Transgender adolescents are at greater risk for attempting suicide than cisgender teens who identify with the gender they are assigned at birth. This is according to a study from the University of Arizona, which takes a deeper look at who within the transgender adolescent community is most at risk.

More specifically, transmasculine adolescents – or those who were born female but identify as male – and teens who don’t identify as exclusively male or female are at the greatest risk for attempting suicide.

The research, done by Russell Toomey and his colleagues and published in the journal Pediatrics, is consistent with findings on transgender adults and could help inform suicide-prevention efforts for transgender youth.

In the past, research on transgender adolescent suicide behaviors focused on comparing transgender youth as a whole group to cisgender youth as a whole group, rather than looking for any within-group differences that might exist.

Toomey and his co-authors found that 50.8% of transmasculine adolescents between the ages of 11 and 19 have attempted suicide at least once, while 41.8% of nonbinary adolescents – those who don’t identify as exclusively male or exclusively female – have attempted suicide. The next most at-risk adolescent groups were transfeminine – those who were born male but identify as female – at 29.9%, and those questioning their gender identity, at 27.9%.

Risk was lower for cisgender teens, or those who identify with the sex they were assigned at birth. Among females, 17.6% said they had attempted suicide, while the number for males was 9.8%.

The findings are based on an analysis of data from the Profiles of Student Life: Attitudes and Behaviors survey, a national survey designed to provide a snapshot of youth behaviors, attitudes and experiences. The survey focuses on 40 developmental assets know to be associated with healthy development, as well as risk behaviors, such as depression and suicidal behaviors. Data was collected over a 36-month period between 2012 and 2015, and from 120,617 adolescents, most of whom identified as cisgender.

Survey respondents were asked, among other things, about their gender identity and whether or not they had ever attempted suicide. Nearly 14% of all adolescents surveyed reported having attempted suicide at least once.

“Nonbinary youth are putting themselves out there every day as not being read by society as male or female, and there hasn’t been much research on this population, but we expect that they’re probably experiencing the highest levels of discrimination or victimization from their peers and from communities, based on their gender presentation,” Toomey said.

The researchers also found that sexual orientation exacerbated suicide risk for almost everyone in the survey. The only population whose risk didn’t seem to be affected by sexual orientation was the nonbinary population.

“Nonbinary youth do not identify as totally masculine or totally feminine, so it complicates an understanding of sexual orientation, which is rooted in a binary, male-female understanding of gender. Thus, for these youth, the combination of gender and sexual orientation may be more complicated,” Toomey said.

Toomey and his colleagues similarly examined the impact of other factors – including race and ethnicity, parents’ educational attainment, and the types of communities where teens grow up – on suicide risk.

They found that although cisgender teens who belonged to a racial or ethnic minority had a heightened suicide risk, race and ethnicity was not associated with higher suicide risk in transgender teens.

Toomey and his co-authors also found that some factors that seem to protect cisgender teens from suicide risk – such as having parents with a higher level of educational attainment or having grown up in a more urban versus rural community – do not have the same effect for transgender teens.

Suicide ranks as the second leading cause of death among adolescents and young adults ages 10 to 34 in the US alone; and research suggests that between 28% and 52% of transgender people attempt suicide at some point in their lives. As such, trans-specific factors should be integrated into suicide prevention and intervention strategies.

“Transmasculine youth and nonbinary youth are the two populations that often are the least focused on in the transgender community,” he said. “So really reorganizing our efforts to focus in and try to really understand and learn about the experiences of these youth is critical.”

People who are bullied at work or experience violence at work are at higher risk of heart and brain blood vessel problems, including heart attacks and stroke. This is according a study – “Workplace bullying and workplace violence as risk factors for cardiovascular disease: a multi-cohort study” – done by Tianwei Xu et al. and published in the European Heart Journal.

It is worth stressing that the study was observational, and – as such – “cannot show that workplace bullying or violence cause cardiovascular problems”. However, it – nonetheless – shows that “there is an association (between the two),” and so the results “have important implications for employers and national governments.”

“If there is a causal link between bullying or violence at work and cardiovascular disease, then the removal of workplace bullying would mean we could avoid five per cent of all cardiovascular cases, and the eradication of violence at work would avoid more than three per cent of all cases,” said Tianwei, the lead researcher.

