Understanding self-harm, suicidal ideation and behaviours amongst transgender and non-binary people

Abstract

This thesis consists of three separate papers: 1) a systematic literature review, 2) an empirical study, and 3) a critical and reflective review of the research process. The systematic review (Paper 1) has been prepared for submission to The Journal of Affective Disorders. The paper presents a narrative systematic review of the literature that reported quantitative analyses on associations between one or more minority stress factor and suicidal ideation and/or behaviours amongst Transgender and Gender Non- Conforming (TGNC) adults. Twenty-eight studies were included, with an overall number of participants totalling 101,378. Findings presented in a narrative synthesis highlighted positive associations between external and internal minority stressors and suicidal ideation and behaviour. Community resilience was negatively associated with suicidal outcomes but did not consistently buffer the effects of minority stress. Dysfunctional individual coping was associated with a greater likelihood of suicide attempts. In light of these findings, individual and systemic clinical implications and recommendations for future research are outlined. The empirical study (Paper 2) has been prepared for submission to The Journal of Gay and Lesbian Mental Health. The paper is a qualitative study that seeks to gain a greater understanding of self-harm urges and behaviour amongst non-binary young adults and what helped them to manage these urges. The impact of Covid-19 on participants experiences was also explored. Eleven participants were recruited to take part in the study. Data were collected and analysed in line with a constructivist grounded theory approach. This method allowed for the emergence of a theoretical framework, which consisted of seven categories: (1) Growing up feeling outside of the binary, (2) The pain of living in a cisnormative world, (3) Family discord, (4) Self-harm, (5) Suicidal ideation, (6) What helps, and (7) Life in Covid-19. Findings offer clinical implications and highlight a need for increased awareness, understanding and acceptance of non-binary identities. Paper 3 offers a critical and reflective appraisal of the entire research process. Strengths and limitations of the systematic review and empirical study are discussed, as well as theoretical and clinical implications of the work. Personal and professional reflections on the process of conducing the thesis are also discussed.

Date of Award	31 Dec 2021
Original language	English
Awarding Institution	The University of Manchester
Supervisor	James Lea (Supervisor) & Daniel Pratt (Supervisor)