Article(id=1324070959069667996, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324070892967428793, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202507395, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1753459200000, receivedDateStr=2025-07-26, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793612716691, onlineDateStr=2026-11-02, pubDate=1766592000000, pubDateStr=2025-12-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793612716691, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793612716691, creator=13701087609, updateTime=1793612716691, updator=13701087609, issue=Issue{id=1324070892967428793, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='24', pageStart='4417', pageEnd='4608', issueExtLink='null', onlineDate='null', pubDate='1766592000000', pubDateStr='2025-12-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793612700931, creator='13701087609', updateTime=1793612772549, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324071193430602023, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324070892967428793, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324071193430602024, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324070892967428793, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=4553, endPage=4557, ext={EN=ArticleExt(id=1324070959304549021, articleId=1324070959069667996, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Factors influencing suicidal ideation among transgender individuals in a clinical setting, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the factors influencing suicidal ideation in transgender individuals.

Methods

A study was conducted on transgender individuals from a medical institution. Participants were surveyed using a self-designed general information questionnaire, the Self-Concept Clarity Scale (SCCS), the Satisfaction with Life Scale (SWLS), and the Perceived Social Support Scale (PSSS). Logistic regression was used to analyze factors influencing suicidal ideation.

Results

A total of 170 participants was included. The detection rate of suicidal ideation among transgender individuals was 54.7% (93/170). Risk factors for suicidal ideation included age ≥30 years (OR=3.35, 95% CI=1.31-8.56), experience of domestic violence (OR=2.97, 95% CI=1.16-7.61), low life satisfaction (OR=5.13, 95% CI=2.29-11.50), and low family support (OR=3.31, 95% CI=1.43-7.66). A higher education level (bachelor’s degree or above) was identified as a protective factor (OR=0.42, 95% CI=0.19-0.93).

Conclusion

Higher education (bachelor’s degree or above) serves as a protective factor against suicidal ideation in transgender individuals, while older age (≥30 years), experience of domestic violence, low life satisfaction, and lack of family support are risk factors.

, authors=Yue-qian ZHANG1, 2, Ruo-fei WANG1, 2, Zhao ZHANG1, Juan TAN1, Rong-jiang ZHAO2, Ya-juan NIU2, authorsList=Yue-qian ZHANG, Ruo-fei WANG, Zhao ZHANG, Juan TAN, Rong-jiang ZHAO, Ya-juan NIU, authorCompany=null, correspAuthors=Ya-juan NIU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324070960344736422, articleId=1324070959069667996, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=某医疗机构就诊的跨性别者自杀意念的影响因素研究, columnId=1228016572640461823, journalTitle=现代预防医学, columnName=健康与社会行为, runingTitle=null, highlight=null, articleAbstract=
目的

分析跨性别者自杀意念的影响因素。

方法

以某医疗机构的跨性别者为研究对象,采用自编一般资料调查表、自我概念清晰度量表(Self-Concept Clarity Scale, SCCS)、生活满意度量表(Satisfaction With Life Scale, SWLS)、领悟社会支持量表(Perceived Social Support Scale, PSSS)进行问卷调查,使用logistic回归分析跨性别者自杀意念的影响因素。

结果

共170人,跨性别者自杀意念检出率为54.7%(93/170)。年龄≥30岁(OR=3.35,95% CI=1.31~8.56)、经历过家庭暴力(OR=2.97,95% CI=1.16~7.61)、低生活满意度(OR=5.13,95% CI=2.29~11.50)、低家庭支持(OR=3.31,95% CI=1.43~7.66)是跨性别者自杀意念的危险因素。受教育程度为本科以上是跨性别者自杀意念的保护因素(OR=0.42,95% CI=0.19~0.93)。

结论

高学历(本科及以上)是跨性别者自杀意念的保护因素,而高龄(≥30岁)、家庭暴力经历、低生活满意度及缺乏家庭支持是危险因素。

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张月倩(2000—),女,硕士在读,研究方向:临床心理咨询与治疗

