Understanding Factors Associated with Suicidality Among Transgender and Gender-Diverse Identified Youth.

Purpose: Individuals who identify as transgender and gender-diverse (TGD) experience heightened rates of mental health challenges compared with cisgender people (including both heterosexual and lesbian, gay, and bisexual individuals). Furthermore, adolescence has been identified as a critical period for intervention as the majority of suicide attempts occur during this time period. However, no study to date has synthesized prior literature to understand the correlates of suicidal behavior among TGD youth, which is an essential step needed to inform intervention development and reduce suicidal behaviors in this community. Methods: Three databases were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method to assess eligibility for study inclusion. Five studies met full inclusion criteria. Results: Analyses revealed a consistent relationship across studies between suicidal behaviors and symptoms of depression, gender-based victimization, and bullying, and lack of parental support. Conclusions: Consistent with minority stress theory, this systematic review demonstrates that identification as TGD is associated with increased environmental stressors, highlighting the importance of considering both individual and contextual factors in the development of mental health interventions for TGD youth. Given the significance of findings related to the association between both depression and gender-based victimization and suicidal behavior, it is critical to advocate for the destigmatization of noncisgender identities through policy-level change.