Attempting Suicide as Related To Gender Nonconformity and Transgender Issues.

Attempted Suicide, First Time: Homosexual vs. Heterosexual White/Black Males and Females, To Age 17 Years Bell & Weinberg (1978): Bay Area, San Francisco
Category	Incidence % (n / N)	Risk Ratio* (95% CI)	Odd Ratio* (95% CI)	p
White Homosexual Males, n = 575	4.9% 28 / 575	13.8 (1.9, 101.1)	14.5 (2.0, 107.0)	0.000
White Heterosexual Males, n - 284	0.35% 1 / 284	-	-	-
Black Homosexual Males, n = 111	11.7% 7 / 111	--	--	0.062
Black Heterosexual Males, n = 53	0.0% 0 / 53	-	-	-
White Homosexual Females, n = 229	5.2% 12 / 229	1.1 (0.38, 2.9)	1.1 (0.36, 3.1)	0.913
White Heterosexual Females, n = 101	5.0% 5 / 101	-	-	-
Black Homosexual Females, n = 64	6.2 % 4 / 64	0.79 (0.19, 3.3)	0.78 (0.16, 3.8)	0.751
Black Heterosexual Females, n = 38	7.9% 3 / 38	-	-	-
All information calculated from information given in Bell & Weinberg (1978): Tables 21.14 & 21.15, pages 453-454. * Compared with heterosexual counterpart.

Attempted Suicide, First Time: Homosexual vs. Heterosexual White/Black Males and Females, To Age 20 Years Bell & Weinberg (1978): Bay Area, San Francisco
Category	Incidence % (n / N)	Risk Ratio* (95% CI)	Odd Ratio* (95% CI)	p
White Homosexual Males, n = 575	9.4% 54 / 575	13.3 (3.3, 54.3)	14.6 (3.5, 60.4)	0.000
White Heterosexual Males, n - 284	0.7% 2 / 284	-	-	-
Black Homosexual Males, n = 111	11.7% 13 / 111	6.2 (0.83, 46.2)	6.9 (0.88, 54.2)	0.035
Black Heterosexual Males, n = 53	1.9% 1 / 53	-	-	-
White Homosexual Females, n = 229	10.5% 24 / 229	1.8 (0.74, 4.2)	1.8 (0.73, 4.7)	0.186
White Heterosexual Females, n = 101	5.9% 6 / 101	-	-	-
Black Homosexual Females, n = 64	9.4% 6 / 64	1.2 (0.31, 4.5)	1.2 (0.28, 5.1)	0.874
Black Heterosexual Females, n = 38	7.9% 3 / 38	-	-	-
All count & results calculated from information given in Bell & Weinberg (1978): Tables 21.14 & 21.15, pages 453-454. * Compared with heterosexual counterpart.

Childhood (To Age 17) Femininity / Masculinity Self-Rating Categories & Suicidality of White Predominantly Homosexual Males: First Time Suicide Attempts to Age 20 and After Age 20 - Bell et al. (1981) Data
Femininity / Masculinity Categories	Fem. 0 - 1	Feminine / Masculine 2 - 3	Masc. 4 - 6
% of Males in Category	9.6% (55/573)	47.8% 274/573	42.6% (244/573)
Attempted Suicide Percent	21.6% (12/55)	10.9% ¹ (30/274)	4.9% ^{2, 3} (12/244)
Attempted Suicide To Age 20	12.8% (42/329)		4.9% ⁴ (12/244)
Attempted Suicide After Age 20	7.6% (25/329)		10.6% ⁵ (26/244)

Calculations from Data Set (Tremblay & Ramsay, 2002): Femininity to Masculinity Scale: 0 to 6

Greater risk (95% Confidence Intervals) for attempting suicide: 1. "0-1" F-M Category vs. this Category - RR = 1.1<2.0<3.6 (χ² = 4.8, p = .027); 2. "0-1" F-M Category vs. this Category - RR = 2.1<4.4<9.3 (χ² = 17.4, p < .0000); 3. "2-3" F-M Category vs. this Category - RR = 1.2<2.2<4.2 (χ² = 6.3, p = .012); 4. "0-3" F-M Category vs. this Category - RR = 1.4<2.6<4.8 (χ² = 10.1, p = .001); 5. "0-3" F-M Category vs. this Category - RR = .42<.71<1.2 (χ² = 1.6, p = .20). See Note 2 for Odds Ratios.