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牛雅娟,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=oDFT9OShY98XxQ0MdZ8b8A==, magXml=gT/yb5bM6/oUBPCMH3Bw0g==, pdfUrl=null, pdf=WQVFauXb4dYeMDn/dZsabA==, pdfFileSize=579840, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=ErtU5EtCgzNbg739fWZbiA==, mapNumber=null, fund=null)}, authors=[Author(id=1324070962362196653, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1324070962479637168, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, authorId=1324070962362196653, language=EN, stringName=Yue-qian ZHANG, firstName=Yue-qian, middleName=null, lastName=ZHANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=Chengde Medical College, Chengde, Hebei 067000, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1324070962546746033, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, authorId=1324070962362196653, language=CN, stringName=张月倩, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.承德医学院,河北 承德 067000
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Int J Transgend Health, 2024, 77: 1-13., articleTitle=Mental health and wellbeing outcomes associated with social, medical, and legal gender affirmation among trans young People in Australia, refAbstract=null), Reference(id=1324070972046844671, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, doi=null, pmid=null, pmcid=null, year=2024, volume=74, issue=6, pageStart=1095, pageEnd=1105, url=null, language=null, rfNumber=[29], rfOrder=34, authorNames=Wang YC, Hoatson T, Stamoulis C, journalName=Journal of Adolescent Health, refType=null, unstructuredReference=Wang YC, Hoatson T, Stamoulis C, et al. Psychological distress and suicidality among transgender young adults in the United States [J]. Journal of Adolescent Health, 2024, 74 (6): 1095-1105., articleTitle=Psychological distress and suicidality among transgender young adults in the United States, refAbstract=null), Reference(id=1324070972130730752, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, doi=null, pmid=null, pmcid=null, year=2024, volume=69, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[30], rfOrder=35, authorNames=Raj P, Dubey A, journalName=International Journal of Public Health, refType=null, unstructuredReference=Raj P, Dubey A. Comprehending health of the transgender population in India through bibliometric analysis [J]. International Journal of Public Health, 2024, 69: 1606598., articleTitle=Comprehending health of the transgender population in India through bibliometric analysis, refAbstract=null)], funds=[Fund(id=1324070967202423516, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, awardId=Z211100002921039, language=CN, fundingSource=首都临床诊疗技术研究及转化应用(Z211100002921039), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324070962169258663, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, xref=1., ext=[AuthorCompanyExt(id=1324070962186035880, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, companyId=1324070962169258663, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Chengde Medical College, Chengde, Hebei 067000, China), AuthorCompanyExt(id=1324070962198618793, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, companyId=1324070962169258663, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.承德医学院,河北 承德 067000)]), AuthorCompany(id=1324070962274116266, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, xref=2., ext=[AuthorCompanyExt(id=1324070962286699179, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, companyId=1324070962274116266, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.北京回龙观医院)])], figs=[ArticleFig(id=1324070966627803862, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, language=EN, label=Table 1, caption=

Presents the comparison of general characteristics and relevant factors of study subjects[n(%)/()]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量全部
(n=170)
无自杀意念
(n=77)
有自杀意念
(n=93)
χ2/t值P值
自我认同性别0.020.896
女154(90.6)70(90.9)84(90.6)
男16(9.4)7(9.1)9(9.7)
年龄(岁)6.180.046
18~2467(39.4)37(48.1)30(32.3)
>24~3048(28.2)22(28.6)26(28.0)
≥3055(32.4)18(23.4)37(39.8)
首次出现性别焦虑的年龄(岁)1.170.557
<1326(15.3)10(13.0)16(17.2)
≥13~1866(38.8)33(42.9)33(35.5)
≥1834(44.2)44(47.3)78(45.9)
是否独生子女0.050.829
否125(73.5)56(72.7)69(74.2)
是45(26.5)21(27.3)24(25.8)
受教育程度2.150.142
本科及以下103(60.6)42(54.5)61(65.6)
本科以上67(39.4)35(45.5)32(34.4)
是否有吸烟史0.410.523
否147(86.5)68(88.3)79(84.9)
是23(13.5)9(11.7)14(15.1)
是否有饮酒史1.270.259
否107(62.9)52(67.5)55(59.1)
是63(37.1)25(32.5)38(40.9)
是否经历过家庭暴力2.040.154
否121(71.2)59(76.6)62(66.7)
是49(28.8)18(23.4)31(33.3)
是否经历过校园暴力0.780.379
否102(60.0)49(63.6)53(57.0)
是68(40.0)28(36.4)40(43.0)
激素使用情况0.970.616
从未使用91(53.5)43(55.8)48(51.6)
间断使用47(27.6)22(28.6)25(26.9)
连续使用32(18.8)12(15.6)20(21.5)
自我概念清晰度32.0±6.636.1±6.328.7±4.78.80<0.001
生活满意度16.5±6.821.6±5.112.3±4.812.20<0.001
领悟社会支持52.8±12.458.6±11.348.0±11.36.09<0.001
家庭支持16.1±6.221.1±4.012.0±4.513.71<0.001
朋友支持20.1±5.220.3±4.819.9±5.50.450.656
其他支持16.6±6.317.3±6.716.0±5.91.360.175
), ArticleFig(id=1324070966715884247, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, language=CN, label=表1, caption=

