The prevalence of suicide attempts among respondents to the National Transgender Discrimination Survey (NTDS), conducted by the National Gay and Lesbian Task Force and National Center for Transgender Equality, is 41 percent, which vastly exceeds the 4.6 percent of the overall U.S. population who report a lifetime suicide attempt, and is also higher than the 10-20 percent of lesbian, gay and bisexual adults who report ever attempting suicide. Much remains to be learned about underlying factors and which groups within the diverse population of transgender and gender non-conforming people are most at risk. In the present study, we sought to increase understanding of suicidal behavior among transgender and gender non-conforming people through an in-depth analysis of NTDS data. The specific aims of our analysis were to identify the key characteristics and experiences associated with lifetime suicide attempts in the NTDS sample as a whole, and to examine how lifetime suicide attempts vary among different groups of transgender and gender non-conforming people. Key findings of this report include the following: • Suicide attempts among trans men (46%) and trans women (42%) were slightly higher than the full sample (41%). Cross-dressers assigned male at birth have the lowest reported prevalence of suicide attempts among gender identity groups (21%). • Analysis of other demographic variables found prevalence of suicide attempts was highest among those who are younger (18 to 24: 45%), multiracial (54%) and American Indian or Alaska Native (56%), have lower levels of educational attainment (high school or less: 48-49%), and have lower annual household income (less than $10,000: 54%). • Prevalence of suicide attempts is elevated among those who disclose to everyone that they are transgender or gender-non-conforming (50%) and among those that report others can tell always (42%) or most of the time (45%) that they are transgender or gender non-conforming even if they don’t tell them. • Respondents who are HIV-positive (51%) and respondents with disabilities (55-65%) also have elevated prevalence of suicide attempts. In particular, 65 percent of those with a mental health condition that substantially affects a major life activity reported attempting suicide.
• Respondents who experienced rejection by family and friends, discrimination, victimization, or violence had elevated prevalence of suicide attempts, such as those who experienced the following: — Family chose not to speak/spend time with them: 57% — Discrimination, victimization, or violence at school, at work, and when accessing health care • Harassed or bullied at school (any level): 50-54% • Experienced discrimination or harassment at work: 50-59% • Doctor or health care provider refused to treat them: 60% • Suffered physical or sexual violence: — At work: 64-65% — At school (any level): 63-78% — Discrimination, victimization, or violence by law enforcement • Disrespected or harassed by law enforcement officers: 57-61% • Suffered physical or sexual violence: By law enforcement officers: 60-70 — Experienced homelessness: 69% Overall, the most striking finding of our analysis was the exceptionally high prevalence of lifetime suicide attempts reported by NTDS respondents across all demographics and experiences. Based on prior research and the findings of this report, we find that mental health factors and experiences of harassment, discrimination, violence and rejection may interact to produce a marked vulnerability to suicidal behavior in transgender and gender non-conforming individuals. More research on suicidal behavior among transgender and gender non-conforming people is needed. EXECUTIVE SUMMARY “Overall, the most striking finding of our analysis was the exceptionally high prevalence of lifetime suicide attempts reported by NTDS respondents across all demographics and experiences.”