BEM: Femininity / Masculinity Categories & Suicidality Gay And Bisexual Male Youth: Age 14 - 21 Years Remafedi, Farrow & Deisher (1991)
Femininity / Masculinity Categories	Feminine	Androgynous: 31% Undifferentiated: 26%	Masculine
% of Males in Category	23% (31/137)	31% + 26% = 57% (42/137) / (35/137)	20% (28/137)
Attempted Suicide Percent Incidence	48% (15/31)	Androgynous = 26%, Undifferentiated = 34% (23/77 = 30% )¹	11% (3/28)^{2, 3}
Attempted Suicide Percent Incidence	Feminine = 48%, Androgynous = 26%, Undifferentiated = 34% (38/108 = 35.2% )		11% (3/28)⁴

Bem Sex Role Inventory: Feminine: High F, Low M scores- Masculine: Low F, High M scores

Androgynous High F & M scores - Undifferentiated: Low F & M scores

Greater risk (95% Confidence Intervals) for attempting suicide: 1. "Feminine" Category vs. this Category - RR = .98<1.6<2.7 (χ² = 3.3, p = .068); 2. "Feminine" Category vs. this Category - RR = 1.4<4.5<14.0 (χ² = 9.8, p = .002); "Androgynous / Undifferentiated" Category vs. this Category - RR = .91<2.8<8.6 (χ² = 4.0, p = .044); 4. "Feminine / Androgynous / Undifferentiated" Category vs. this Category - RR = 1.1<3.3<9.9 (χ² = 6.3, p = .012). See Note 3 for Odds Ratios

"Attempted Suicide" Incidences/Risks Transgender (TG) Populations
Study	Sample Size (N) TG	Compa- rison Group	Attempted Suicide % (n / N)	Sampling Information Risk Ratio, p Odd Ratios, Specified
Xavier (2000) Washington D.C.	252 *MTF: 189	None	16%	70% African-American, 22% Latino/a, 8% Others. Age Range: 13 to 61 Years Nearly 80% = 36 years and under
** Nemoto (2001) San Francisco	MTF: 245	None	32%	MTF Of Color
	?		51%	African American
	?		31%	Latina
	?		18%	Asian / Pacific Islander
Nemoto et al. (2002) San Francisco	MTF: 332	None	29%	MTF Of Color ***8
	112		41%	African American - Mean Age: 36.5***
	110		45%	Latina - Mean Age: 32.9
	110		15%	Asian/Pacific Islander - Mean Age: 32.9
Mathy (2002b) Additional Results North American	73 TG 61 TG = Canadians 12 TG = Americans	1,083	23.3% vs 11.4%	TG vs. Random Heterosexual Females 2.9, p < .01
		1,077	23.3% vs 5.0	TG vs. Random Heterosexual Males 4.7, p < .001
		73	23.3% vs 11.0%	TG vs. Matched Females 2.1, p < .05
		73	23.3% vs 4.1%	TG vs. Matched Males 5.7, p < .001
		256	23.3% vs 16.0%	TG vs. Random Homosexual Females 1.5, ns
		356	23.3% vs 8.7%	TG vs. Random Homosexual Males 2.7, p < .001
Kenagy (2005) Philadelphia	All MTF: 182	None	30.1%	Volunteers: Face-to-Face Interview or Questionnaire - 41.3: African American, 33.0% white, 10.1% multiracial, 6.1& Hispanic, 5.6% biracial, 3.9% others. See also: Kenagy (1998)
	MTF: 113		32.4%
	* FTM: 69		26.2%
Operario & Nemoto (2005) San Francisco	MTF: 110 Asian Pacific Islanders	None	15% Same Sample as in Nemoto et al. (2002)	Volunteers: San Francisco **** Mean Age: 33, Range: 18 to 57 Years 46% of FTM = Filipino, 9% Laotian, 7% Vietnamese, 4% Hawaiian, remainder identifying as other Asian/PI ethnicities.
Clements- Nolle et al. (2006) San Francisco Additional Results	All TG: 515	None	32.2%	63.7% Non-White, 36.3% White
	MTF: 391	MTF vs. FTM	32.5%	OR = 1.04 (0.67, 1.6) ns, No Controls OR = 1.1 (0.59, 1.9), 9 Controls
	FTM: 123	MTF vs. FTM	31.7%
	White: 188	White vs. Non- White	37.8%	OR = 1.5 (1.02, 2.2), No Controls OR = 1.5 (0.92, 2.4), 9 Controls
	Others: 323	White vs. Non- White	28.8%
	< 25 Yrs: 66	< 25 vs 25 + Yrs	47.0%	OR = 2.1 (1.2, 3.5), No Controls OR = 2.17 (1.17, 4.01), 9 Controls
	25+ Yrs: 449	< 25 vs 25 + Yrs	30.1%
Zians (2006)	TG: 136	None	17.6% (24 / 136)	San Diego, California Mean Age: 38.3 (SD: 13.1) Age Range: 9 to 79 Years 48.3% White, 16.2% Latino, 14% African American, 10.3% Biracial
Kim et. al. (2006)	MTF: 43	49 Matched non-FTMs	62.8% (27 / 43)	Presenting at compulsory military service in 3 Korean Cities. Age Range: 19 to 23 Years
Taylor (2006)	TG: 73	None	28%	Winnipeg, Manitoba, Canada 49 Born Male, 21 Born Female, 3 Intersexed. 20 Aboriginal Age Range: 18 to 60+
* MTF: Male to Female - FTM: Female to Male The Nemoto (2001) Study Sample is Likely a Subset of Nemoto et al. (2002) Study Sample. * Mean Ages are from Nemoto et al. (2004). **** Face-to-Face Interviews.

