Date Available

3-11-2020

Year of Publication

2020

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Social Work

Department/School/Program

Social Work

First Advisor

Dr. Julie Cerel

Abstract

Despite their frequent utilization of mental health resources, transgender and gender diverse (TGD) adults are more likely than their cisgender counterparts to attempt suicide. While this phenomenon may inspire a myriad of explanations, the present dissertation is interested in two exploratory ideas: namely, that 1) mental health professionals may be failing their TGD clients, and 2) traditional mental health paradigms may be myopically inadequate. Paper 1 addresses the first issue by considering TGD experiences of active discrimination by mental health professionals. In addition to investigating the prevalence of abuse, this paper analyzes how intersectionality of oppression plays a role in mental health discrimination. Results suggest that age, income, race/ethnicity, gender identity, and sexual orientation are significant predictors of discrimination, and certain populations (people of color, non-binary individuals, and those living in poverty) are particularly vulnerable to abuse. Paper 2, a content analysis, builds on the quantitative foundation of Paper 1, establishing themes associated with TGD-inclusive mental healthcare. Here, more direct links between ineffective providers and suicide attempts are realized. Competent providers are identified by their helpfulness, trustworthiness, and understanding of TGD issues, while incompetent providers inflate their expertise, conflate TGD experiences with LGB experiences, and manipulate their clients. Finally, Paper 3 introduces an alternative to pathologizing mental health paradigms: a model that pinpoints protective social support mechanisms. Regression results reveal that community support, acquaintance support, and family support, along with race, age, and income, are predictive of not attempting suicide. All three papers draw from one of the most expansive (N= 4,467) mental health surveys of TGD Adults: the 2017 Trans Mental Health Survey. The statistical analyses reported in Papers 1 and 3 were performed in IBM SPSS version 26 software. Ultimately, the cumulative purpose of these papers is to inform mental health providers about iatrogenic and ameliorative practices involved in working with TGD clients. These papers also highlight the protective quality of social support: the significance of which must not be ignored in TGD suicide research or in clinical practice.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2020.104

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