Sexual Violence, Suicide Risk, and Mental Health Among Gender Diverse Young Adults: A Qualitative Study

Background: Gender diverse adolescents and young adults (AYA) experience disproportionately high rates of sexual violence victimization (SVV), suicidal thoughts and behaviors (STBs), and adverse mental health outcomes. Limited qualitative research has explored how acute SVV influences mental health and STBs among this population. Aims: This study aimed to explore how acute SVV influences STBs and mental health among gender diverse AYAs. Methods: This qualitative study was conducted from June to July 2025. Seventeen gender diverse young adults aged 21 to 24 years participated in semi-structured interviews exploring experiences of sexual violence, STBs, coping strategies, minority stress, support systems, and mental health outcomes. Interviews were analyzed using thematic analysis with constant comparison. Two reviewers achieved substantial interrater reliability (κ = .808). Results: Five themes captured the impact of sexual violence on identity, mental health, and relationships. Participants described erosion of self-worth, internalized stigma, and loss of trust following sexual violence. Psychological outcomes included depression, anxiety, posttraumatic stress disorder symptomatology, and STBs, often intensified by discrimination, racism, and transphobia. Interpersonal effects included fear of intimacy and social withdrawal. Disclosure and help-seeking were shaped by distrust; however, supportive confidants and online communities facilitated emotional validation. Participants described a range of coping strategies, from avoidance and substance use to creative and goal-directed activities. Conclusion: Acute SVV is associated with substantial impacts on psychological functioning and suicide risk among gender-diverse AYA. Trauma-informed, person-centered interventions are needed to support adaptive coping and improve mental health outcomes.