Evidence of syndemic effects influencing older transgender persons’ likelihood of contemplating suicide: results from a large national study

Abstract

Objectives

Very little research has examined suicidal ideation or the factors associated with contemplating suicide among older transgender adults. This paper examines whether or not there is evidence of syndemic effects influencing suicidal ideation among transgender persons aged 50 or older.

Methods

Data from the 2015 U.S. National Transgender Survey were used to examine five domains of potentially-syndemic effects (workplace issues, interactions with professionals, using public services, personal safety, and socioeconomic disadvantages) in a sample of 3,724 transgender Americans aged 50 or older. A dichotomous measure of suicidal ideation during the past year was the main outcome measure.

Results

The odds of contemplating suicide increased anywhere from 96% to 121% among people experiencing any of the problems under study, and anywhere from 258% to 1,552% (depending upon the syndemic effect domain in question) when they were faced by all of the experiences included in any particular domain. When all items were combined, exposure to any of the domains’ problems elevated the risk of contemplating suicide by 276% and exposure to all of the problems examined increased the risk by 861%. The syndemic effects measure remained significant in multivariate analysis controlling for the influence of other potentially-relevant factors.

Conclusions

Considerable evidence for the presence of syndemic effects was found, demonstrating that the more different types of adverse conditions that older transgender person’s face, the more likely they are to experience to contemplate suicide. There is evidence that these effects diminish with advancing age.

Keywords:

• Syndemic effects
• suicidal ideation
• transgender
• older adults

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 In the multivariate analyses conducted in conjunction with the present study, gender identity was coded as “male” or “female.” Nonbinary individuals who, when asked the question about their gender identity, did not self-identify as one or the other of these categories (many did but some did not) were offered the opportunity to decline to use “male” and/or “female” to describe themselves. Those individuals are not included in the “male” or “female” gender identity designations used in the present research. It should be noted that, numerically speaking, there were not enough such persons in the present study to merit examining them as a separate gender category all their own. (Readers should keep in mind that the total N for this research was 3,724 persons, subdivided by gender identity, and then subdivided even further by smaller numbers of persons in the comparison subgroups used in the analyses.)

2 Throughout the present study, “transgender male” refers to someone who was assigned the female gender at birth but who currently self-identifies as a male. “Transgender female” refers to someone who was assigned the male gender at birth but who currently self-identifies as a female.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.