Bullying ‘follows’ LGB people from school to work

It is worth noting that members of the LGBTQIA community are more exposed to bullying. A study released last April 2018, for instance, investigated gender expression and victimization of youth aged 13-18, and it found that the most gender nonconforming students reported higher levels of being bullied, were more likely to report missing school because they feel unsafe, and are most likely to report being victimized with a weapon on school property.

Sadly, for LGBTQIA people who are bullied at school, the bullying follows them to the workplace. A study released in November 2018 found that 35.2% of gay/bisexual men who had experienced frequent school-age bullying experience frequent workplace bullying. Among lesbian women, the figure was 29%.

For Tianwei’s study in particular, the researchers looked at data from 79,201 working men and women in Denmark and Sweden, aged 18 to 65, with no history of cardiovascular disease (CVD), who were participants in three studies that started between 1995 and 2011; the participants have been followed up ever since. When they joined the studies, the participants were asked about bullying and violence in the workplace and the frequency of their experience of each of them. Information on the number of cases of heart and brain blood vessel disease and deaths was obtained from nationwide registries.

The researchers also took account of other factors that could affect whether or not the participants were affected by CVD, including body mass index, alcohol consumption, smoking, mental disorders and other pre-existing health conditions, shift working and occupation.

Nine percent of participants reported being bullied at work and 13% reported experiencing violence or threats of violence at work in the past year. After adjusting for age, sex, country of birth, marital status and level of education, the researchers found that those who were bullied or experienced violence (or threats of violence) at work had a 59% and 25% higher risk of CVD, respectively, compared to people who were not exposed to bullying or violence.

The more bullying or violence that was encountered, the greater the risk of CVD. Compared with people who did not suffer bullying, people who reported being bullied frequently (the equivalent to being bullied almost every day) in the past 12 months had 120% higher risk of CVD, while those who were exposed most frequently to workplace violence had a 36% higher risk of cerebrovascular disease (such as stroke) than those not exposed to violence, but there did not appear to be a corresponding increase in heart disease.

1-in-4 girls, 1-in-10 boys report self-injury or attempt suicide due to fighting, bullying or forced sex

“Workplace bullying and workplace violence are distinct social stressors at work. Only 10-14% of those exposed to at least one type of exposure were suffering from the other at the same time. These stressful events are related to a higher risk of cardiovascular disease in a dose-response manner – in other words, the greater the exposure to the bullying or violence, the greater the risk of cardiovascular disease,” Tianwei said. “From this study we cannot conclude that there is a causal relation between workplace bullying or workplace violence and cardiovascular disease, but we provide empirical evidence in support of such a causal relation, especially given the plausible biological pathway between workplace major stressors and cardiovascular disease.”

The effect of bullying and violence on the incidence of cardiovascular disease in the general population is comparable to other risk factors, such as diabetes and alcohol drinking, which further highlights the importance of workplace bullying and workplace violence in relation to cardiovascular disease prevention. For Tianwei, “it is important to prevent workplace bullying and workplace violence from happening, as they constitute major stressors for those exposed. It is also important to have policies for intervening if bullying or violence occurs.”

Other interesting findings from the research included the fact that bullying in the workplace occurred mostly from colleagues (79%) rather than from people outside the organization (21%), whereas violence or threats of violence at work originated mainly from people outside the organization (91%), than from within (9%). This, combined with the fact that those exposed most frequently to workplace violence were not more likely to suffer from heart disease, suggests that workers may have received training about how to deal with violence they encounter as part of their jobs and may be better equipped to deal with it and avoid long-term consequences.

Yes, your personal identity may be at the mercy of sophisticated hackers on many websites; but surprisingly, when it comes to health data breaches, hackers aren’t the ones to blame. Instead, hospitals, doctors’ offices and even insurance companies are oftentimes the culprits.

This is according to a research from Michigan State University and Johns Hopkins University, which found that more than half of the recent personal health information (or PHI) data breaches were because of internal issues with medical providers – not because of hackers or external parties.

