When you can’t go home: Associations between family environment and suicidality for transgender youth with histories of homelessness

Abstract

Transgender youth who are or have been homeless are at an increased risk of suicide. To better understand risk and protective factors for suicide in this population, the present qualitative study analyzed interviews with 30 racially diverse transgender young people (ages 15-26) who had experienced homelessness. Inductive qualitative content analysis revealed that gender-based rejection from family members, other dysfunctional family dynamics (e.g., domestic violence, substance abuse), and mental illness appeared to increase risk of both homelessness and suicide, rather than homelessness itself increasing suicide risk. Results show that although homelessness was a stressor in these young people’s lives, conflict and rejection from family members could also be severe stressors. In these instances, participants managed conflictual relationships in ways that allowed them to maintain relationships when safe, and to create distance when relationships were not supportive. Findings suggest that clinicians and other service providers working with homeless transgender youth need to be mindful of the intersectional nature of potential familial stressors, wherein gender-based prejudice can interact with other family dysfunction to make the home unsafe, and to facilitate their clients’ agency in establishing appropriate boundaries with family members. Additionally, efforts to support trans youth may need to focus on advocating for the expansion of social safety net programs that provide access to basic necessities in order to proactively reduce harm to transgender people, regardless of their specific family circumstances.