研究对象的社会人口学特征比较 [n(%)/()]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量全部
(n=170)
无自杀意念
(n=77)
有自杀意念
(n=93)
χ2/t值P值
自我认同性别0.020.896
女154(90.6)70(90.9)84(90.6)
男16(9.4)7(9.1)9(9.7)
年龄(岁)6.180.046
18~2467(39.4)37(48.1)30(32.3)
>24~3048(28.2)22(28.6)26(28.0)
≥3055(32.4)18(23.4)37(39.8)
首次出现性别焦虑的年龄(岁)1.170.557
<1326(15.3)10(13.0)16(17.2)
≥13~1866(38.8)33(42.9)33(35.5)
≥1834(44.2)44(47.3)78(45.9)
是否独生子女0.050.829
否125(73.5)56(72.7)69(74.2)
是45(26.5)21(27.3)24(25.8)
受教育程度2.150.142
本科及以下103(60.6)42(54.5)61(65.6)
本科以上67(39.4)35(45.5)32(34.4)
是否有吸烟史0.410.523
否147(86.5)68(88.3)79(84.9)
是23(13.5)9(11.7)14(15.1)
是否有饮酒史1.270.259
否107(62.9)52(67.5)55(59.1)
是63(37.1)25(32.5)38(40.9)
是否经历过家庭暴力2.040.154
否121(71.2)59(76.6)62(66.7)
是49(28.8)18(23.4)31(33.3)
是否经历过校园暴力0.780.379
否102(60.0)49(63.6)53(57.0)
是68(40.0)28(36.4)40(43.0)
激素使用情况0.970.616
从未使用91(53.5)43(55.8)48(51.6)
间断使用47(27.6)22(28.6)25(26.9)
连续使用32(18.8)12(15.6)20(21.5)
自我概念清晰度32.0±6.636.1±6.328.7±4.78.80<0.001
生活满意度16.5±6.821.6±5.112.3±4.812.20<0.001
领悟社会支持52.8±12.458.6±11.348.0±11.36.09<0.001
家庭支持16.1±6.221.1±4.012.0±4.513.71<0.001
朋友支持20.1±5.220.3±4.819.9±5.50.450.656
其他支持16.6±6.317.3±6.716.0±5.91.360.175
), ArticleFig(id=1324070966824936152, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, language=EN, label=Table 2, caption=

Variable assignment details

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变量赋值
自我认同性别女=1,男=2
年龄(岁)18~24岁=1,>24~30岁=2,≥30岁=3
首次出现性别焦虑的年龄(岁)<13岁=1,≥13~18岁=2,≥18岁=3
是否独生子女否=0,是=1
受教育程度本科及以下=1,本科以上=2
是否有吸烟史否=0,是=1
是否有饮酒史否=0,是=1
是否经历过家庭暴力否=0,是=1
是否经历过校园暴力否=0,是=1
激素使用情况从未使用=1,间断使用=2,连续使用=3
自我概念清晰度高自我概念清晰度=1,低自我概念清晰度=2
生活满意度高生活满意度=1,低生活满意度=2
家庭支持高家庭支持=1,低家庭支持=2
朋友支持高朋友支持=1,低朋友支持=2
其他支持高其他支持=1,低其他支持=2
), ArticleFig(id=1324070966904627929, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, language=CN, label=表2, caption=

变量赋值情况

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变量赋值
自我认同性别女=1,男=2
年龄(岁)18~24岁=1,>24~30岁=2,≥30岁=3
首次出现性别焦虑的年龄(岁)<13岁=1,≥13~18岁=2,≥18岁=3
是否独生子女否=0,是=1
受教育程度本科及以下=1,本科以上=2
是否有吸烟史否=0,是=1
是否有饮酒史否=0,是=1
是否经历过家庭暴力否=0,是=1
是否经历过校园暴力否=0,是=1
激素使用情况从未使用=1,间断使用=2,连续使用=3
自我概念清晰度高自我概念清晰度=1,低自我概念清晰度=2
生活满意度高生活满意度=1,低生活满意度=2
家庭支持高家庭支持=1,低家庭支持=2
朋友支持高朋友支持=1,低朋友支持=2
其他支持高其他支持=1,低其他支持=2
), ArticleFig(id=1324070966988514010, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, language=EN, label=Table 3, caption=

