Factors Associated with Suicidal Ideation and Suicide Attempt in Brazilian Transgender Youth.

The rates of suicidal ideation and suicide attempts among transgender youths are high. However, in Brazil, there are no studies about these outcomes in this population. The present study aims to investigate the prevalence of suicidal ideation and suicide attempts in Brazilian transgender youths (binary and non-binary), in association with predictor variables, following the Minority Stress Theory. The predictor variables analyzed were depressive symptoms, discrimination, gender distress, deprivation, social support, and gender identity support from parents and friends. Participants were recruited through an online survey. The final sample consisted of 213 participants, aged 13 to 25 years old. Two equal regression analyses were performed, one for each outcome. Out of the total, 103 (48.6%) identified as transgender boys, 44 (20.8%) as transgender girls, and 65 (30.7%) as non-binary. The mean age was 18.53 years (SD 2.50). The study found that 57.6% of the sample had depressive symptoms, 72.3% experienced suicidal ideation, and 42.7% had attempted suicide. In the final model, the variables that were associated with suicidal ideation were deprivation, gender distress, and depressive symptoms. As for suicide attempts, the variables deprivation and depressive symptoms were correlated. Further studies on this population should be conducted to analyze protective factors for these outcomes.

Impact of minority stress in depressive symptoms, suicide ideation and suicide attempt in trans persons / Impacto do estresse de minoria em sintomas depressivos, ideação suicida e tentativa de suicídio em pessoas trans.

Minority stress comprehends the relationship between prejudice (perceived, anticipated and internalized) and mental health in people belonging to minority groups, as well as protective factors for stressors. This study evaluated the prevalence of depressive symptoms, suicidal ideation and attempted suicide in Brazilian trans people, and it`s relationship with minority stress, passability, social support and trans identity support. 378 people participated through a questionnaire answered online and in the hospital services they attended. Of these, 67.20% had depressive symptoms, 67.72% suicidal ideation and 43.12% attempted suicide. Three Poisson regression analyzes were performed in two steps, according to the outcomes. In the three outcomes there was a positive association with internalized prejudice and a negative association with social support, which were the only associations in the suicide attempt. Depressive symptoms and suicidal ideation were also positively associated with anticipated prejudice and negatively passability and support for trans identity. The vulnerability of transgender people to negative mental health outcomes and the importance of addressing prejudice on an individual and social level, as well as promoting social support and transgender identity support are perceived.

O estresse de minoria aborda a relação entre preconceito (percebido, antecipado e internalizado) e saúde mental em pessoas pertencentes a grupos minoritários, assim como fatores de proteção aos estressores. Este trabalho avaliou a prevalência de sintomas depressivos, ideação suicida e tentativa de suicídio em pessoas trans brasileiras, e sua relação com estresse de minoria, passabilidade, apoio social e apoio à identidade trans. Participaram 378 pessoas, por meio de questionário respondidos on-line e nos serviços hospitalares a que frequentavam. Desses, 67,20% apresentaram sintomas depressivos, 67,72% ideação suicida e 43,12% tentativa de suicídio. Foram realizadas três análises de regressão de Poisson, em dois passos, conforme os desfechos. Nos três desfechos houve associação positiva com o preconceito internalizado e negativa com o apoio social, sendo essas as únicas associações na tentativa de suicídio. Nos sintomas depressivos e na ideação suicida, também se associou positivamente o preconceito antecipado e negativamente a passabilidade e o apoio à identidade trans. Percebe-se a vulnerabilidade das pessoas trans para os desfechos negativos de saúde mental e a importância de enfrentar o preconceito em nível individual e social, assim como promover o apoio social e à identidade trans.

Impacto do estresse de minoria em sintomas depressivos, ideação suicida e tentativa de suicídio em pessoas trans / Impact of minority stress in depressive symptoms, suicide idea and try suicide in trans

Resumo O estresse de minoria aborda a relação entre preconceito (percebido, antecipado e internalizado) e saúde mental em pessoas pertencentes a grupos minoritários, assim como fatores de proteção aos estressores. Este trabalho avaliou a prevalência de sintomas depressivos, ideação suicida e tentativa de suicídio em pessoas trans brasileiras, e sua relação com estresse de minoria, passabilidade, apoio social e apoio à identidade trans. Participaram 378 pessoas, por meio de questionário respondidos on-line e nos serviços hospitalares a que frequentavam. Desses, 67,20% apresentaram sintomas depressivos, 67,72% ideação suicida e 43,12% tentativa de suicídio. Foram realizadas três análises de regressão de Poisson, em dois passos, conforme os desfechos. Nos três desfechos houve associação positiva com o preconceito internalizado e negativa com o apoio social, sendo essas as únicas associações na tentativa de suicídio. Nos sintomas depressivos e na ideação suicida, também se associou positivamente o preconceito antecipado e negativamente a passabilidade e o apoio à identidade trans. Percebe-se a vulnerabilidade das pessoas trans para os desfechos negativos de saúde mental e a importância de enfrentar o preconceito em nível individual e social, assim como promover o apoio social e à identidade trans.

