Lower levels of social support are associated with risk for future suicide attempts in a clinical sample of transgender and gender diverse adults

Purpose Transgender and gender diverse (TGD) adults are disproportionately affected by suicide. Social support and connection to the broader TGD community may help lower TGD adults’ odds of having a suicide attempt (SA). The current study examined whether baseline levels of social support and community connectedness were associated with TGD adult’s prospective odds of having a SA over 12 months of follow-up. Methods Longitudinal data for the current study came from a patient cohort of TGD adults enrolled in the LEGACY Project. Descriptive statistics and an attrition analysis were used to examine characteristics of the cohort and missingness over time. Logistic generalized estimating equation models were used to examine factors associated with patients’ odds of having a past 6-month SA at 6- or 12-month follow-up. Results During the 12-month follow-up period, a total of 26 patients (3.1%; N = 830) reported having a SA. The 6-month incidence of SAs was approximately 2% at both 6- and 12-months of follow-up (6 months: N = 830; 12 months: N = 495). Baseline factors associated with increased odds of a future SA included gender identity (transfeminine vs. transmasculine: adjusted odds ratio [aOR] = 3.73, 95% confidence interval [CI] = 1.26–11.08; nonbinary vs. transmasculine: aOR = 3.09, 95% CI = 1.03–9.21), having a prior SA (aOR = 6.44, 95% CI = 2.63–15.79), and having moderate vs. high perceived social support (aOR = 4.25, 95% CI = 1.65–10.90). Conclusion Lower levels of social support are associated with risk for future suicide attempts among TGD adults. Findings may inform screening practices for future suicide risk and the development of interventions to improve mental health outcomes for TGD adults.