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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.
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.