Research Article
No access
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

Abstract

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.

Get full access to this article

View all available purchase options and get full access to this article.

References

1.
Reisner SL, Bailey Z, Sevelius J: Racial/ethnic disparities in history of incarceration, experiences of victimization, and associated health indicators among transgender women in the U.S. Women Health 2014;54:750–767.
2.
Khan L: Transgender health at the crossroads: Legal norms, insurance markets, and the threat of healthcare reform. Yale J Health Policy Law Ethics 2011;11:375–418.
3.
Lombardi EL, Wilchins RA, Priesing D, Malouf D: Gender violence. J Homosex 2001;42:89–101.
4.
Testa RJ, Sciacca LM, Wang F, et al.: Effects of violence on transgender people. Prof Psychol Res Pr 2012;43:452–459.
5.
Nemoto T, Bödeker B, Iwamoto M: Social support, exposure to violence and transphobia, and correlates of depression among male-to-female transgender women with a history of sex work. Am J Public Health 2011;101:1980–1988.
6.
Grant J, Mottet L, Tanis J: Injustice at Every Turn. A Report of the National Transgender Discrimination Survey. Washington, DC, The National Center for Transgender Equality, 2011.
7.
Haas AP, Rodgers PL, Herman JL: Suicide Attempts Among Transgender and Gender Non-Conforming Adults. Los Angeles, CA, The Williams Institute, 2014.
8.
Goldblum P, Testa RJ, Pflum S, et al.: The relationship between gender-based victimization and suicide attempts in transgender people. Prof Psychol Res Pr 2012;43:468–475.
9.
Jefferson K, Neilands TB, Sevelius J: Transgender women of color: Discrimination and depression symptoms. Ethn Inequal Health Soc Care 2013;6:121–136.
10.
Baral SD, Poteat T, Strömdahl S, et al.: Worldwide burden of HIV in transgender women: A systematic review and meta-analysis. Lancet Infect Dis 2013;13:214–222.
11.
Herbst JH, Jacobs ED, Finlayson TJ, et al.: Estimating HIV prevalence and risk behaviors of transgender persons in the United States: A systematic review. AIDS Behav 2008;12:1–17.
12.
Reisner SL, Gamarel KE, Nemoto T, Operario D: Dyadic effects of gender minority stressors in substance use behaviors among transgender women and their non-transgender male partners. Psychol Sex Orientat Gend Divers 2014;1:63–71.
13.
Clements-Nolle K, Marx R, Guzman R, Katz M: HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: Implications for public health intervention. Am J Public Health 2001;91:915–921.
14.
Clements-Nolle K, Marx R, Katz M: Attempted suicide among transgender persons. J Homosex 2006;51:53–69.
15.
Benotsch EG, Zimmerman R, Cathers L, et al.: Non-medical use of prescription drugs, polysubstance use, and mental health in transgender adults. Drug Alcohol Depend 2013;132:391–394.
16.
Bauer GR, Hammond R, Travers R, et al.: “I don't think this is theoretical; this is our lives”: How erasure impacts health care for transgender people. J Assoc Nurses AIDS Care 2009;20:348–361.
17.
Bradford J, Reisner SL, Honnold JA, Xavier J: Experiences of transgender-related discrimination and implications for health: Results from the Virginia transgender health initiative study. Am J Public Health 2013;103:1820–1829.
18.
Lombardi E: Public health and trans-people: Barriers to care and strategies to improve treatment. In: The Health of Sexual Minorities: Public Health Perspectives on Lesbian, Gay, Bisexual, and Transgender Populations. Edited by Meyer IH and Northridge ME. New York: Springer Press, 2007, pp 638–652.
19.
Escudero DJ, Kerr T, Operario D, et al.: Inclusion of trans women in pre-exposure prophylaxis trials: A review. AIDS Care 2015;27:637–641.
20.
Lombardi EL: Integration within a transgender social network and its effect upon members' social and political activity. J Homosex 1999;37:109–126.
21.
Graham LF, Crissman HP, Tocco J, et al.: Interpersonal relationships and social support in transitioning narratives of black transgender women in Detroit. Int J Transgend 2014;15:100–113.
22.
Xavier J, Bobbin M, Singer B, Budd E: A needs assessment of transgendered people of color living in Washington, DC. Int J Transgend 2008;8:31–47.
23.