Abstract Minority stress comprehends the relationship between prejudice (perceived, anticipated and internalized) and mental health in people belonging to minority groups, as well as protective factors for stressors. This study evaluated the prevalence of depressive symptoms, suicidal ideation and attempted suicide in Brazilian trans people, and it`s relationship with minority stress, passability, social support and trans identity support. 378 people participated through a questionnaire answered online and in the hospital services they attended. Of these, 67.20% had depressive symptoms, 67.72% suicidal ideation and 43.12% attempted suicide. Three Poisson regression analyzes were performed in two steps, according to the outcomes. In the three outcomes there was a positive association with internalized prejudice and a negative association with social support, which were the only associations in the suicide attempt. Depressive symptoms and suicidal ideation were also positively associated with anticipated prejudice and negatively passability and support for trans identity. The vulnerability of transgender people to negative mental health outcomes and the importance of addressing prejudice on an individual and social level, as well as promoting social support and transgender identity support are perceived.

Corrigendum: Descriptive Study of Transgender Youth Receiving Health Care in the Gender Identity Program in Southern Brazil.

[This corrects the article DOI: 10.3389/fpsyt.2021.627661.].

Descriptive Study of Transgender Youth Receiving Health Care in the Gender Identity Program in Southern Brazil.

Since 2014, the Gender Identity Program (PROTIG) of Hospital de Clínicas de Porto Alegre (HCPA) has been assisting transgender youth seeking gender-affirmative treatment offered at a public health-care service specializing in gender in southern Brazil. This article aims to analyze sociodemographic and clinical data regarding the diagnoses of gender dysphoria and gender incongruence, psychiatric comorbidities, and clinical aspects of a sample of transgender youths seeking health care in the gender identity program. The research protocol consisted of a survey of the data collected in the global psychological evaluation performed at the health-care service for youths diagnosed with gender incongruence and their caretakers. Participating in this research were 24 transgender youths between 8 and 16 years old with diagnostic overlap of gender dysphoria [Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)] and gender incongruence [International Classification of Diseases, 11th Revision (ICD-11)] and 34 of their caregivers. Of the young people, 45.8% were positive for some psychiatric comorbidity throughout their lives, with almost half (45.4%) having two or more psychiatric comorbidities in addition to gender dysphoria. The mental health professionals comprising affirmation care teams face the challenge of adapting the care protocols to the uniqueness of each demand by developing individualized forms to promote healthy development. This can be done by focusing not only on medical and physical interventions for gender affirmation but also on the promotion of mental health and general emotional well-being. Thus, the gender affirmation model, which advocates for global assessment and personalized guidance, proved to be adequate. Nevertheless, access to multidisciplinary health services specializing in gender is essential for promoting the general well-being of the population of transgender youth.

Gender Affirmation Is Associated with Transgender and Gender Nonbinary Youth Mental Health Improvement.

Purpose: The present study aimed to evaluate the impact of each domain of gender affirmation (social, legal, and medical/surgical) on the mental health of transgender and gender nonbinary youth. Methods: Three hundred fifty transgender boys, transgender girls, and gender nonbinary Brazilian youth, from 16 to 24 years old, answered an online survey. Results: The final sample consisted of 350 youth who participated in this study. A total of 149 (42.64%) youth identified as transgender boys, 85 (24.28%) identified as transgender girls, and 116 (33.14%) identified as gender nonbinary youth. The mean age was 18.61 (95% confidence interval 18.34-18.88) years. Having accessed multiple steps of gender affirmation (social, legal, and medical/surgical) was associated with fewer symptoms of depression and less anxiety. Furthermore, engaging in gender affirmation processes helped youth to develop a sense of pride and positivity about their gender identity and a feeling of being socially accepted. Conclusion: Enabling transgender and gender nonbinary youth to access gender affirmation processes more easily should be considered as a strategy to reduce depression and anxiety symptoms, as well as to improve gender positivity.

