Association of Gender Identity Acceptance with Fewer Suicide Attempts Among Transgender and Nonbinary Youth.

Purpose: Transgender and nonbinary (TGNB) youth report more than four times greater rates of suicide attempts compared with their cisgender peers. Gender identity acceptance from others can reduce the risk for these youth.

Methods: Using data from a 2018 cross-sectional survey of LGBTQ youth, the current study examined the association of gender identity acceptance from others with suicide attempts among 8218 TGNB youth. Youth reported gender identity acceptance levels from parents, other relatives, school professionals, health care professionals, friends, and classmates to whom they were "out."

Results: Each category of adult and peer gender identity acceptance was associated with lower odds of a past-year suicide attempt, with the strongest associations within each individual category being acceptance from parents (adjusted odds ratio [aOR]=0.57) and other family members (aOR=0.51). The TGNB youth who reported gender identity acceptance from at least one adult had one-third lower odds of reporting a past-year suicide attempt (aOR=0.67), and acceptance from at least one peer was also associated with lower odds of a past-year suicide attempt (aOR=0.66). Peer acceptance was particularly impactful for transgender youth (aOR=0.47). The relationship between adult and peer acceptance remained significant after controlling for the association of each form, suggesting unique relationships for each on TGNB youth suicide attempts. Acceptance was more impactful for TGNB youth assigned male at birth compared with TGNB youth assigned female at birth.

Conclusion: Interventions aimed at suicide prevention for TGNB youth should include efforts aimed at leveraging gender identity acceptance from supportive adults and peers in their lives.