Associations between Gender Discrimination, Resilience and Social Support with Self-Harm and Suicidality among Transgender Women in Brazil.

Background: Transgender individuals experience pervasive discrimination throughout their lives on both structural and interpersonal levels, greatly impacting on suicide risk. Gender-based discrimination can affect up to 96% of transgender individuals in Brazil, the country selected as the focus of this study.

Aims: To explore suicidal behaviour among transgender women by investigating the associations between resilience, social support, and experiences of gender discrimination and thoughts of self-harm, suicide ideation and suicide attempt among transgender women in Brazil.

Methods: This study draws from cross-sectional data from the Brazilian DIVAS study. A respondent-driven sampling method was used to recruit 2,470 participants. Fourteen experiences of discrimination were used in a latent class analysis model to separate the sample into classes. A multiple logistic regression model was used to assess the association of each outcome (i.e., recent thoughts of self-harm and suicidal ideation, lifetime suicidal ideation, and recent and lifetime suicide attempts) with gender discrimination, resilience and social support scores.

Results: Four classes of discrimination were obtained and named as "low", "medium-low", "medium-high", and "high". Higher levels of discrimination were associated with thoughts of self-harm and suicidal ideation (ORs from 1.26 to 2.39) and suicide attempt (ORs from 1.68 to 3.34), as well as lower levels of resilience (ORs from 1.79 to 4.08). On the other hand, higher levels of social support were associated with lower chances of thoughts of self-harm or suicidal ideation (ORs from 0.66 to 0.43) and suicide attempt (ORs from 0.78 to 0.58).

Conclusions: The clear link between discrimination, whether it be structural or interpersonal, and suicidal ideation found in this study calls for structural changes that address harassment in all forms against gender minorities.