Gender minority stress is associated with past-year suicidal ideation in a national probability sample of transgender and gender diverse adults.

Transgender and gender diverse (TGD) adults experience increased discrimination and victimization relative to cisgender adults, thus elevating their risk for suicidal ideation (SI). Social support and connection to the broader TGD community may mitigate the relationship between gender identity-based stressors (i.e., interpersonal minority stressors), psychological stress processes (i.e., intrapsychic minority stress processes), and TGD adults' risk for SI. The current study examined TGD adults' exposure to interpersonal minority stressors, intrapsychic minority stress processes, perceived social support, community connectedness, and risk for past-year SI. Data came from a U.S. national probability study of TGD adults (N = 274). Survey-weighted linear and log-Poisson regression models measured the association between interpersonal stressors, intrapsychic stress processes, and TGD adults' risk for past-year SI while adjusting for sociodemographic characteristics, perceived social support, and community connectedness. Findings revealed gender nonbinary adults had 1.79 times the risk for past-year SI relative to transmasculine adults (adjusted risk ratio aRR = 1.79, 95% confidence interval CI 1.13, 2.85). A 1 SD higher gender-based victimization score was associated with 33% higher risk for past-year SI (aRR = 1.33, 95% CI 1.14, 1.56), and a 1 SD higher negative expectations for the future score was associated with 37% higher risk for past-year SI (aRR = 1.37, 95% CI 1.18, 1.59). Results indicate interpersonal minority stressors and intrapsychic minority stress processes are associated with TGD adults' risk for past-year SI despite controlling for socially-based confounders. Findings may inform the development of interventions to disrupt gender minority stress processes and lower TGD adults' risk for SI.