Negotiating Multiple Minoritised Identities: An Interpretative Phenomenological Analysis of Intersecting Sexual Orientation, Gender Identity, and Suicidal Thoughts and Behaviours Among Transgender and Gender-Diverse Young Adults

Transgender and gender-diverse young adults, most of whom identify as lesbian, gay, bisexual, or queer, encounter considerable health, social, and systemic inequalities, leading to higher rates of trauma exposure, mental health difficulties, and suicidal thoughts and behaviours compared to their heterosexual and cisgender peers. The complex relationship between sexual orientation, gender identity, and suicide has received considerable attention, primarily from quantitative research focused on risk narratives, rather than an individual’s lived experiences or specific healthcare needs. The aim was to explore the lived experiences of transgender and gender-diverse young adults, highlighting the impact of navigating multiple minoritised identities, exposure to trauma, victimisation, unmet healthcare needs, suicidal distress, and barriers and facilitators to accessing mental health services and gender-affirming care. Six young adults from Northern Ireland (UK) were recruited via social media and participated in semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and analysed using Interpretative Phenomenological Analysis (IPA), following a process of coding, theme development, and interpretative synthesis. Five group experiential themes were identified: (1) Delicate peace, delicate progress; (2) Queer suffering, safety and otherness; (3) Queerness shaping ones’ worldview; (4) Unresolved trauma, and unmet healthcare needs; (5) Suicidal distress, and recovery. The findings elucidated two central narratives; the psychosocial impact of negotiating multiple minoritised identities in a heteronormative and cisnormative society and navigating suicidal distress by regaining a sense of control over your life. The findings provide valuable insights into the unique lived experiences, and specific healthcare needs of this population. Clinical implications are discussed, including the importance of trauma-informed care, cultural competence among healthcare practitioners, and tailored suicide prevention strategies for LGBTQ+ youth.