TY - JOUR PY - 2021// TI - Differences in methods of suicide death among transgender and nontransgender patients in the Veterans Health Administration, 1999-2016 JO - Medical care A1 - Shipherd, Jillian C. A1 - Kauth, Michael R. A1 - Brown, George R. A1 - Boyer, Taylor L. A1 - Blosnich, John R. SP - S31 EP - S35 VL - 59 IS - N2 - BACKGROUND: Limited research suggests that rates of suicide death among transgender people may be higher than their nontransgender peers.

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.

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.

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.

Language: en

LA - en SN - 0025-7079 UR - http://dx.doi.org/10.1097/MLR.0000000000001384 ID - ref1 ER -