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Published Online: 25 May 2016

Family Rejection as a Predictor of Suicide Attempts and Substance Misuse Among Transgender and Gender Nonconforming Adults

Publication: LGBT Health
Volume 3, Issue Number 3


Purpose: We examined associations between family rejection and risk of suicide attempts and substance misuse among a national sample of transgender and gender nonconforming adults.
Methods: Data were drawn from the National Transgender Discrimination Survey (N = 6456). This secondary analysis was restricted to 3458 individuals who self-identified as transgender or gender nonconforming and provided complete data on study variables. We used multivariable logistic regression to examine health risks by level of reported family rejection (low/moderate/high), controlling for relevant sociodemographic characteristics.
Results: Overall, 42.3% of the sample reported a suicide attempt and 26.3% reported misusing drugs or alcohol to cope with transgender-related discrimination. After controlling for age, race/ethnicity, sex assigned at birth, binary gender identity, income, education, and employment status, family rejection was associated with increased odds of both behaviors. Odds increased significantly with increasing levels of family rejection.
Conclusions: Family rejection related to gender identity is an understudied interpersonal stressor that may negatively affect health outcomes for transgender and gender nonconforming individuals. A better understanding of the role of close relationships in both risk and resilience for transgender individuals is critical in the development of effective public health interventions for this community.

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Published In

cover image LGBT Health
LGBT Health
Volume 3Issue Number 3June 2016
Pages: 193 - 199
PubMed: 27046450


Published in print: June 2016
Published online: 25 May 2016
Published ahead of print: 5 April 2016


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Augustus Klein
Department of Social Welfare, The Graduate Center of the City University of New York (CUNY), New York, New York.
Sarit A. Golub
Basic and Applied Social Psychology PhD Program, The Graduate Center of the City University of New York (CUNY), New York, New York.
Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York.


Address correspondence to:Augustus Klein, MSWDepartment of Social WelfareThe Graduate Center of the City University of New York (CUNY)365 5th AvenueNew York, NY 10016E-mail: [email protected]

Author Disclosure Statement

No competing financial interests exist.

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