Results of multivariate logistic regression analysis on influencing factors of suicidal ideation in transgender individuals(n=170)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量B值OR(95% CI)P值R2
自我认同性别(ref:女)0.280.37
男0.191.21(0.32~4.66)0.780
年龄(岁)(ref:18~24)
>24~300.892.43(0.96~6.14)0.060
≥301.213.35(1.31~8.56)0.012
首次出现性别焦虑的年龄(岁)(ref:<13)
≥13~18-0.500.61(0.19~1.96)0.403
≥18-0.230.80(0.25~2.56)0.702
是否独生子女(ref:否)
是0.181.20(0.51~2.82)0.681
受教育程度(ref:本科及以下)
本科以上-0.870.42(0.19~0.93)0.033
是否有吸烟史(ref:否)
是0.231.26(0.39~4.08)0.706
是否有饮酒史(ref:否)
是-0.130.88(0.40~1.94)0.753
是否经历过家庭暴力(ref:否)
是1.092.97(1.16~7.61)0.023
是否经历过校园暴力(ref:否)
是0.111.11(0.47~2.62)0.808
激素使用情况(ref:从未使用)
间断使用-0.070.94(0.38~2.30)0.883
连续使用0.301.36(0.48~3.86)0.570
低自我概念清晰度(ref:高自我概念清晰度)0.361.43(0.56~3.68)0.460
低生活满意度(ref:高生活满意度)1.645.13(2.29~11.50)<0.001
低家庭支持(ref:高家庭支持)1.203.31(1.43~7.66)0.005
低朋友支持(ref:高朋友支持)-0.070.94(0.35~2.51)0.893
低其他支持(ref:高其他支持)0.571.77(0.78~4.03)0.175
), ArticleFig(id=1324070967084983003, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324070959069667996, language=CN, label=表3, caption=

跨性别者自杀意念影响因素的多因素logistic分析结果(n=170)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量B值OR(95% CI)P值R2
自我认同性别(ref:女)0.280.37
男0.191.21(0.32~4.66)0.780
年龄(岁)(ref:18~24)
>24~300.892.43(0.96~6.14)0.060
≥301.213.35(1.31~8.56)0.012
首次出现性别焦虑的年龄(岁)(ref:<13)
≥13~18-0.500.61(0.19~1.96)0.403
≥18-0.230.80(0.25~2.56)0.702
是否独生子女(ref:否)
是0.181.20(0.51~2.82)0.681
受教育程度(ref:本科及以下)
本科以上-0.870.42(0.19~0.93)0.033
是否有吸烟史(ref:否)
是0.231.26(0.39~4.08)0.706
是否有饮酒史(ref:否)
是-0.130.88(0.40~1.94)0.753
是否经历过家庭暴力(ref:否)
是1.092.97(1.16~7.61)0.023
是否经历过校园暴力(ref:否)
是0.111.11(0.47~2.62)0.808
激素使用情况(ref:从未使用)
间断使用-0.070.94(0.38~2.30)0.883
连续使用0.301.36(0.48~3.86)0.570
低自我概念清晰度(ref:高自我概念清晰度)0.361.43(0.56~3.68)0.460
低生活满意度(ref:高生活满意度)1.645.13(2.29~11.50)<0.001
低家庭支持(ref:高家庭支持)1.203.31(1.43~7.66)0.005
低朋友支持(ref:高朋友支持)-0.070.94(0.35~2.51)0.893
低其他支持(ref:高其他支持)0.571.77(0.78~4.03)0.175
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某医疗机构就诊的跨性别者自杀意念的影响因素研究
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张月倩 1, 2 , 王若飞 1, 2 , 张钊 1 , 谭娟 1 , 赵荣江 2 , 牛雅娟 2
现代预防医学 | 健康与社会行为 2025,52(24): 4553-4557
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现代预防医学 |健康与社会行为 2025 , 52 (24) : 4553 -4557
某医疗机构就诊的跨性别者自杀意念的影响因素研究
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张月倩1, 2, 王若飞1, 2, 张钊1, 谭娟1, 赵荣江2, 牛雅娟2
作者信息
  • 1.承德医学院,河北 承德 067000
  • 2.北京回龙观医院
通讯作者:
牛雅娟,E-mail:
作者简介:

