ArticleSocial psychiatry and psychiatric epidemiology2022
Syndemic relationship of depressive symptoms, substance use, and suicidality in transgender youth: a cross-sectional study using the U.S. youth risk behavior surveillance system.
Article in Social psychiatry and psychiatric epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 17 citations in OpenAlex.
- Strategies to Facilitate Service Utilization Among Youth at Risk for HIV: A Randomized Controlled Trial (ATN 149).AIDS and behavior · 2025Trial
- Latent Class Analysis of Substance Use Behaviors and Associations of Class Membership With Gender Affirmation, Social Determinants of Health, and HIV Status Among Transfeminine Adults in the Eastern and Southern United States.Journal of studies on alcohol and drugs · 2026Article
- Exploring syndemic vulnerability among adolescents living in urban cities in the Netherlands: a latent class analysis.BMJ public health · 2026Article
- Forms of transphobia and their influence on health outcomes among transgender, nonbinary, and gender diverse individuals: a global systematic review.International journal of transgender health · 2025Article
- Identifying Intersecting Factors Associated With Suicidal Thoughts and Behaviors Among Transgender and Gender Diverse Adults: Preliminary Conditional Inference Tree Analysis.Journal of medical Internet research · 2025Article
- A Syndemic Clustering of Adversities on Suicide Risk among YMSM Living with HIV in Bangkok: A Causal Latent Class Analysis.AIDS and behavior · 2025Article
- High-risk polysubstance use among LGBTQ+ people who use drugs in the United States: An application of syndemic theory.The International journal on drug policy · 2023Article
- Prevalence of self-inflicted injuries among transgender and gender diverse adolescents and young adults compared to their peers: an examination of interaction with mental health morbidity.Annals of epidemiology · 2023Article
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Authors and funding
5 authors at 5 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
purposeSyndemics are co-occurring epidemics that cluster within populations due to shared socio-structural factors and are often in populations with intersecting forms of vulnerability. Suicide, depression, and substance use all disproportionately affect transgender and gender diverse (TGD) youth. In this study, we test a syndemic model of the relationship between these three mental health conditions in the context of economic deprivation and interpersonal discrimination.
methodsWe used data on substance use, depressive symptoms, suicidality, and social-structural factors from 2680 TGD youth captured in the 2017 and 2019 survey waves of the Youth Risk Behavior Surveillance System. We used a latent class analysis (LCA) to identify groups with distinct patterns of self-reported substance use and depressive symptoms, and regression models to characterize the relationship between substance-use, depressive symptoms, class membership, social-structural factors, and suicidality.
resultsA three-class LCA solution identified a subset of student respondents in a "high use" latent class characterized by high self-reported substance use frequency and depressive symptoms compared with other classes. Online bullying (aOR: 1.58; 95% CI: 1.28-1.95) and housing insecurity (aOR: 8.78; 95% CI: 4.35-17.71) were associated with increased odds of "high use" class membership relative to the "no use" class membership. "High use" class membership was associated with increased odds of suicidal ideation (aOR: 2.26; 95% CI: 1.75-2.94), plans (aOR: 2.59; 95% CI: 2.01-3.36), and attempts (aOR: 6.85; 95% CI: 3.17-15.68).
conclusionThe co-occurrence of substance use and depressive symptoms is associated with socio-structural factors and may drive risk for suicidality among TGD youth. Meaningful suicide prevention efforts that address disproportionate risk in this population must be attentive to and mitigate the shared determinants of mood symptoms and substance use behavior.
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