The Mathy (2002b) Study of Transgender Suicidality North America: Internet Survey
Categories	TG	Random Heterosexual		Matched		Homosexual
Gender *	TG	F	M	F	M	F	M
N's	73	1,083	1,077	73	73	256	356
Mean Age SD Age Range	36.9 (10.0) 19-58	30.1 (9.3) 18-76	33.7 (11.0) 18-80	36.0 (9.8) 19-53	37.0 (10.0) 19-56	33.7 (8.9) 18-69	33.0 (9.7) 18-70
Attempted Suicide / Self-Harm **	23.3%	11.4%	5.0%	11.0%	4.1%	16.0%	8.7%
*** Risk Ratio: TG vs. Specified Category		2.9	4.7	2.1	5.7	1.5	2.7
p		< .01	< .001	< .05	< .001	ns	< .001
* TG = Transgender - M = Males - F = Females -- * Not Given in Mathy (2002b) Suicide Question: "I have made a serious suicide attempt or gesture." Yes/No Sampling: News Web Site: MSNBC - Every 1000th visitor: USA, Canada - A Sexuality Survey Using mostly counts from random sample, but also from volunteer sample. TG (Transgender) Sample: N = 73, 61 Canadian, 12 American, with 12 / 73 from random sample.

The Clements-Nolle et al. (2006) Study of Suicidality* In The San Francisco Transgender Population
Categories	Attempted Suicide Lifetime: % (n / n)	Odds Ratio (95%CI) Unadjusted **	Odds Ratio (95%CI) Adjusted
All, N = 515	32.2% (166 / 515)
MTF, n = 391 Male-to-Female	32.5% (127 / 391)	1.04 (0.67, 1.6) ns	1.1 (0.59, 1.9) Controls: 9 Variables
FTM, n = 123 Female-to-Male	31.7% (39 / 123_	1.04 (0.67, 1.6) ns	1.1 (0.59, 1.9) Controls: 9 Variables
White	37.8% (71 / 188)	1.5 (1.02, 2.2) p = 0.036	1.5 (0.92, 2.4) Controls: 9 Variables
Non-White	28.8% (93 / 323)	1.5 (1.02, 2.2) p = 0.036	1.5 (0.92, 2.4) Controls: 9 Variables
< 25 Years-Old	47.0% (31 / 66)	2.1 (1.2, 3.5) p = 0.006	2.17 (1.17, 4.01) Controls: 9 Variables
25 + Years-Old	30.1% (135 / 449)	2.1 (1.2, 3.5) p = 0.006	2.17 (1.17, 4.01) Controls: 9 Variables
Volunteers Interviewed. 37% White, 23% Black, 23% Latino/a, 11% Asian/PI, 5% Native American Median Age: 34, Age Range: 18 to 67 Years The "Attempted Suicide" 32% Lifetime Incidence was First Reported by Clements-Nolle et al. (2001) ** Odds Ratios Not Given. Calculated From Given Counts

