@article{ref1,
title="Differences in methods of suicide death among transgender and nontransgender patients in the Veterans Health Administration, 1999-2016",
journal="Medical care",
year="2021",
author="Shipherd, Jillian C. and Kauth, Michael R. and Brown, George R. and Boyer, Taylor L. and Blosnich, John R.",
volume="59",
number="",
pages="S31-S35",
abstract="BACKGROUND: Limited research suggests that rates of suicide death among transgender people may be higher than their nontransgender peers. <br><br>OBJECTIVE: The objective of  this study was to compare rates of suicide deaths by different means between  transgender and nontransgender patients. RESEARCH DESIGN: This secondary analysis  used VHA administrative and electronic health record (EHR) data from October 1, 1999  through December 31, 2016. SUBJECTS: Transgender patients (n=8981) were categorized  as such based on a set of International Classification of Disease codes, and a  comparison sample was selected by randomly choosing 3 nontransgender patients  (n=26,924). MEASURES AND ANALYSES: Cause and date of death data are from the  National Death Index. Because of low frequencies amid different methods of suicide  death, we combined categories into self-poisoning; hanging, strangulation and  suffocation; discharge of firearms; and self-harm by all other and unspecified  means. We conducted Cox regression analyses to model time-to-event for each method  of suicide, adjusted for age, sex based on EHR, race, ethnicity, marital status, and  whether patients had ever been diagnosed with depression. <br><br>RESULTS: Among transgender  patients, 73 died by suicide (22 female EHR-based sex, 51 male EHR-based sex), and  among nontransgender patients, 71 died by suicide (4 female EHR-based sex, 67 male  EHR-based sex). In adjusted models, transgender patients had significantly greater  hazards of death by self-poisoning and firearms than their nontransgender peers. <br><br>CONCLUSIONS: Differences in methods of suicide death suggest that firearms and  self-poisoning may be specific areas of concern for transgender individuals  experiencing suicidal crisis, which underscore needs for examining effective  delivery of evidence-based care.<p /> <p>Language: en</p>",
language="en",
issn="0025-7079",
doi="10.1097/MLR.0000000000001384",
url="http://dx.doi.org/10.1097/MLR.0000000000001384"
}