Transgender suicidal ideation rate in Iran similar to those of Western countries

As many as 70% of transgender men and transgender women in Iran experienced suicidal ideation, according to results of an observational retrospective study published in Journal of Psychiatric Research.

This finding was “surprisingly similar” to those of Western studies despite transgender individuals in Iran facing more significant difficulties in a non-Western sociopolitical context, the authors said.

“A high incidence of psychiatric morbidity among people with [gender dysphoria] can be due to several factors such as victimization (social stigma, discrimination, transphobia, sexual abuse, gender abuse, minority stress), difficulties accessing health care and social services, and interpersonal problems they experience in during lifetime,” Behzad S. Khorashad, of the Psychiatry and Behavioral Sciences Research Center at Mashhad University of Medical Sciences in Iran, and colleagues wrote. “Given the influence of the sociopolitical context in each society on the lived experience of sexual and gender minorities, it is plausible to expect different levels of stress and, consequently, different levels of mental health disorders in people with gender dysphoria. Therefore, it is helpful to study the mental health aspects of transgender people in non-Western societies.”

The researchers aimed to outline the psychiatric profiles of 205 (transgender men = 110; transgender women = 95; mean age, 24.41 years) individuals who were referred to the Transgender Studies Centre (TSC) at the Mashhad University of Medical Sciences in Iran between February 2015 and March 2017. During four or more sessions, referred individuals underwent evaluation for sociodemographic and psychiatric characteristics. A subset of these individuals (n = 154) underwent assessment via the Structured Clinical Interview based on the DSM-5.  

Results showed no significant difference between transgender men and transgender women (P = 0.96). A total of 48% of participants had one or more current psychiatric conditions and 67% during their lifetime. Depressive-, trauma- and stressor-related disorders were the most common conditions. Both genders exhibited similar prevalence rates. Up to 70% of individuals in both transgender men and transgender women groups reported having experienced suicidal ideation.

“These findings demand more extensive attention of mental health providers at all levels to protect this vulnerable community, particularly during puberty and early adolescence,” Khorashad and colleagues wrote. “These findings should not only help clinicians in Iran, but also those in countries with similar socio-political and cultural contexts to carefully monitor and follow their clients. Future studies should focus on the long-term outcomes of transition, the effect of gender-affirming treatment and whether it improves health and quality of life.”