Intersectional analysis of suicide risk among transgender and non-binary people

Transgender and non-binary (TNB) people experience high rates of suicidal thoughts and behaviors, but less is known about how suicide risk varies within TNB communities. We investigated variation in suicidality among TNB people across intersecting social identities and positions. This study uses data from Trans PULSE Canada, a 2019 community-based survey of TNB people aged 14+ in Canada. Among 2054 participants aged 16+, conditional inference trees (CTREE) were used to identify subgroups with varying levels of past-year suicidal ideation and suicide attempts. Twelve predictor variables were chosen through literature review and community knowledge based on their relevance to suicide risk. Findings show that over the past year, 30.2 % of participants reported suicidal ideation and 4.2 % reported a suicide attempt. Six subgroups with varying levels of past-year suicidal ideation were identified, with a higher prevalence of ideation among those with lower educational attainment (particularly youth aged 16–24; 49.4 %) and among college-educated participants who identified as disabled (38.3 %). The CTREE for past-year suicide attempts identified variation across three subgroups: participants aged 16–19 (11.0 % attempted), and those aged 20+ with or without a history of sex work (8.4 % and 2.5 %, respectively). In conclusion, past-year suicidal ideation and attempts were high compared to general population estimates, although somewhat lower than in previous Canadian TNB studies. Suicide attempts were concentrated among those aged 16–19, and amongst those 20+ with a history of sex work. Suicide prevention research should investigate individual and structural level interventions to reduce disproportionate suicide risk among these groups.