Language
English (en)
Date of Award
8-13-2024
Degree Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Chair and Committee
Patrick Fowler
Abstract
Transgender and gender-expansive people (collectively referred to here as trans) attempt suicide and experience homelessness at much higher-than-average national rates, signaling the need for culturally responsive support. Strikingly, over 50% of trans people with experiences of homelessness attempt suicide, and Black, Indigenous, Latine, and other persons of color exhibit even higher rates of suicidal behavior and homelessness (James et al., 2016). Although conceptual models of gender minority stress and multi-minority stress suggest suicidal thoughts and behaviors (STB) as an outcome of multilevel drivers, there has been little examination of structural determinants such as housing. A need exists for trans-affirmative research investigating the complex intersections between suicide and housing insecurity among trans young adults transitioning into adulthood (J. Shelton, 2015, 2016). It has been well established that trans people experience elevated levels of suicidal thoughts and behaviors (STB), as well as high rates of housing insecurity (homelessness and risk of homelessness). But the extent of the cooccurrence and the temporal relationship between the two is less explored (McCann & Brown, 2021; McNeil et al., 2017; Rhoades et al., 2018). Evidence from systematic reviews suggests that trans young adults who experience suicidal ideation or behavior are not a homogenous group (Adams & Vincent, 2019; McNeil et al., 2017), and there is a range of trans young adults pathways to homelessness (McCann & Brown, 2021). Many studies either lump trans young adults within the wider LGBTQIA+ community or analyze risk factors for combined ideation and attempts, and as such, there are significant gaps in knowledge on trans-specific patterns of suicide risk with even less knowledge of these patterns among trans young adults of color (Adams & Vincent, 2019; McNeil et al., 2017). Thus, there is a vital need to generate knowledge of housing insecurity and suicide risk among trans young adults that treats trans young adults as a homogenous group with intersectional gender, sexual, and racial/ethnic identities The present study addresses the evidence gap by examining housing-related suicide behaviors among trans young adults (16–25) using two datasets—the 2015 USTS and HYM+TRUTH study—specifically designed to address gaps in knowledge in the health and well-being of trans people and trans young people of color. Predicated on a life-course perspective and an adaptation of the gender minority stress theory, the investigation focuses on the multidetermined and multilevel contextual factors that expose trans young adults to precarious housing and the progression of suicidal ideation, plans, and attempts according to the idea-to-action framework. Structural factors, including racism and protection from informal trans community support in emerging adulthood, are critical in escalating and de-escalating risks. The sequential design will first use cross-sectional survey data from the USTS to enable robust tests of the cross-sectional relationship between housing insecurity and SBT. Second, informed by the first aim, longitudinal analyses of the Healthy Young Men + Trans Youth of Color (TRUTH) (Calvetti et al., 2022) study conducted in Los Angeles will be used to make a prospective inquiry into housing and STB risk over time. Findings from analyses indicate that housing-insecure trans young adults are at significantly higher risk of STB. Family rejection increases the odds of housing insecurity and escalates STB risk. Among trans young adults of color, prior experiences of housing insecurity are significantly associated with 7 times the odds of being in a high-risk class for STB at baseline. Results from both datasets are explored and triangulated to examine other risks and protective factors related to housing insecurity and STB, including family rejection, hazardous drinking, peer support, and racism and gender discrimination. Recommendations for practiced policy and research point to an integrated response from multiple service providers and systems, and further research is needed to address cooccurring trans young housing insecurity and STB.
Recommended Citation
Gaveras, Eleni Margareta, "Housing Insecurity and Suicidal Behavior Among Transgender and Gender-Expansive Young Adults" (2024). Brown School Theses and Dissertations. 41.
https://openscholarship.wustl.edu/brown_etds/41