevated Rates of Violence Victimization and Suicide Attempt Among Transgender and Gender Diverse Patients in an Urban, Safety Net Health System', World Medical and Health Policy, vol. 13, no. 2, pp. 176-198. https://doi.org/10.1002/wmh3.403

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abstract = "The extent to which violent victimization may explain higher rates of suicidality for transgender and gender diverse (TGD) populations is not well-understood. We identified likely-TGD patients using 2008–2019 electronic health record data and compared them with non-TGD patients to characterize differences in suicide attempt, ideation, and violent victimization. TGD patients (n = 916) had more suicide attempts (5.2 vs. 0.4 percent), ideation (20.5 vs. 1.8 percent), and violent victimization (5.4 vs. 1.7 percent, all p <.001) than non-TGDs (n = 511,026). Violent victimization and TGD cohort were independent predictors of suicide attempt (odds ratios [ORs], 7.23 and 10.84) and ideation (ORs, 6.83 and 11.03, all p <.001). We did not observe a differential impact of violent victimization for gender minorities. TGD patients are at higher baseline risk for suicidality, which is higher still for those experiencing violent victimization. Routine screening for both outcomes, including in primary care settings, may improve treatment.",

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author = "Progovac, {Ana M.} and Tran, {Nathaniel M.} and Mullin, {Brian O.} and {De Mello Libardi Maia}, Juliana and Creedon, {Timothy B.} and Emilia Dunham and Reisner, {Sari L.} and Alex McDowell and Natalie Bird and {S{\'a}nchez Rom{\'a}n}, {Mar{\'i}a Jos{\'e}} and Mason Dunn and Cynthia Telingator and Frederick Lu and Breslow, {Aaron Samuel} and Marshall Forstein and Cook, {Benjamin L.{\^e}.}",

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AU - Progovac, Ana M.

AU - Tran, Nathaniel M.

AU - Mullin, Brian O.

AU - De Mello Libardi Maia, Juliana

AU - Creedon, Timothy B.

AU - Dunham, Emilia

AU - Reisner, Sari L.

AU - McDowell, Alex

AU - Bird, Natalie

AU - Sánchez Román, María José

AU - Dunn, Mason

AU - Telingator, Cynthia

AU - Lu, Frederick

AU - Breslow, Aaron Samuel

AU - Forstein, Marshall

AU - Cook, Benjamin L.ê.

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N2 - The extent to which violent victimization may explain higher rates of suicidality for transgender and gender diverse (TGD) populations is not well-understood. We identified likely-TGD patients using 2008–2019 electronic health record data and compared them with non-TGD patients to characterize differences in suicide attempt, ideation, and violent victimization. TGD patients (n = 916) had more suicide attempts (5.2 vs. 0.4 percent), ideation (20.5 vs. 1.8 percent), and violent victimization (5.4 vs. 1.7 percent, all p <.001) than non-TGDs (n = 511,026). Violent victimization and TGD cohort were independent predictors of suicide attempt (odds ratios [ORs], 7.23 and 10.84) and ideation (ORs, 6.83 and 11.03, all p <.001). We did not observe a differential impact of violent victimization for gender minorities. TGD patients are at higher baseline risk for suicidality, which is higher still for those experiencing violent victimization. Routine screening for both outcomes, including in primary care settings, may improve treatment.

AB - The extent to which violent victimization may explain higher rates of suicidality for transgender and gender diverse (TGD) populations is not well-understood. We identified likely-TGD patients using 2008–2019 electronic health record data and compared them with non-TGD patients to characterize differences in suicide attempt, ideation, and violent victimization. TGD patients (n = 916) had more suicide attempts (5.2 vs. 0.4 percent), ideation (20.5 vs. 1.8 percent), and violent victimization (5.4 vs. 1.7 percent, all p <.001) than non-TGDs (n = 511,026). Violent victimization and TGD cohort were independent predictors of suicide attempt (odds ratios [ORs], 7.23 and 10.84) and ideation (ORs, 6.83 and 11.03, all p <.001). We did not observe a differential impact of violent victimization for gender minorities. TGD patients are at higher baseline risk for suicidality, which is higher still for those experiencing violent victimization. Routine screening for both outcomes, including in primary care settings, may improve treatment.

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KW - victimization

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Elevated Rates of Violence Victimization and Suicide Attempt Among Transgender and Gender Diverse Patients in an Urban, Safety Net Health System

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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