Transgender and Transsexual People in Sweden An Internet Sample, N = 374 *
Age Group	Attempted Suicide, Lifetime
16 - 29 Years	27%, n = ?
30 - 44 years	28%, n = ?
45 - 54 years	12%, n = ?
55 - 64 Years	21%, n = ?
* Web Survey Data: Reported in National Public Health Survey, 2005. For comparison of Transgender Suicidality results to GLB & HeterosexualResults, See Table.

Transgender and Transsexual People in the United Kingdom An Internet Sample, N = 872**
Frequency	Attempted Suicide / Self-Harmed in Adulthood*
Once	14%
Twice	7%
Three or More Tmes	14%
One or More Times	34.4%
Resulting from being a crossdresser, transgender/transsexual person or because of other people’s reactions to them being trans. Note: Data was solicited on suicdality before the age of 21 years, but the results were not reported. In Whittle et al. (2008), the incidence in this category was reported to be also 34%. * Sample may include duplicates? Data Source: Whittle et al. (2007)

Transgender and Transsexual People in Europe An Internet Sample, N = 985 (UK = 322)**
Frequency	Attempted Suicide / Self-Harmed in Adulthood*
Once	?
Twice	?
Three or More Tmes	?
One or More Times	29.9%
Resulting from being a crossdresser, transgender/transsexual person or because of other people’s reactions to them being trans. Note: Data was solicited on suicdality before the age of 21 years, but the results were not reported. * Duplicates Removed. Data Source: Whittle et al. (2008)

Note 1

The Sampling for Bell & Weinberg (1978): The largest sample pool was of white predominantly homosexual males obtained via the following venues: Public Advertising (914), Bars (994), Personal Contacts (617), Gay Baths (249), Public Areas such as parks rest rooms, and streets (137), Homophile Organizations (222), Mailing Lists - with mail back cards (200), and private Bars (220). The total sample of white homosexual males (N = 3533) was then subjected to random sampling within contact cells to produce the final study sample of 575 white predominantly homosexual males. Obtaining a good (likely highly representative) study sample was accomplished because the researchers applied their great knowledge of homosexually oriented males to the sampling process. Therefore, the final study sample represented, as best as possible, the great majority of homosexually oriented males living in the San Francisco Bay Area. The sampling method also likely produced the most representative sample taken to the 1990s of white homosexually oriented males living in a North American city. The matching sample of predominantly heterosexual males (N = 284) was obtained via stratified random sampling in the same area.

Note 2

For the Bell et al. (1981) data (1969 sample, mean age = 37 years) generated by Tremblay and Ramsay (2002), and using the 2 X 2 Table located at - http://home.clara.net/sisa/twoby2.htm, the following Risk Ratios (RR) and Odds Ratios OR) for attempting suicide were calculated with 95% Confidence Intervals. 1. "0-1" F-M Category vs. "2-3" F-M Category - RR = 1.1<2.0<3.6, RR = 1.1<2.3<4.8 (χ² = 4.8, p = .027); 2. "0-1" F-M Category vs. "4 to 6" Category - RR = 2.1<4.4<9.3, OR = 2.3<2.4<12.8 (χ² = 17.4, p < .0000); 3. "2-3" F-M Category vs. "4 to 6" Category - RR = 1.2<2.2<4.2, OR = 1.2<2.4<4.8 (χ² = 6.3, p = .012); 4. "0-3" F-M Category vs. "4 to 6" Category - RR = 1.4<2.6<4.8, RR = 1.4<2.8<5.5 (χ² = 10.1, p = .001); 5. "0-3" F-M Category vs. "4 to 6" Category - RR = .42<.71<1.2, OR = .39<.69<1.2 (χ² = 1.6, p = .20). Categories: Feminine (0) to Masculine (6) Self-Rating on 7-point scale for childhood and adolescence (to the age of 17 years).

