Symposia
Suicide and Self-Injury
Sarah E. Victor, Ph.D.
Assistant Professor
Texas Tech University
Lubbock, Texas
Transgender and non-binary (TNB) people report high rates of self-injurious thoughts and behaviors (SITB), which may be driven by gender minority stressors. Prior research has been limited, however, by use of retrospective methods and little consideration of gender minority resilience. Here we describe data from TNB adults with recent SITB who completed a 3-week ecological momentary assessment protocol (EMA, N = 48). Participants were on average 28 years old, held non-binary gender identities (56%), and were non-Hispanic white (69%). EMA compliance was high (M = 72%), as was endorsement of SITB, with 96% reporting suicidal ideation, 94% reporting NSSI urges, and 56% reporting NSSI behaviors. We examined whether baseline external and internal minority stressors, as well as minority resilience, would predict a) proportion of EMA surveys with suicidal ideation, b) proportion of EMA surveys with NSSI urges, and c) engagement in NSSI during EMA. Then, we examined whether EMA-reported internal or external minority stressors, or EMA-reported minority resilience, would predict the same EMA SITB outcomes.
Some baseline minority stressors predicted EMA SITB (discrimination, victimization, negative expectations, non-disclosure), while others showed no association (rejection, non-affirmation, internalized transphobia). Both EMA-reported internal and external minority stressors predicted more frequent NSSI urges, and internal minority stressors also predicted suicidal ideation. Baseline gender resilience factors (identity pride, community connection) did not predict EMA SITB, but EMA-reported resilience was strongly negatively associated with NSSI urge and suicidal ideation frequency. Of note, no baseline or EMA-reported predictors differentiated participants with and without NSSI behaviors.
These results have implications for real-time interventions to prevent SITB among TNB adults, for instance, via strategies to increase gender resilience. Findings also highlight the need for further nuanced examinations of unique experiences within broad categories of internal and external gender minority stressors, to elucidate specific pathways to SITB prevention for this population.