Suicide, Homicide, and All-Cause Mortality Among Transgender and Cisgender Patients in the Veterans Health Administration.

Boyer TL, Youk AO, Haas AP, Brown GR, Shipherd JC, Kauth MR, Jasuja GK, Blosnich JR. Suicide, Homicide, and All-Cause Mortality Among Transgender and Cisgender Patients in the Veterans Health Administration. LGBT health. 2021 Apr 1; 8(3):173-180.

Related HSR&D Project(s)

• CDA 14-408 – Health Outcomes and Healthcare Use Among Transgender Veterans

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Abstract:

This study examines the differences in suicide, homicide, and all-cause mortality between transgender and cisgender Veterans Health Administration (VHA) patients. VHA electronic medical record data from October 1, 1999 to December 31, 2016 were used to create a sample of transgender and cisgender patients (? = 32,441). Cox proportional hazard regression was used to evaluate differences in survival time (date of birth to death date/study end). Death data were from the National Death Index. Transgender patients had more than twofold greater hazard of suicide than cisgender patients (adjusted hazard ratio [aHR]? = 2.77, 95% confidence interval [CI]? = 1.88-4.09), especially among younger (18-39 years) (aHR? = 3.35, 95% CI? = 1.30-8.60) and older ( = 65 years) patients (aHR? = 9.48, 95% CI? = 3.88-23.19). Alternatively, transgender patients had an overall lower hazard of all-cause mortality (aHR? = 0.90, 95% CI? = 0.84-0.97) compared with cisgender patients, which was driven by patients 40-64 years old (aHR? = 0.78, 95% CI? = 0.72-0.86) and reversed by those 65 years and older (aHR? = 1.17, 95% CI? = 1.03-1.33). Transgender patients'' hazard of suicide mortality was significantly greater than that of cisgender VHA patients.