Note 3

For the Remafedi et al. (1991) data (Age Range 14-21 years), and using the 2 X 2 Table located at - http://home.clara.net/sisa/twoby2.htm, the following Risk Ratios (RR) and Odds Ratios (OR) for attempting suicide were calculated with 95% Confidence Intervals. 1. "Feminine" Category vs. "Androgynous / Undifferentiated" Category - RR = .98<1.6<2.7, OR = .93<2.2<5.2 (χ² = 3.3, p = .068); 2. "Feminine" Category vs. "Masculine" Category - RR = 1.4<4.5<14.0, OR = 1.9<7.8<31.3 (χ² = 9.8, p = .002; 3. "Androgynous / Undifferentiated" Category vs. "Masculine" Category - RR = .91<2.8<8.6, OR = .97<3.5<12.9 (χ² = 4.0, p = .044); 4. "Feminine / Androgynous / Undifferentiated" Category vs. "Masculine Category - RR = 1.1<3.3<9.9, OR = 1.3<2.9<16.0 (χ² = 6.3, p = .012). Categories: Bem (1981) Sex Role Inventory.

Note 4

Harry J (1983a).Abstract: The hypotheses that gender-role nonconformity during childhood is associated with social isolation, which in turn is related to subsequent suicidal feelings and attempts, were tested. These ideas were explored in a four-group sample of homosexual and heterosexual men and women living in San Francisco. The data indicated that there was support for the hypotheses; however, childhood gender-role nonconformity was more consequential for the later suicidality of men than of women. The data indicated consistently that gender deviance was more benign in women than in men.

D'Augelli, A.R., Grossman, A.H., & Starks, M.T. (2005), Parents' awareness of lesbian, gay, and bisexual youths' sexual orientation. Journal of Marriage and Family, 67, 474-482. Have

Grossman, A.H., & D'Augelli, A.R. (2006). Transgender youth: Invisible and vulnerable. Journal of Homosexuality,51(1), 111-128. PubMed Abstract.

Grossman, A.H.,, D'Augelli, A.R., Salter, N.P. (2006). Male-to-Female Transgender Youth: Gender Expression Milestones, Gender Atypicality, Victimization, and Parents' Responses. Journal of GLBT Family Studies, 2(1), 71-91.

Grossman, A.H., D'Augelli, A.R., Salter, N.P., Hubbard, S.M. (2005). Comparing gender expression, gender nonconformity, and parents' responses of female-to-male and male-to-female transgender youth: Implications for counseling. Journal of LGBT Issues in Counseling, 1(1), 41-59.

D'Augelli, A.R., Grossman, A.H., & Starks, M.T. (2006). Childhood gender atypicality, victimization, and PTSD among lesbian, gay, and bisexual youth. Journal of Interpersonal Violence, 21(11), 1462-1482. have

Grossman, A. H., O’Connell, T. S., & D’Augelli, A. R. (2005). Leisure and recreational “girl-boy”activities: Studying the unique challenges provided by transgendered young people. Leisure: Journal of the Canadian Association for Leisure Studies, 29 (1), 5-26

Journal of Gay & Lesbian Social Services, Vol. 18(1): 3-16. 2005 Haworth Abstract.
Parents’ Reactions to Transgender Youths’ Gender Nonconforming Expression and Identity
Arnold H. Grossman
Anthony R. D’Augelli
Tamika Jarrett Howell
Steven Hubbard

Williams, W. (1996). Two-spirited persons: Gender nonconformity among Native American and Native Hawaiian youths. In R.Savin-Williams & K. Cohen (Eds.), The Lives of Lesbians, Gays, and Bisexuals (pp. 416-435). New York: Harcourt Brace College Publishers.

