The Impact of Family Support and Rejection on Suicide Ideation and Attempt among Transgender Adults in the U.S.

Figures & data

Table 1. Weighted descriptive statistics of sample respondents (N = 19,829).

Suicidality
Ever had serious suicidal thoughts	79.00%
Ever attempted suicide	42.89%
Level of Family Support
Supportive	60.05%
Neutral	20.82%
Unsupportive	19.14%
Family Rejection Experiences (Family member(s)…)
Stopped speaking to you or ended relationships	33.25%
Were violent toward you	11.46%
Kicked you out of the house	9.50%
Didn’t allow clothes that match gender	25.21%
Sent you to a therapist, counselor, or religious advisor	13.46%
Gender Identity
Transgender Woman	58.08%
Transgender Man	26.56%
Gender Non-Binary/Gender Queer	15.36%
Race/Ethnicity
American Indian or Alaska Native	1.06%
Asian American	2.94%
Black or African American	13.76%
Latinx	15.62%
Middle Eastern or North African	0.23%
Native Hawaiian or Other Pacific Islander	0.06%
White	63.63%
Biracial or Multiracial	2.16%
Age
18-24	13.08%
25-44	42.28%
45-64	34.43%
65+	10.21%
Marital Status
Married or Cohabitating	24.42%
Never Married	54.77%
Divorced	18.37%
Widowed	2.44%
Educational Attainment
Less than High School	14.18%
High School (including GED)	28.63%
Some College	22.37%
Associate’s Degree	8.13%
Bachelor’s Degree	16.43%
Graduate or Professional Degree	10.25%
Unemployed	39.02%

Table 2. Logistic regression models of suicide ideation and suicide attempt and family support expressed in odds ratios.

		Suicide ideation (N = 19,803)			Suicide attempt (N = 19,792)
Family Support (Ref. Neutral)
Supportive		0.688***	0.700***	0.717**	0.837*	0.823*	0.842
		(0.0909)	(0.0965)	(0.0971)	(0.0875)	(0.0909)	(0.0901)
Unsupportive		1.447*	1.520**	1.478**	1.374**	1.422***	1.369**
		(0.295)	(0.295)	(0.284)	(0.174)	(0.178)	(0.171)
Gender Identity (Ref. Nonbinary/Gender Queer)
Transgender Woman			1.126	1.062		1.255*	1.110
			(0.173)	(0.169)		(0.148)	(0.131)
Transgender Man			1.355**	1.364**		1.456***	1.464***
			(0.200)	(0.202)		(0.153)	(0.152)
Race/Ethnicity (Ref. White)
American Indian or Alaska Native			2.066**	1.802*		2.753***	2.170***
			(0.722)	(0.631)		(0.730)	(0.549)
Asian American			1.177	1.206		1.061	1.158
			(0.372)	(0.368)		(0.244)	(0.241)
Black or African American			0.619**	0.586***		1.178	1.048
			(0.128)	(0.117)		(0.217)	(0.179)
Latinx			0.835	0.809		1.188	1.083
			(0.162)	(0.154)		(0.168)	(0.150)
Middle Eastern or North African			2.235*	2.119*		1.358	1.290
			(0.998)	(0.902)		(0.653)	(0.690)
Native Hawaiian or Other Pacific Islander			0.409	0.401		1.220	1.121
			(0.331)	(0.315)		(0.817)	(0.804)
Biracial or Multiracial			2.011***	1.881***		1.867***	1.725***
			(0.357)	(0.334)		(0.255)	(0.232)
Age (Ref. 18–24 years old)
25-44 years old			0.705***	0.821**		1.044	1.262***
			(0.0657)	(0.0818)		(0.0670)	(0.0878)
45-64 years old			0.424***	0.497***		0.779*	0.936
			(0.0781)	(0.0961)		(0.108)	(0.135)
65+ years old			0.222***	0.248***		0.309***	0.369***
			(0.0545)	(0.0674)		(0.0774)	(0.0992)
Marital Status (Ref. Married or Cohabitating)
Never Married			1.022	0.982		1.006	0.951
			(0.166)	(0.163)		(0.124)	(0.120)
Divorced			1.234	1.218		1.297**	1.290**
			(0.184)	(0.179)		(0.167)	(0.161)
Widowed			0.677	0.647		1.543	1.363
			(0.293)	(0.275)		(0.635)	(0.533)
Education (Ref. Less than High School)
High School (including GED)				0.839			0.612**
				(0.258)			(0.136)
Some College				1.198			0.699*
				(0.342)			(0.143)
Associate’s Degree				0.838			0.547***
				(0.252)			(0.121)
Bachelor’s Degree				0.884			0.463***
				(0.257)			(0.0984)
Graduate or Professional Degree				0.666			0.380***
				(0.196)			(0.0846)
Unemployed				1.370**			1.479***
				(0.175)			(0.137)
Constant		4.498***	7.599***	6.953***	0.785***	0.644***	0.875
		(0.517)	(1.539)	(2.247)	(0.0694)	(0.100)	(0.219)

Notes: Standard Errors in parentheses. ***p < 0.001, **p < 0.01, *p < 0.05.