Operario D, Yang MF, Reisner SL, et al.: Stigma and the syndemic of HIV-related health risk behaviors in a diverse sample of transgender women. J Community Psychol 2014;42:544–557.
24.
Mossakowski KN, Zhang W: Does social support buffer the stress of discrimination and reduce psychological distress among Asian Americans? Soc Psychol Q 2014;77:273–295.
25.
Pearlin LI, Menaghan EG, Lieberman M, Mullan JT: Process the stress. J Health Soc Behav 2011;22:337–356.
26.
Hughes M, Kiecolt KJ, Keith VM, Demo DH: Racial identity and well-being among African Americans. Soc Psychol Q 2015;78:25–48.
27.
Thoits PA: Mechanisms linking social ties and support to physical and mental health. J Health Soc Behav 2011;52:145–161.
28.
Factor RJ, Rothblum ED: A study of transgender adults and their non-transgender siblings on demographic characteristics, social support, and experiences of violence. J LGBT Health Res 2007;3:11–30.
29.
Koken JA, Bimbi DS, Parsons JT: Experiences of familial acceptance-rejection among transwomen of color. J Fam Psychol 2009;23:853–860.
30.
Cohen S, Wills TA: Stress, social support, and the buffering hypothesis. Psychol Bull 1985;98:310–357.
31.
Lauby JL, Marks G, Bingham T, et al.: Having supportive social relationships is associated with reduced risk of unrecognized HIV infection among black and Latino men who have sex with men. AIDS Behav 2012;16:508–515.
32.
House JS, Landis KR, Umberson D: Social relationships and health. Science 1988;241:540–545.
33.
Uchino BN, Cacioppo JT, Kiecolt-Glaser JK: The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychol Bull 1996;119:488–531.
34.
Ryan C, Huebner D, Diaz RM, Sanchez J: Family rejection as a predictor of negative health outcomes in White and Latino lesbian, gay, and bisexual young adults. Pediatrics 2009;123:346–352.
35.
Ryan C, Russell ST, Huebner D, et al.: Family acceptance in adolescence and the health of LGBT young adults. J Child Adolesc Psychiatr Nurs 2010;23:205–213.
36.
Bariola E, Lyons A, Leonard W, et al.: Demographic and psychosocial factors associated with psychological distress and resilience among transgender individuals. Am J Public Health 2015;105:2108–2116.
37.
Simons L, Schrager SM, Clark LF, et al.: Parental support and mental health among transgender adolescents. J Adolesc Health 2013;53:791–794.
38.
Tabachnick B, Fidell LS: Using Multivariate Statistics, 6th ed. Boston, MA: Pearson, 2013.
39.
Needham BL, Austin EL: Sexual orientation, parental support, and health during the transition to young adulthood. J Youth Adolesc 2010;39:1189–1198.
40.
Feinstein BA, Wadsworth LP, Davila J, Goldfried MR: Do parental acceptance and family support moderate associations between dimensions of minority stress and depressive symptoms among lesbians and gay men? Prof Psychol Res Pr 2014;45:239–246.
41.
Moak ZB, Agrawal A: The association between perceived interpersonal social support and physical and mental health: Results from the national epidemiological survey on alcohol and related conditions. J Public Health (Oxf) 2010;32:191–201.
42.
Watt RG, Heilmann A, Sabbah W, et al.: Social relationships and health related behaviors among older US adults. BMC Public Health 2014;14:533–544.

Information & Authors

Information

Published In

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

History

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

Permissions

Request permissions for this article.

Topics

Authors

Affiliations

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.

Notes

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.

Metrics & Citations

Metrics

Citations

Export citation

Select the format you want to export the citations of this publication.

View Options

Get Access

Access content

To read the fulltext, please use one of the options below to sign in or purchase access.

Society Access

If you are a member of a society that has access to this content please log in via your society website and then return to this publication.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF/EPUB

View PDF/ePub

Full Text

View Full Text

Media

Figures

Other

Tables

Share

Share

Copy the content Link

Share on social media

Back to Top