A cross-sectional study of mental health, suicidal ideation and suicide attempt among transgender women in Jiangsu province, China

Abstract Objectives To measure prevalence and risk factors of poor mental health, suicidal ideation, and suicide attempt among transgender women in Jiangsu province, China. Methods We investigated 250 transgender women with mean age of 27.9 years from July 2018 to May 2019 in Jiangsu province, China. Logistic regression analysis characterized risk factors for mental health, suicidal ideation, and suicide attempt. Results Many transgender women experienced discrimination, including verbal abuse (56.0%), physical abuse (32.0%), and sexual violence (32.0%) during their lifetime. Classification by the Kessler Psychological Distress Scale found 32.4% in good mental health, while 24.0%, 16.8%, and 26.8% had mild, moderate, and severe psychological distress, respectively. In multivariable logistic regression, more severe psychological distress was correlated with bisexual orientation (vs. gay/lesbian, OR = 2.9, 95%CI = 1.5-5.8), unsure of sexual orientation (vs. gay/lesbian, OR = 4.7, 95%CI = 1.8-12.8), experience of verbal abuse(OR = 1.8, 95%CI = 1.1-3.1),and less severe with alcohol use (OR = 0.6, 95%CI = 0.3-0.9) (P Conclusion Chinese transgender women experience high levels of discrimination, abuse, poor mental health, suicidal ideation, and suicide attempts in Jiangsu province. Society-wide interventions need to be developed to mitigate trans phobic discrimination among transgender women in China.