Psychosocial mediators of perceived stigma and suicidal ideation among transgender women

Kota, K.K., Salazar, L.F., Culbreth, R.E. et al. Psychosocial mediators of perceived stigma and suicidal ideation among transgender women. BMC Public Health 20125 (2020). https://doi.org/10.1186/s12889-020-8177-z

Abstract

Background

Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation.

Methods

Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact of gender minority status, and substance use behaviors as potential mediators for the relationship between perceived stigma and suicidal ideation. All models were controlled for age, race, education, and homelessness.

Results

Suicidal ideation was reported by 33% (N = 30) of the study participants. In multivariable analysis, suicidal ideation was associated with sexual abuse (AOR = 3.17, 95% CI = 1.10–9.30), anxiety (AOR = 1.74, 95% CI = 1.10–2.73), family verbal abuse (AOR = 2.99, 95% CI = 1.10–8.40), stranger verbal abuse (AOR = 3.21, 95% CI = 1.02–10.08), and psychosocial impact of gender minority status (AOR = 3.42, 95% CI = 1.81–6.46). Partner support was found to be the protective factor for suicidal ideation (AOR = 0.34, 95% CI = 0.13–0.90). In the mediation analysis, the psychosocial impact of gender minority status mediated the relationship between perceived stigma and suicidal ideation. The estimated conditional indirect effect was 0.46, (95% CI = 0.12–1.11).

Conclusion

Interventions that aim to reduce suicidal behaviors among TGW should address stigma, psychosocial imfamilpact of gender minority status, and different forms of violence and abuse.

Sexual minority women face barriers to health care

The Conversation, October 23, 2019 9.25pm AEDT

Stigma and discrimination are common experiences that people who identify as LGBT or sexual minority face when accessing health services. One report found that one in seven LGBT people in the UK avoided seeking healthcare for fear of discrimination from staff. As many as one in four also experienced negative remarks against LGBT people from healthcare staff.

 

Transgender women taking PrEP have lower levels of PrEP drugs than cisgender men

aidsmap/nam, November 9th 2018

A study presented at October’s HIV Research for Prevention conference (HIVR4P) in Madrid shows that transgender women who are taking feminising hormones and also taking pre-exposure prophylaxis (PrEP) have levels of the PrEP drugs tenofovir and emtricitabine in their blood that are about 25% lower than those in cisgender men, and levels in rectal tissue cells about 40% lower. Tenofovir levels in rectal tissue were 44% lower.

However, the study also confirmed that the interaction between hormones and PrEP did not appear to go the other way; blood levels of estradiol, the one hormone all of the transgender women took in one form or another, do not appear to be affected by PrEP.