张月倩(2000—),女,硕士在读,研究方向:临床心理咨询与治疗

Factors influencing suicidal ideation among transgender individuals in a clinical setting
Yue-qian ZHANG1, 2, Ruo-fei WANG1, 2, Zhao ZHANG1, Juan TAN1, Rong-jiang ZHAO2, Ya-juan NIU2
Affiliations
  • Chengde Medical College, Chengde, Hebei 067000, China
出版时间: 2025-12-25 doi: 10.20043/j.cnki.MPM.202507395
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目的

分析跨性别者自杀意念的影响因素。

方法

以某医疗机构的跨性别者为研究对象,采用自编一般资料调查表、自我概念清晰度量表(Self-Concept Clarity Scale, SCCS)、生活满意度量表(Satisfaction With Life Scale, SWLS)、领悟社会支持量表(Perceived Social Support Scale, PSSS)进行问卷调查,使用logistic回归分析跨性别者自杀意念的影响因素。

结果

共170人,跨性别者自杀意念检出率为54.7%(93/170)。年龄≥30岁(OR=3.35,95% CI=1.31~8.56)、经历过家庭暴力(OR=2.97,95% CI=1.16~7.61)、低生活满意度(OR=5.13,95% CI=2.29~11.50)、低家庭支持(OR=3.31,95% CI=1.43~7.66)是跨性别者自杀意念的危险因素。受教育程度为本科以上是跨性别者自杀意念的保护因素(OR=0.42,95% CI=0.19~0.93)。

结论

高学历(本科及以上)是跨性别者自杀意念的保护因素,而高龄(≥30岁)、家庭暴力经历、低生活满意度及缺乏家庭支持是危险因素。

跨性别者  /  自我概念清晰度  /  生活满意度  /  领悟社会支持  /  自杀意念
Objective

To analyze the factors influencing suicidal ideation in transgender individuals.

Methods

A study was conducted on transgender individuals from a medical institution. Participants were surveyed using a self-designed general information questionnaire, the Self-Concept Clarity Scale (SCCS), the Satisfaction with Life Scale (SWLS), and the Perceived Social Support Scale (PSSS). Logistic regression was used to analyze factors influencing suicidal ideation.

Results

A total of 170 participants was included. The detection rate of suicidal ideation among transgender individuals was 54.7% (93/170). Risk factors for suicidal ideation included age ≥30 years (OR=3.35, 95% CI=1.31-8.56), experience of domestic violence (OR=2.97, 95% CI=1.16-7.61), low life satisfaction (OR=5.13, 95% CI=2.29-11.50), and low family support (OR=3.31, 95% CI=1.43-7.66). A higher education level (bachelor’s degree or above) was identified as a protective factor (OR=0.42, 95% CI=0.19-0.93).

Conclusion

Higher education (bachelor’s degree or above) serves as a protective factor against suicidal ideation in transgender individuals, while older age (≥30 years), experience of domestic violence, low life satisfaction, and lack of family support are risk factors.

