Risk and Protective Factors for Suicidal Ideation and Attempt: Comparing Gender Diverse and Cisgender Youth

Transgender and gender diverse adolescents are at especially high risk for suicidal behavior compared with cisgender peers. Based on ideation-to-action models of suicide, study aims were to compare transgender and gender diverse (TGD) and cisgender youth on suicide risk and protective factors and identify gender differences in the strength of the associations between protective factors and suicide-related outcomes. Participants were n = 26,887 (n = 1352 TGD youth; n = 12,529 cis boys; n = 13,006 cis girls) 8th and 11th grade respondents on a state-representative school-based survey in Oregon in 2019. Consistent with prior studies, TGD youth more often reported suicidal ideation (45%) than cisgender boys (12%) and girls (24%). TGD youth demonstrated higher odds of risk factors (depression, bullying, parental rejection) and lower levels of protective factors (adult support, problem solving) than cisgender peers. These differences did not fully explain TGD adolescents' higher odds of suicidal thoughts and behaviors. Results support the need for targeted prevention efforts for TGD youth.