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Trajectories of Self-Injurious Thoughts and Behavior: Risk and Resiliency Among Cisgender and Gender Diverse Youth
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DOI：10.1016/j.jaacop.2025.10.006.png)
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Abstract
En 中文
Objective: Transgender and gender diverse (TGD) youth are at high risk for self-injurious thoughts and behaviors (SITB) including suicidal ideation, nonsuicidal self-injury (NSSI), and suicide attempt. We compared total SITB endorsements during a 4-year period among 3 groups: TGD youth with high gender-related social stress (TGD+High-Stress); TGD youth with low gender-related social stress (TGD+Low-Stress); and non-TGD youth. We further identified risk and resiliency correlates of 3 longitudinal SITB trajectories (NSSI, suicidal ideation, and suicide attempt), accounting for gender-related social stress and other known robust risk factors. Method: This study (N = 11,851) used longitudinal data for youth spanning ages 10 to 14 years from the Adolescent Brain Cognitive Development study (release 5.1), of whom 4% were TGD. Analyses of variance were used to compare mean SITB endorsements across groups. Three mixed-effects logistic regressions identified correlates of SITB trajectories during the study. Results: On average, TGD+High-Stress experienced more SITB events than TGD+Low-Stress and non-TGD youth, respectively. Longitudinal results found that TGD compared to non-TGD youth experienced higher NSSI and suicidal ideation risk regardless of gender-related social stress. TGD+High-Stress but not TGD+Low-Stress youth had greater suicide attempt risk than non-TGD youth. Higher psychopathology symptoms and family conflict were associated with higher NSSI and suicidal ideation risk. Only school involvement was protective against ideation and NSSI risk. Conclusion: TGD youth experience higher SITB risk, particularly when facing higher gender-related social stressors at home or school. We urgently need interventions supporting positive connections between TGD youth and their families and peers. Plain language summary: Using longitudinal data from the Adolescent Brain Cognitive Developments (ABCD) Study (N = 11,851), the authors compared total self-injurious thoughts and behaviors (SITB) among transgender and gender diverse (TGD) youth and non-TGD youth from ages 10 to 14 years. This study found that TGD youth experience higher risk for SITB than non-TGD youth. High gender-related social stress, more mental health symptoms, and family conflict were associated with higher risk of SITB, whereas school involvement was protective against SITB. This study highlights the need for developing interventions that support positive connections between TGD youth and their families and peers.
Keywords:
self-injurious thoughts and behavior
transgender
gender diverse youth
suicide attempt
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