Prevalence of gender identity disorder and suicide risk among transgender veterans utilizing veterans health administration care.
OBJECTIVE
We estimated the prevalence and incidence of gender identity disorder (GID) diagnoses among veterans in the Veterans Health Administration (VHA) health care system and examined suicide risk among veterans with a GID diagnosis.


METHODS
We examined VHA electronic medical records from 2000 through 2011 for 2 official ICD-9 diagnosis codes that indicate transgender status. We generated annual period prevalence estimates and calculated incidence using the prevalence of GID at 2000 as the baseline year. We cross-referenced GID cases with available data (2009-2011) of suicide-related events among all VHA users to examine suicide risk.


RESULTS
GID prevalence in the VHA is higher (22.9/100 000 persons) than are previous estimates of GID in the general US population (4.3/100 000 persons). The rate of suicide-related events among GID-diagnosed VHA veterans was more than 20 times higher than were rates for the general VHA population.


CONCLUSIONS
The prevalence of GID diagnosis nearly doubled over 10 years among VHA veterans. Research is needed to examine suicide risk among transgender veterans and how their VHA utilization may be enhanced by new VA initiatives on transgender care.
John R. Blosnich is with the Department of Psychiatry, University of Rochester, Rochester, NY. George R. Brown is with the VA Office of Health Equity (10A6), Washington, DC. Jillian C. Shipherd is with VA Boston Healthcare System, Boston, MA. Michael Kauth is with VA South Central Mental Illness Research, Education, & Clinical Center, Michael E. DeBakey VA Medical Center, Houston, TX. At the time of this study, Rebecca I. Piegari was with Department of Veteran Affairs VISN-2 Center of Excellence for Suicide Prevention, Canandaigua, NY. Robert M. Bossarte is with the Department of Veteran Affairs VISN-2 Center of Excellence for Suicide Prevention.
John R
JR
Blosnich
George R
GR
Brown
Jillian C
JC
Shipherd Phd
Michael
M
Kauth
Rebecca I
RI
Piegari
Robert M
RM
Bossarte
D016001:Confidence Intervals; D057286:Electronic Health Records; D005260:Female; D005783:Gender Identity; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D013405:Suicide / Q000706:statistics & numerical data*; D014189:Transsexualism / Q000453:epidemiology* / Q000523:psychology*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D000092864:Suicide Prevention