Transgender individuals  /  Self-concept clarity  /  Life satisfaction  /  Perceived social support  /  Suicidal ideation
张月倩, 王若飞, 张钊, 谭娟, 赵荣江, 牛雅娟. 某医疗机构就诊的跨性别者自杀意念的影响因素研究. 现代预防医学, 2025 , 52 (24) : 4553 -4557 . DOI: 10.20043/j.cnki.MPM.202507395
Yue-qian ZHANG, Ruo-fei WANG, Zhao ZHANG, Juan TAN, Rong-jiang ZHAO, Ya-juan NIU. Factors influencing suicidal ideation among transgender individuals in a clinical setting[J]. Modern Preventive Medicine, 2025 , 52 (24) : 4553 -4557 . DOI: 10.20043/j.cnki.MPM.202507395
自杀意念是自杀者的早期心理活动,指个体有明确想要结束自己生命的想法,但还未付诸行动[1]。跨性别者指心理上无法认同自己出生时的生理性别,持续地相信并希望自己应该属于其他性别的人,主要包括跨性别男性(出生时的生理性别为女性,自我认同性别为男性)和跨性别女性(出生时的生理性别为男性,自我认同性别为女性)[2]。《精神障碍诊断与统计手册(第五版)》(Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5)中将其命名为“性别焦虑”[3]。性别焦虑指性别认同与生理性别之间不一致所带来的一种心理上的主观痛苦[4]。对于跨性别者而言,实现自我认同性别的表达和抑制生理性别的特征发育,是其核心的心理需求[5]。当这一需求无法实现时,跨性别者就会产生强烈的性别焦虑[6]。多项研究发现,跨性别者自杀意念和自杀企图远高于普通人群[7-9]。越来越多的研究证实,跨性别群体由于其身份,经历的独特社会和家庭压力,可能是导致其高自杀意念的更重要的因素[10]。本研究旨在识别自杀意念的影响因素,为制定真正符合该群体自杀预防策略提供有针对性的干预靶点。
本研究中以2024年5月至2025年3月于北京回龙观医院两性心理门诊就诊并符合纳入与排除标准的170名跨性别者为研究对象。在此期间共发放纸质版问卷175份,回收有效问卷170份,有效率为97.1%(问卷无效判定标准:自杀意念量表掩饰因子> 4分)。入组标准:(1)年龄满18周岁;(2)符合ICD-11中“性别不一致”的标准;(3)自愿参与研究且签署知情同意书。排除标准:(1)染色体异常;(2)重大精神障碍及认知功能障碍。
根据横断面研究的样本量公式进行样本估算。n为样本例数,p为估计率,参考已有研究中跨性别者自杀意念检出率为82%[11],q=1-p,δ为容许误差,为0.1×p,设α=0. 05,Zα/2=1.96≈2,得: n=(2)2*p*(1-p)/(0.01p)=400*(1-p)/p=400*q/p=400×0.17/0.82≈83。计算样本量至少为83名。
本研究已通过北京回龙观医院伦理审查批准(批号:2022-26-科)。
本研究采用一对一、纸质量表调查的方式,由经过培训的一名调查员在安静诊室内进行。在调查前,由研究人员向参与者详细说明研究目的、保密原则和自愿参与原则等,并签署知情同意书。所有问卷当场发放、填写并回收。
主要包括自我认同性别、年龄、首次出现性别焦虑的年龄、是否独生子女、受教育程度等。
采用自杀意念调查量表(Self-rating Idea of Suicide Scale, SIOSS)调查。量表包括绝望、乐观、睡眠、掩饰4个因子共26个条目,每个条目选择是或否。当前三个因子总分≥12分且掩饰因子< 4分,则纳入有自杀意念组[12]。本量表在本研究中的Cronbach α系数为0.78。
采用自我概念清晰度量表(Self-Concept Clarity Scale, SCCS)调查。该量表共12个条目,采用Likert 5点评分,从“非常不赞同”到“非常赞同”,分值范围为12 ~ 60,得分越高,表示自我概念清晰度越高[13]。本研究中,根据中位数将连续变量自我概念清晰度分数转换为分类变量,得分< 30为低自我概念清晰度,≥ 30为高自我概念清晰度。本量表在本研究中的Cronbach α系数为0.83。
采用生活满意度量表(Satisfaction With Life Scale, SWLS)调查。该量表共5个条目,采用1(完全不同意)~7(完全同意)7级计分,总分在0~35分,总分越高表示生活满意度越高,得分> 20分为高生活满意组,≤ 20为低生活满意组[14]。本量表在本研究中的Cronbach α系数为0.90。
采用领悟社会支持量表(Perceived Social Support Scale, PSSS)调查。该量表共12个条目,主要用于衡量个体对于来自不同社会支持来源的感知程度,采用Likert 7级评分,总分为12~84分,总分越高领悟社会支持水平越高。领悟社会支持分为三个维度,分别为家庭、朋友和其他支持,各维度量表得分范围在4~28分[15]。本研究中,将三个分量表的得分分别转换为分类变量,得分< 20分为低支持组,≥20为高支持组。本量表在本研究中的Cronbach α系数为0.88。