Table 3. Logistic regression models of suicide ideation and suicide attempt and family rejection expressed in odds ratios.

		Suicide ideation (N = 19,803)			Suicide attempt (N = 19,792)
Family Rejection Experience (Family member(s)…)
Stopped speaking to you or ended relationship		1.507***	1.832***	1.810***	1.622***	1.752***	1.742***
		(0.202)	(0.243)	(0.240)	(0.150)	(0.165)	(0.170)
Were violent toward you		3.087***	3.234***	3.127***	1.605***	1.614***	1.437**
		(0.621)	(0.738)	(0.738)	(0.293)	(0.291)	(0.259)
Kicked you out of the house		2.054***	2.193***	2.155***	1.648**	1.677**	1.607**
		(0.453)	(0.557)	(0.551)	(0.326)	(0.340)	(0.320)
Didn’t allow clothing that match gender		1.490***	1.348**	1.330**	1.397***	1.322***	1.342***
		(0.217)	(0.189)	(0.187)	(0.143)	(0.135)	(0.135)
Sent you to a therapist, counselor, or religious advisor		1.211	1.172	1.163	1.079	1.054	1.093
		(0.249)	(0.253)	(0.256)	(0.148)	(0.147)	(0.153)
Gender Identity (Ref. Nonbinary/Gender Queer)
Transgender Woman			0.966	0.932		1.067	0.954
			(0.126)	(0.124)		(0.108)	(0.0948)
Transgender Man			1.298**	1.311**		1.354***	1.363***
			(0.169)	(0.173)		(0.123)	(0.122)
Race/Ethnicity (Ref. White)
American Indian or Alaska Native			1.868*	1.694		2.637***	2.108***
			(0.676)	(0.615)		(0.737)	(0.552)
Asian American			1.270	1.303		1.042	1.138
			(0.472)	(0.467)		(0.270)	(0.269)
Black or African American			0.487***	0.476***		0.982	0.895
			(0.0943)	(0.0912)		(0.160)	(0.147)
Latinx			0.745	0.735*		1.100	1.013
			(0.143)	(0.137)		(0.168)	(0.147)
Middle Eastern or North African			2.135	2.033		1.264	1.200
			(1.034)	(0.942)		(0.688)	(0.704)
Native Hawaiian or Other Pacific Islander			0.400	0.405		1.264	1.171
			(0.294)	(0.287)		(0.780)	(0.765)
Biracial or Multiracial			1.791***	1.699***		1.694***	1.588***
			(0.331)	(0.314)		(0.237)	(0.218)
Age (Ref. 18–24 years old)
25-44 years old			0.670***	0.774***		0.986	1.189**
			(0.0598)	(0.0746)		(0.0645)	(0.0835)
45-64 years old			0.369***	0.429***		0.704***	0.850
			(0.0633)	(0.0786)		(0.0883)	(0.116)
65+ years old			0.217***	0.237***		0.297***	0.356***
			(0.0493)	(0.0588)		(0.0631)	(0.0790)
Marital Status (Ref. Married or Cohabitating)
Never Married			1.045	1.007		1.025	0.978
			(0.160)	(0.159)		(0.121)	(0.121)
Divorced			1.367**	1.335*		1.397***	1.384**
			(0.203)	(0.197)		(0.181)	(0.176)
Widowed			0.731	0.715		1.714	1.524
			(0.330)	(0.316)		(0.752)	(0.627)
Education (Ref. Less than High School)
High School (including GED)				0.948			0.642**
				(0.270)			(0.134)
Some College				1.324			0.722*
				(0.350)			(0.137)
Associate’s Degree				0.981			0.587**
				(0.277)			(0.121)
Bachelor’s Degree				1.001			0.485***
				(0.268)			(0.0940)
Graduate or Professional Degree				0.758			0.401***
				(0.207)			(0.0815)
Unemployed				1.324**			1.441***
				(0.158)			(0.129)
Constant		2.704***	5.471***	4.596***	0.523***	0.512***	0.675*
		(0.174)	(0.916)	(1.345)	(0.0269)	(0.0713)	(0.144)

Notes: Standard Errors in parentheses. ***p < 0.001, **p < 0.01, *p < 0.05.

Figure 1. Predicted probabilities of reporting suicide ideation and suicide attempt, by number of family rejection experiences. Covariates not shown are set to their means.

Data Availability Statement

The data used in this article is restricted and archived at ICPSR. James, SE, Herman, J, Keisling, M, Mottet, L, and Anafi, M. (2019). U.S. Transgender

Survey. Inter-university Consortium for Political and Social Research [distributor]. https://doi.org/10.3886/ICPSR37229.v1.