Use of the House-Tree-Person Projective Drawings and Parental Styles Inventory in the Global Psychological Evaluation of Transgender Youth Who Seek Healthcare at the Gender Identity Program.

The present study explores data collected in the psychological evaluation of transgender youth and their families who seek healthcare at the Gender Identity Program. Great psychosocial changes mark the transition from infancy to adulthood. Transgender youth may have these aspects of their developmental stage potentialized. A study was conducted with 23 transgender youth (mean age = 14 ± 2.38 years) and their caregivers. Eleven of the youngsters were assigned male at birth, while 12 were assigned female. The research protocol consisted of a survey and systematization of the data collected in the initial global psychological evaluation performed at the healthcare facility, including house-tree-person (HTP) projective drawings and the parental styles inventory. The present study aimed to explore the data collected during the psychological evaluation of youngsters diagnosed with gender incongruence, relating the HTP projective drawing technique to parental styles and gender trajectories. The results indicate two key points. One evidenced that parental styles could be either preventive or risk components in maintaining adequate socialization in these young people but not in affecting the level of gender dysphoria. The other was that coherence is introduced in the person's perception of his or her projected self-image and his or her expressed gender as he/she becomes more comfortable in expressing his/her gender identity. Treating youngsters inherently brings ethical issues to clinical practice. Thus, global psychological evaluation tailored to this population is a fundamental resource that the psychology professional can use in consultations with youngsters because this tool brings a global understanding about the natural development cycle, facilitating the formulation of therapeutic conducts and exchanges within interdisciplinary transgender health care teams.

Comportamento sexual de risco em jovens: aspectos cognitivos e emocionais / Sexual risk behavior in youngsters: cognitive and emotional aspects / Conducta sexual de riesgo en jóvenes: aspectos cognitivos y emocionales

O estudo avalia a contribuição dos construtos da Teoria do Comportamento Planejado e variáveis emocionais sobre a intenção de repetir o comportamento de manter relações sexuais sem preservativo entre jovens. Participaram 1.245 estudantes com idades entre 15 e 24 anos, de Canoas/RS. A prevalência do comportamento foi de 40% (500 jovens), os quais constituíram a amostra. Os instrumentos usados foram: questionário baseado na Teoria do Comportamento Planejado aplicada ao comportamento e sobre a intensidade de emoções básicas antes, durante e depois da realização. Os dados foram analisados através de regressão linear múltipla. No modelo final, o construto atitude se apresentou como o maior preditor da intenção (80%). As emoções de medo depois, alegria antes e culpa depois explicaram, conjuntamente, 12,5%. Os resultados indicam a influência dos aspectos emocionais na realização do comportamento e revelam a prioridade do componente atitudinal na predição da intenção de realizar relações sexuais sem preservativo entre jovens.(AU)

The study assesses the contribution of the Theory of Planned Behavior's constructs and emotional variables on the intention to repeat the behavior of maintain sexual intercourse without using condom among youngsters. Participated 1,245 students aged between 15 and 24 years, from Canoas/RS. The prevalence of the behavior was 40% (500 youngsters), which constituted the sample. The instruments were: questionnaire on the Theory of Planned Behavior applied to behavior and on the intensity of basic emotions before, during and after implementation. Data were analyzed using multiple linear regression. In the final model, the attitude presented itself as the greatest predictor of intention (80%). The emotions of fear after, joy before and guilt after, jointly, explained 12,5%. Results indicate the importance of emotional aspects in the behavior realization, but reveal the priority of the attitudinal component in the prediction of the intention to have sex without condom among youngsters.(AU)

El estudio evalúa la contribución de los constructos de la Teoría del Comportamiento Planificado y variables emocionales sobre la intención de repetir la conducta de mantener relaciones sexuales sin preservativo entre jóvenes. Participaron 1245 estudiantes con edad entre 15 y 24 años, de Canoas/RS. La prevalencia de la conducta fue de 40% (500 jóvenes), los cuales constituyeron la muestra. Los instrumentos fueron: cuestionario sobre la Teoría del Comportamiento Planificado aplicada a la conducta y sobre la intensidad de emociones básicas antes, durante y después de la realización. Los datos fueron analizados a través de regresión lineal múltiple. En el modelo final la actitud presentóse como el mayor predictor de la intención (80%). Las emociones de miedo después, alegría antes y culpa después explicaron conjuntamente el 12,5%. Los resultados indican la importancia de los aspectos emocionales en la realización de la conducta, pero revelan la prioridad del componente actitudinal en la predicción de la intención de mantener relaciones sexuales sin preservativo entre jóvenes.(AU)

