270360 Transgender Veterans within the Veterans Healthcare Administration System: Prevalence and risk for suicide

Tuesday, October 30, 2012

John R. Blosnich, PhD, MPH , VISN-2 Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua, NY
George Brown, MD , Psychiatry, VAMC Mountain Home, Mountain Home, TN
Jillian Shipherd, PhD , National Center for PTSD, Women's Health Sciences Division, VAMC Boston, Jamaica Plain, MA
Rebecca Piegari , Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY
Robert. Bossarte, PhD , Department of Psychiatry, University of Rochester, Rochester, NY
The limited literature about health among transgender persons indicates a population that experiences many disparities, including elevated risk of suicide. Derived by case studies, one theoretical framework – “Flight into Hypermasculinity” – suggests that military and Veteran populations may have higher prevalence of transgenderism than the general US population. In order to gauge transgender Veterans within the Veterans Healthcare Administration (VHA) system, electronic inpatient and outpatient files from FY2000 through FY2011 were examined for the two official ICD-9 diagnosis codes that indicate transgender status. Identified cases were then cross-referenced with a database of suicide-related events among all VHA users, spanning FY2009 through FY2011, in order to generate prevalence of suicide risk. Across 12-year period, we identified 3,177 unique transgender patients within the VHA system. Prevalence of transgender persons in the VHA (22.8/100,000 population) is higher than previous estimates for the general US population cited by the Diagnostic and Statistical Manual (DSM-IV). Transgender VHA-utilizing Veterans had prevalence of suicide-related events that was much higher than estimates of intentional self-harm in the general population. The VHA recently issued a directive outlining healthcare for transgender and intersex populations, yet very little is known about unique health and risk indicators among this population. The present results indicate extremely high rates of suicide risk among this population. Further work is needed to better understand the onset and course of suicide risk disparities among transgender Veterans, and immediate attention may be needed in terms of assessing how current VHA suicide prevention and intervention strategies reach this population.

Learning Areas:
Diversity and culture

Learning Objectives:
Explain theoretical framework suggesting elevated prevalence of transgenderism among US Military/Veteran populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have written reports on health disparities regarding LGBT populations and was PI on a federal dissertation training grant to examine specific health risk behavior among sexual minority populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.