The Gay Male Gaze: Body Image Disturbance and Gender Oppression Among Gay Men
Page Range: 43 - 62
DOI: 10.1300/J041v17n02_03
Copyright Year: 2004
Contributors:     Mitchell J. Wood MDiv, MSW, New York University Ehrenkranz School of Social Work, Columbia University Center for Gay and Lesbian Mental Health, Brooklyn, NY 11215, mjw245@nyu.edu
Abstract:
This article examines body image disturbance among gay men from various sociocultural perspectives. A review of the empirical literature on body image disturbance indicates that gay males experience greater body dissatisfaction than other groups due to their higher levels of gender nonconformity. The impact of gendered power relations on body image is considered in light of feminist, postmodernist, queer, and disability theories of the body. The history of gay bodily beauty is also examined, along with contemporary critiques of gay body politics. The author concludes that gender oppression constitutes a distinct mode of psychosocial oppression among gay men that is no less disabling than heterosexism, and therefore deserves greater attention in gay affirmative theory, research, and practice.

Self-Perceived Gender Typicality and the Peer Context During Adolescence

    * Tara E. Smith11University of California Santa Cruz and
    * Campbell Leaper11University of California Santa Cruz 2006

Bibliography

Bell AP, and Weinberg MS (1978). Homosexualities: a study of diversity among men & women. Simon and Schuster, N.Y. Research Highlights.

Bell A, Weinberg M, Hammersmith S (1981). Sexual Preference: Its Development in Men and Women. Bloomington, Indiana: Indiana University Press.

Bell A, Weinberg M, Hammersmith S (1981). Sexual Preference: Statistical Appendix. Bloomington, Indiana: Indiana University Press.

Bergling, Tim (2001). Sissyphobia: Gay Men and Effeminate Behavior. New York: Harrington Park Press. Internet: http://www.timbergling.com/sissyphobia/ - Excerpt: Amazon.com. Book Review.

Boney, Bradley (1996). The Lavender Brick Road: Paul Bonin-Rodriguez and the Sissy Bo(d)y. Theatre Journal, 48(1): 35-57. Internet: http://muse.jhu.edu/demo/tj/48.1boney.html .

Clements-Nolle KD (2001). HIV Prevalence, Risk Behaviors and Attempted Suicide in a Hidden Population: Results From the Transgender Community Health Project. Ph.D. Dissertation. University of California, Berkeley. Full Text available from UMI ProQuest Digital Dissertations.

Clements-Nolle K, Marx R, Guzman R, Katz M (2001). HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention. American Journal of Public Health, 91(6): 915-21. PubMed Abstract. Full Text.

Clements-Nolle K, Marx R, Katz M (2006). Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. Journal of Homosexuality, 51(3): 53-69. PubMed Abstract.

FHI-Rapport (2005). Homosexuellas, bisexuellas och transpersoners hälsosituation. Återrapportering av regeringsuppdrag att undersöka och analysera hälsosituationen bland HBT-personer. (nr. 19) Statens folkhälsoinstitut [Gay, bisexual and transgender people's health. A goverment report examining and analysing the health situation among LGBT people. Translations to English was done by Google, with some editing needed.]. PDF Download.

Friedman MS, Koeske GF, Silvestre AJ, Korr WS, Sites EW (2006). The impact of gender-role nonconforming behavior, bullying, and social support on suicidality among gay male youth. Journal of Adolescent Health, 38(5): 621-3. PubMed Abstract.

Friedman MS (2002). Gender Role Nonconformity, Bullying and Suicidality Among Gay and Bisexual Male Adolescents. Ph.D. Dissertation. School of Social Work, University of Pittsburgh. Full Text available from UMI ProQuest Digital Dissertations.

Harry J (1983a). Parasuicide, gender, and gender deviance. Journal of Health and Social Behavior, 24(4): 350-61. PubMed Reference. Abstract.

Harry J (1983b). Defeminization and adult psychological well-being among male homosexuals. Archives of Sexual Behavior, 12(1): 1-19. PubMed Abstract.

Kenagy GP (2005). Transgender Health: Findings from Two Needs Assessment Studies in Philadelphia. Health and Social Work, 30(1): 19-26. PubMed Abstract. Full Text.

