Current and Military-Specific Gender Minority Stress Factors and Their Relationship with Suicide Ideation in Transgender Veterans

Raymond P. Tucker, Louisiana State University, Baton Rouge, LA.
Rylan J. Testa, Rhodes College, Memphis, TN, USA.
Mark A. Reger, VA Puget Sound Health Care System, Seattle, WA.
Tracy L. Simpson, VA Puget Sound Health Care System, Seattle, WA.
Jillian C. Shipherd, Department of Veterans Affairs, National Center for PTSD, VA Boston Healthcare System, Boston University, Boston, MA, USA.
Keren Lehavot, VA Puget Sound Health Care System, Seattle, WA.

Abstract

Research suggests the prevalence of suicide ideation and suicide attempts in the transgender veteran community may be upwards of 20 times higher than nontransgender veterans, who are known to be at increased risk than the general US population. This study aimed to understand the potential influence of external and internal minority stress experienced during and after military service on past-year and recent suicide ideation in a sample of 201 transgender veterans. Nonparametric bootstrapping analyses indicated past-year transgender-specific discrimination and rejection (external minority stress) indirectly predicted frequency of both past-year and past 2-week suicide ideation through past-year shame related to gender identity (internal minority stress). This result was significant when controlling for symptoms of depression and demographics. Similar patterns emerged when examining relationships among military external and internal minority stress on suicide outcomes. These results suggest that attempts to reduce both the experience and impact of minority stressors related to gender identity during and after military service may be an important avenue for suicide prevention.