“There’s no perfect way to store information, but more than half of the cases we reviewed were not triggered by external factors – but rather by internal negligence,” said John (Xuefeng) Jiang, lead author and associate professor of accounting and information systems at MSU’s Eli Broad College of Business.

The research, published in JAMA Internal Medicine, follows the joint 2017 study that showed the magnitude of hospital data breaches in the US. The research revealed nearly 1,800 occurrences of large data breaches in patient information over a seven years, with 33 hospitals experiencing more than one substantial breach.

For this research, Jiang and co-author Ge Bai, associate professor at the John’s Hopkins Carey Business School, dove deeper to identify triggers of the PHI data breaches. They reviewed nearly 1,150 cases between October 2009 and December 2017 that affected more than 164 million patients.

“Every time a hospital has some sort of a data breach, they need to report it to the Department of Health and Human Services and classify what they believe is the cause,” Jiang said. “These causes fell into six categories: theft, unauthorized access, hacking or an IT incident, loss, improper disposal or ‘other.'”

After reviewing detailed reports, assessing notes and reclassifying cases with specific benchmarks, Jiang and Bai found that 53% were the result of internal factors in healthcare entities.

“One quarter of all the cases were caused by unauthorized access or disclosure – more than twice the amount that were caused by external hackers,” Jiang said. “This could be an employee taking PHI home or forwarding to a personal account or device, accessing data without authorization, or even through email mistakes, like sending to the wrong recipients, copying instead of blind copying or sharing unencrypted content.”

While some of the errors seem to be common sense, Jiang said that the big mistakes can lead to even bigger accidents and that seemingly innocuous errors can compromise patients’ personal data.

“Hospitals, doctors offices, insurance companies, small physician offices and even pharmacies are making these kinds of errors and putting patients at risk,” Jiang said.

Of the external breaches, theft accounted for 33% with hacking credited for just 12%.

While some data breaches might result in minor consequences, such as obtaining the phone numbers of patients, others can have much more invasive effects. For example, when Anthem Inc. suffered a data breach in 2015, 37.5 million records were compromised. Many of the victims were not notified immediately, so weren’t aware of the situation until they went to file their taxes only to discover that a third-party fraudulently filed them with the data they obtained from Anthem.

While tight software and hardware security can protect from theft and hackers, Jiang and Bai suggest health care providers adopt internal policies and procedures that can tighten processes and prevent internal parties from leaking PHI by following a set of simple protocols. The procedures to mitigate PHI breaches related to storage include transitioning from paper to digital medical records, safe storage, moving to non-mobile policies for patient-protected information and implementing encryption. Procedures related to PHI communication include mandatory verification of mailing recipients, following a “copy vs. blind copy” protocol (bcc vs cc) as well as encryption of content.

“Not putting on the whole armor opened health care entities to enemy’s attacks,” Bai said. “The good news is that the armor is not hard to put on if simple protocols are followed.”

Over 50% of LGBT people suffered depression in the past year.

This is according to a new Stonewall study which found that 52% of LGBT people experienced depression and 61% experienced anxiety.

The “health report” that involved over 5,000 LGBT people, also found that one in eight people aged between 18 and 24 claimed to have attempted to take their own life in the past year. For trans people, 46% had thought about taking their own life.

According to Stonewall chief executive Ruth Hunt, “Despite the strides we’ve made towards LGBT equality in recent years, many LGBT people still face significant barriers to leading healthy, happy and fulfilling lives… today.”

This discrimination – both experienced and expected – can also “deter LGBT people from accessing help when they’re in need: one in seven LGBT people, including more than a third of trans people, have avoided treatment for fear of prejudice.”

And since the study was done in Great Britain, the findings similarly show that poor mental health is also higher among LGBT people who are young, Black, Asian or minority ethnic, disabled or from a socio-economically deprived background.

“It’s a shocking picture, that must serve as a wake up call for healthcare providers across the sector,” Hunt said.