Kenagy GP (1998). Exploring an Oppressed Group: A Study of the Health and Social Service Needs of Transgendered People in Philadelphia. Ph.D Dissertation. University of Pennsylvania. Full Text available from UMI ProQuest Digital Dissertations. Full Text.

Kim TS, Cheon YH, Pae CU, Kim JJ, Lee CU, Lee SJ, Paik IH, Lee C (2006). Psychological burdens are associated with young male transsexuals in Korea. Psychiatry and Clinical Neuroscience, 60(4): 417-21. PubMed Abstract.

Kruks G (1991). Gay and lesbian homeless/street youth: special issues and concerns. Journal of Adolescent Health, 12(7): 515-8. PubMed Abstract.

Mathy, RM (2002a). Suicidality and Sexual Orientation in Five Continents: Asia, Australia, Europe, North America, and South America. International Journal of Sexuality and Gender Studies, 7, 2/3, 215-225. Abstract. Springer Abstract.

Mathy, RM (2002b). Transgender Identity and Suicidality in a Nonclinical Sample: Sexual Orientation, Psychiatric History, and Compulsive Behaviors. Journal of Psychology & Human Sexuality, 14(4): 47-65. Haworth Abstract.

Nemoto T, Keatley J, Operario D, Soma T (2002). Psychosocial Factors affecting HIV Risk Behaviors among Male to Female transgenders in San Francisco. Poster # WePeE6583, presented at the XIV International AIDS Conference in Barcelona, Spain, July 2002. Internet: http://www.hawaii.edu/hivandaids/Psychosocial%20Factors%20Affecting%20HIV%20Risk%20Behaviors%20Among%20MTF%20Transgenders.pdf .

Nemoto T, Operario D, Keatley J, Han L, Soma T (2004). HIV risk behaviors among male-to-female transgender persons of color in San Francisco. American Journal of Public Health, 94(7): 1193-9. PubMed Abstract. Full Text.

Nemoto (2001). Study results reported in "TRANS Research," Center For AIDS Prevention Studies. Internet: http://caps.ucsf.edu/projects/TRANS/transresearch.php .

Operario D, Nemoto T (2005). Sexual risk behavior and substance use among a sample of Asian Pacific Islander transgendered women. AIDS Education and Prevention, 17(5): 430-43. PubMed Abstract.

Remafedi G, Farrow JA, Deisher RW (1991). Risk factors for attempted suicide in gay and bisexual youth. Pediatrics, 87(6): 869-75. PubMed Abstract.

Taylor (2006). Nowhere Near Enough: A Needs Assessment of Health and Safety Services for Transgender and Two Spirit People in Manitoba and Northwestern Ontario. Winnipeg, Manitoba. Internet: http://www.turtleisland.org/healing/transgender.doc . Executive Summary and Download Page: http://www.turtleisland.org/discussion/viewtopic.php?p=7927 .

Tremblay P, Ramsay R (2002). Statistical results generated via SPSS-10 by Thomas G. Albright, Systems Analyst/Programmer at the Kinsey Institute for Research in Sex, Gender and Research. January 9 and 11, 2002.

Whittle S, Turner L, Al-Alami M (2007). Engendered Penalties: Transgender and Transsexual People’s Experiences of Inequality and Discrimination. Manchester Metropolitan University. A Research Project and Report Commissioned by the Equalities Review. PDF Download. PDF Download.

Whittle S, Turner L, Combs R, Rhodes s (2008). Transgender EuroStudy: Legal Survey and Focus on the Transgender Experience of Health Care. Brussels, Belgium: ILGA-Europe: The European Region of the International Lesbian and Gay Association. Download Page. PDF Download.

Xavier JM (2000). The Washington Transgender Needs Assessment Survey. Executive Summary. Internet: http://www.glaa.org/archive/2000/tgneedsassessment1112.shtml .

Zians J (2006). The San Diego County Transgender Assessment Report. San Diego, California. Internet: http://www.calendow.org/reference/publications/pdf/cultural/TransAssessmentREPORTFINAL1-18-06.pdf .