Results:
The suicide attempt rate among transgender persons ranges from 32% to 50% across the countries. Gender-based victimization, discrimination, bullying, violence, being rejected by the family, friends, and community; harassment by intimate partner, family members, police and public; discrimination and ill treatment at health-care system are the major risk factors that influence the suicidal behavior among transgender persons.
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Suicide prevention – the recommendations
The interventions and programs to enhance protective factors and resiliency factors are as important as programs for risk reduction; these interventions should be delivered through cultural competence approach[25,27] and should be more LGBT inclusive[26] which help an agency, system, or a professional to work effectively in cross-cultural situations.
The suicide prevention interventions and programs for all youth can also be implemented for LGBT individuals mainly in three settings, schools (suicide awareness curricula), communities (gate-keeper training) and health-care system (screening) and crisis centres, hotlines, and risk reduction which can include restricted access to lethal means, media training, and youth life-skills training also can be part of it.[7,25] Community awareness campaigns, discrimination and hate crime legislations, culturally and age appropriate suicide prevention interventions[28] including peer-based outreach, counseling and referrals,[9] targeting the institutions such as schools, family, community, health-care system,[25] police and judiciary,[11] effective treatment for symptoms of hopelessness, depression, conduct disorder, family-based interventions to enhance the support and reduce the victimization,[21] effective intervention in addressing high rates of HIV infection, multiple and complex high-risk behavior and comorbid conditions,[27] addressing sociocultural factors such as LGBT assault hate crimes at the neighborhood[22] providing educational and resource materials on LGBT suicide to the LGBT organizations and encourage these organizations to consider suicide prevention at their organizations' mission and activities,[26] all these would help in achieving increased societal acceptance of the transgender community and decreased gender-based prejudice and also in the promotion of mental health and reduction of suicidal risk among transgender community.
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