Comportamento sexual de risco em jovens: aspectos cognitivos e emocionais / Sexual risk behavior in youngsters: cognitive and emotional aspects / Conducta sexual de riesgo en jóvenes: aspectos cognitivos y emocionales

O estudo avalia a contribuição dos construtos da Teoria do Comportamento Planejado e variáveis emocionais sobre a intenção de repetir o comportamento de manter relações sexuais sem preservativo entre jovens. Participaram 1.245 estudantes com idades entre 15 e 24 anos, de Canoas/RS. A prevalência do comportamento foi de 40% (500 jovens), os quais constituíram a amostra. Os instrumentos usados foram: questionário baseado na Teoria do Comportamento Planejado aplicada ao comportamento e sobre a intensidade de emoções básicas antes, durante e depois da realização. Os dados foram analisados através de regressão linear múltipla. No modelo final, o construto atitude se apresentou como o maior preditor da intenção (80%). As emoções de medo depois, alegria antes e culpa depois explicaram, conjuntamente, 12,5%. Os resultados indicam a influência dos aspectos emocionais na realização do comportamento e revelam a prioridade do componente atitudinal na predição da intenção de realizar relações sexuais sem preservativo entre jovens...

The study assesses the contribution of the Theory of Planned Behavior's constructs and emotional variables on the intention to repeat the behavior of maintain sexual intercourse without using condom among youngsters. Participated 1,245 students aged between 15 and 24 years, from Canoas/RS. The prevalence of the behavior was 40% (500 youngsters), which constituted the sample. The instruments were: questionnaire on the Theory of Planned Behavior applied to behavior and on the intensity of basic emotions before, during and after implementation. Data were analyzed using multiple linear regression. In the final model, the attitude presented itself as the greatest predictor of intention (80%). The emotions of fear after, joy before and guilt after, jointly, explained 12,5%. Results indicate the importance of emotional aspects in the behavior realization, but reveal the priority of the attitudinal component in the prediction of the intention to have sex without condom among youngsters...

El estudio evalúa la contribución de los constructos de la Teoría del Comportamiento Planificado y variables emocionales sobre la intención de repetir la conducta de mantener relaciones sexuales sin preservativo entre jóvenes. Participaron 1245 estudiantes con edad entre 15 y 24 años, de Canoas/RS. La prevalencia de la conducta fue de 40% (500 jóvenes), los cuales constituyeron la muestra. Los instrumentos fueron: cuestionario sobre la Teoría del Comportamiento Planificado aplicada a la conducta y sobre la intensidad de emociones básicas antes, durante y después de la realización. Los datos fueron analizados a través de regresión lineal múltiple. En el modelo final la actitud presentóse como el mayor predictor de la intención (80%). Las emociones de miedo después, alegría antes y culpa después explicaron conjuntamente el 12,5%. Los resultados indican la importancia de los aspectos emocionales en la realización de la conducta, pero revelan la prioridad del componente actitudinal en la predicción de la intención de mantener relaciones sexuales sin preservativo entre jóvenes...

Transtornos mentais comuns e fatores associados em trabalhadores: uma análise na perspectiva de gênero / Common mental disorders and associated factors amongworkers: an analysis from a gender perspective

O estudo teve por objetivo identificar a prevalência de Transtornos Mentais Comuns em trabalhadores de empresas e verificar a existência de associações entre variáveis sociodemográficas, laborais e psicossociais entre homens e mulheres. A amostra constituiu-se de 343 trabalhadores pertencentes a empresas de Porto Alegre (RS) em 2009. Os instrumentos utilizados foram o Self Reporting Questionnaire, conhecido como SRQ-20, e um questionário composto por questões acerca de dados demográficos e laborais. Os resultados evidenciaram que as mulheres apresentam maior prevalência de Transtornos Mentais Comuns (20,5%) em relação aos homens (10%). Na relação entre Transtornos Mentais Comuns e variáveis demográficas e laborais, de acordo com o sexo, verifica-se que mulheres cursando ensino superior e que trabalham a menos de 1 ano apresentaram mais Transtornos Mentais Comuns. Homens na faixa de idade de 50 a 62 anos apresentaram maior percentual de Transtornos Mentais Comuns. Os dados foram discutidos a partir da compreensão sobre o mercado de trabalho contemporâneo e sua interface com as