使用EpiData 3.1及双录入原则对数据进行录入。采用SPSS 27.0软件进行统计分析。计数资料采用频数、百分比(%)表示。采用卡方检验、独立样本t检验比较有自杀意念组与无自杀意念组跨性别者人口学特征等的组间差异,采用logistic回归分析跨性别者自杀意念的相关因素,检验水准α=0.05。对于所有多分类变量,均在回归模型中以哑变量的形式进行处理和分析。
共调查跨性别女性154名(90.6%),跨性别男性16名(9.4%),其社会人口学特征见表1。
跨性别者中自杀意念的检出率为54.7%(93/170)。自杀意念组与非自杀意念组在年龄、自我概念清晰度、生活满意度、领悟社会支持和家庭支持方面的差异有统计学意义(P < 0.05)。见表1。
以自杀意念为因变量(无=0,有=1),以年龄、受教育程度、是否经历过家庭暴力、生活满意度水平、家庭支持水平等为自变量,具体赋值见表2。多因素logistic回归分析结果显示,相比18~24岁年龄段,≥30岁的跨性别者更容易出现自杀意念(OR=3.35,95% CI=1.31~8.56);经历过家庭暴力的跨性别者更容易出现自杀意念(OR=2.97,95% CI=1.16~7.61);低生活满意度的跨性别者更容易出现自杀意念(OR=5.13,95% CI=2.29~11.50);低家庭支持的跨性别者更容易出现自杀意念(OR=3.31,95% CI=1.43~7.66),而本科以上的跨性别者不容易出现自杀意念(OR=0.42,95% CI=0.19~0.93);见表3。
本研究显示,跨性别者自杀意念检出率为54.7%,与其他研究结果有一定差异[16-17] ,这可能与调查使用的工具差异以及可能与文化背景有关。我国儒家思想中传统性别主张为二元对立[18],跨性别者的存在可能被视为对社会传统的挑战,使得该群体遭到社会排斥。本研究发现自杀意念检出率显著高于既往研究中顺性别者自杀意念检出率(11.7%)[19]也佐证这一事实。作为性少数群体,跨性别者因其身份的特殊性,长期暴露于多重社会压力源下,例如社会污名与社会歧视[20]。此外,较高的内化污名与身份隐藏行为又与更大的心理压力密切相关[21-22]。这些共同导致该群体自杀意念发生率的增高。
本研究发现,相比18~24岁年龄段,30岁及以上是跨性别者自杀意念的危险因素,与有关研究结果基本一致[23]。这可能是该群体由于社会或家庭的压力多进入婚姻,被迫隐藏跨性别身份,在家庭角色期待与性别表达的矛盾下,心理极度痛苦,更易导致自杀意念的产生[24]。生活满意度低是跨性别者自杀意念的危险因素。跨性别者因其性别认同与指派性别不同,在如厕、入住学校集体宿舍等基本生活场景中,常面临制度性或社会性的排斥,导致其日常生活体验和生活质量显著下降[25]。经历家庭暴力、低家庭支持是跨性别者自杀意念的危险因素。研究显示,跨性别者由于性别表达不一致,在家庭中至少遭受过一种家庭暴力[26]。部分跨性别者的父母甚至将其送至扭转机构,想通过某些手段“矫正”,而这些行为对跨性别者造成严重的身心伤害[27]。本科以上学历是跨性别者自杀意念的保护因素,澳大利亚研究发现,高等教育场所通常设有性别少数群体社团与心理咨询服务,能够为跨性别者提供支持,使得其自杀意念风险降低57%[28]。另有研究显示,66%的跨性别者产生过自杀念头,其中53%的跨性别者遭受过严重的心理困扰,但在政策支持度高的学校中,其心理困扰得分能显著降低[29]。印度关于跨性别者的研究显示,跨性别者常因歧视而辍学,辍学后能获得稳定工作的仅占12%,而高等教育学历能够显著改善就业情况,降低经济困难[30]。
本研究也存在一些局限性:本次研究的样本量偏小,且样本来源于与医疗系统有接触的跨性别者,这部分群体改变性别的意愿更为强烈,故研究结果可能与跨性别者整体的自杀意念相比偏高,建议未来研究可扩大样本范围和数量。
  • 首都临床诊疗技术研究及转化应用(Z211100002921039)
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doi: 10.20043/j.cnki.MPM.202507395
  • 接收时间:2025-07-26
  • 首发时间:2026-11-02
  • 出版时间:2025-12-25
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  • 收稿日期:2025-07-26
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首都临床诊疗技术研究及转化应用(Z211100002921039)
作者信息
    1.承德医学院,河北 承德 067000
    2.北京回龙观医院

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2种不同金属材料的力学参数
科
Family
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Number of
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Number of
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Percentage of total
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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