Differences in Methods of Suicide Death Among Transgender and Nontransgender Patients in the Veterans Health Administration, 1999–2016
Autor: | John R. Blosnich, Taylor L Boyer, Michael R. Kauth, Jillian C. Shipherd, George R. Brown |
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Rok vydání: | 2021 |
Předmět: |
Adult
Male Research design Ethnic group Veterans Health Disease Transgender Persons National Death Index 03 medical and health sciences 0302 clinical medicine Cause of Death Transgender Electronic Health Records Humans Medicine 030212 general & internal medicine Heterosexuality Depression (differential diagnoses) Aged Proportional hazards model business.industry 030503 health policy & services Public Health Environmental and Occupational Health Middle Aged United States Suicide United States Department of Veterans Affairs Marital status Female 0305 other medical science business Demography |
Zdroj: | Medical Care. 59:S31-S35 |
ISSN: | 0025-7079 |
Popis: | Background Limited research suggests that rates of suicide death among transgender people may be higher than their nontransgender peers. Objective The objective of this study was to compare rates of suicide deaths by different means between transgender and nontransgender patients. Research design This secondary analysis used VHA administrative and electronic health record (EHR) data from October 1, 1999 through December 31, 2016. Subjects Transgender patients (n=8981) were categorized as such based on a set of International Classification of Disease codes, and a comparison sample was selected by randomly choosing 3 nontransgender patients (n=26,924). Measures and analyses Cause and date of death data are from the National Death Index. Because of low frequencies amid different methods of suicide death, we combined categories into self-poisoning; hanging, strangulation and suffocation; discharge of firearms; and self-harm by all other and unspecified means. We conducted Cox regression analyses to model time-to-event for each method of suicide, adjusted for age, sex based on EHR, race, ethnicity, marital status, and whether patients had ever been diagnosed with depression. Results Among transgender patients, 73 died by suicide (22 female EHR-based sex, 51 male EHR-based sex), and among nontransgender patients, 71 died by suicide (4 female EHR-based sex, 67 male EHR-based sex). In adjusted models, transgender patients had significantly greater hazards of death by self-poisoning and firearms than their nontransgender peers. Conclusions Differences in methods of suicide death suggest that firearms and self-poisoning may be specific areas of concern for transgender individuals experiencing suicidal crisis, which underscore needs for examining effective delivery of evidence-based care. |
Databáze: | OpenAIRE |
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