The key findings include:

• Half of LGBT people (52%) said they’ve experienced depression in the last year.
• One in eight LGBT people aged 18-24 (13%) said they’ve attempted to take their own life in the last year.
• Almost half of trans people (46%) have thought about taking their own life in the last year, 31% of LGB people who aren’t trans said the same.
• Forty-one per cent of non-binary people said they harmed themselves in the last year compared to 20% of LGBT women and 12% of GBT men.
• One in six LGBT people (16%) said they drank alcohol almost every day over the last year.
• One in eight LGBT people aged 18-24 (13%) took drugs at least once a month.
• One in eight LGBT people (13%) have experienced some form of unequal treatment from healthcare staff because they’re LGBT.
• Almost one in four LGBT people (23%) have witnessed discriminatory or negative remarks against LGBT people by healthcare staff. In the last year alone, six per cent of LGBT people –including 20 per cent of trans people – have witnessed these remarks.
• One in twenty LGBT people (5%) have been pressured to access services to question or change their sexual orientation when accessing healthcare services.
• One in five LGBT people (19%) aren’t out to any healthcare professional about their sexual orientation when seeking general medical care. This number rises to 40% of bi men and 29% of bi women.
• One in seven LGBT people (14%) have avoided treatment for fear of discrimination because they’re LGBT.

Lesbian women were less likely to report receiving a birth control prescription or birth control counseling compared with heterosexual women. This is according to a new study that used data from the National Survey of Family Growth 2006-2015 in the US, and which highlighted sexual and reproductive health care disparities among women.

In “Do Sexual Minorities Receive Appropriate Sexual and Reproductive Health Care and Counseling?”, Bethany Everett, PhD, University of Utah (Salt Lake City) and colleagues from the University of Wisconsin (Madison) and the University of Chicago (IL) investigated sexual orientation disparities in the use of sexual and reproductive health services and receipt of contraceptive counseling in clinical settings in the past 12 months.

The researchers also explored whether having male sex partners influenced sexual minority women’s use of sexual and reproductive health services and the types of sexual health information that they received.

The findings – published in Journal of Women’s Health, a peer-reviewed publication from Mary Ann Liebert, Inc. –  noted that in a clinical setting, lesbian women were less likely to report receiving birth control counseling at a pregnancy test, and lesbian women without recent male sex partners were less likely to report receiving counseling about condom use at an STI-related visit compared with heterosexual women.

However, they were more likely to report having received sexually transmitted infection (STI) counseling, testing, or treatment, after adjusting for sexual partners in the past 12 months.

“This new research emphasizes the importance of considering both sexual orientation and recent sexual behaviors when addressing the sexual and reproductive health needs of sexual minority women,” said Susan G. Kornstein, MD, editor in chief of Journal of Women’s Health and executive director of the Virginia Commonwealth University Institute for Women’s Health, Richmond, VA. “Using inclusive sexual and reproductive health counseling scripts may facilitate the delivery of appropriate sexual health-related information.”

Trauma, including abuse and neglect, is associated with higher cardiovascular disease risk for lesbian and bi women.

This is according to preliminary research presented in Chicago in the US, at the American Heart Association’s Scientific Sessions 2018, a global exchange of the latest advances in cardiovascular science for researchers and clinicians. The research – led by researchers from the Columbia University – showed that sexual minority women with increased severity of childhood, adulthood or lifetime trauma had higher risk for post traumatic stress disorder (PTSD) and a perception of less social support.

For this, the researchers studied 547 sexual minority women. They measured three forms of childhood trauma: physical abuse, sexual abuse and parental neglect; three forms of adult trauma: physical abuse, sexual abuse and intimate partner violence; and lifetime trauma, which was the sum of childhood and adulthood trauma. They analyzed how increasing trauma severity was associated with higher report of several cardiovascular risk factors.

They found that women were 30% more likely to suffer from anxiety if they experienced any forms of adulthood trauma and 41% more likely to be depressed if they faced childhood trauma.

Other findings included:

• 22% more likely to be depressed if they had experienced more forms of lifetime trauma.
• 44% more likely to report overeating in the past three months if they experienced increased forms of childhood trauma.
• 58% more likely to have diabetes if they experienced increasing severity of childhood trauma, and lifetime trauma notably increased their risks of obesity and high blood pressure.

These findings suggest healthcare providers should screen for trauma as a cardiovascular disease risk factor in this population, according to the researchers.

The results were presented at the American Heart Association Scientific Sessions in Chicago.

The research was recognized as the “Cardiovascular Stroke Nursing Best Abstract Award.”