4 - SYM (105) Suicide Prevention for Gender Diverse People: Exploring the Integration of Minority Stress into BCBT-I

Background: Gender diverse people are more likely to experience suicidal thoughts and behaviors (STBs) than their cis-gender peers. Yet, evidence-based models of suicide prevention have rarely evaluated their fit with the needs of gender diverse people. Minority stress, including psychosocial stressors and discrimination, are linked to elevated STBs for gender diverse people, while resilience factors such as positive identity and social connection may be protective. This project aimed to explore whether and how specific risk and resilience factors associated with gender minority stress are integrated into Brief Cognitive Behavior Therapy – Inpatient (BCBT-I) for suicide prevention with gender diverse patients.

Methods: Qualitative and quantitative content analysis were conducted on transcribed treatment sessions for six transgender participants in a randomized controlled trial of BCBT – I. 50% of participants identified as Hispanic, 66.7% as White American, 16.7% as Black American, and 16.7% as another race. Two identified as transgender women, two as transgender men, and two as gender non-conforming.

Results: All participants discussed minority stress themes in relation to their formulation of STBs and skills development. Social connection and disconnection were the most frequently discussed resilience and risk factors by a sizable margin, discussed in every session by all participants a total of 330 and 143 times respectively. Transitioning (5 participants), gender affirming care (3 participants), discrimination (3 participants), anticipation of negative events related to gender identity (2 participants), and gender dysphoria (1 participant) were discussed in some sessions by some participants.

Conclusion: There is scope within existing suicide prevention treatments to integrate specific risk and protective factors for gender diverse people. Doing so may improve clinical case formulations and our responsivity to the needs of gender diverse people who are experiencing STBs.