Suicidality and Self-Harm

Death by suicide is the 10th leading cause of death in the United States, with rates rising over a 20-year period beginning in the early 2000s. While the trends related to death by suicide in the United States are generally concerning, rates of suicidality—suicidal ideation, attempts, and death by suicide—are disproportionately higher within trans populations relative to cis populations. Rates of self-harming behavior (also referred to in the literature as nonsuicidal self-injurious behavior [NSSI]), a common precursor to suicidality, are also disproportionately high within trans populations.

Given these concerning trends, researchers and health practitioners have sought to gain accurate estimates of the prevalence of suicidality within trans populations and to identify correlates of suicidal behavior to improve mental health supports. Some of these efforts are associated with intervention at the individual level by attending to psychological comorbidities associated with suicidality, such as NSSI or depressive symptoms. Other efforts are focused on identifying interpersonal and systemic risk and protective factors across various social contexts, such as experiences of peer and/or familial rejection, discrimination, harassment, and school-based victimization.

Gaining a more nuanced understanding of suicidality among trans populations is needed to better inform prevention and intervention efforts. Therefore, researchers have also sought to identify variations in the prevalence of suicidality and associated risk across diverse gender identities (e.g., gender nonconforming, genderqueer, nonbinary, trans man/trans woman). Notably, this is a field of study that garnered increased attention over the first two decades of the 2000s, yet there is still much that is not well understood. This entry addresses the theoretical frameworks that inform studies on suicidality within trans populations, the prevalence of suicidality across diverse gender identities, methodological limitations on what is known about the prevalence and correlates of suicidal behaviors, and factors that increase the risk of or protect against suicidality and self-harm.