Suicidal ideation among transvestites and transsexuals: a social representations and analytical study

Glauber Weder dos Santos Silva1, Romeika Carla Ferreira de Sena1, Suerda Lillian da Fonseca Lins1, Francisco Arnoldo Nunes de Miranda1
1Federal University of Rio Grande do Norte


Aim: To analyze the association between suicidal ideation, suicide, its risk factors and social representations in the life of transvestites and transsexuals. Method: a qualitative exploratory study with quantitative analytical approach, conducted with transvestites and transsexuals associated to a non-governmental organization in the State of Rio Grande do Norte using semi-structured interviews. Quantitative data will be analyzed by inferential statistics with the application of chi-square, Mann Whitney and Pearson correlation tests. Qualitative data will be interpreted using content and social representation analysis. Expected results: the aim is to identify suicidal ideation, depressive state and social representations about suicide for transvestites and transsexuals, especially with regard to promoting mental health by identifying signs and risk factors for suicide, reduction of harm in the gender transit experiences, and health prevention in socio-cognitive aspects that surround the phenomenon.

Descriptors: Health Care; Transgender People; Mental Health; Suicide.


The phenomena involving depression and suicidal ideation are increasingly present in contemporary society, posing as a serious public health problem. More than 800,000 people commit suicide worldwide every year – one person every forty seconds, the second leading cause of death of the population of 15-29 years of age. It is estimated that, by 2020, over a million and a half people will commit suicide in the world and that the number of attempts will be 20 times higher(1).

Undoubtedly, the prejudice that is assigned to the transvestite and transsexual population (family and extra-family violence, school system abandonment and biological problems related to the process of body changes) have a sociologizing and aggravating character in the construction of a suicidal ideation(2).

A study of transgender people and individuals undergoing the process of gender transit performed in the United States showed that more than 41% of the sample (n=6,456) had already attempted suicide, and this is the largest and one of the few studies developed with this public so far(3). Scientific data focused on mental health of transvestites and transsexuals are absent, neglected and poorly studied in Brazil.


Is there an association between suicidal ideation, depression and higher prevalence of suicide risk factors for the transvestite and transsexual population? What social representations of suicide do influence this population to commit it?


To analyze the association between suicidal ideation and risk factors for suicide and social representations of suicide in the life of transvestites and transsexuals.


• To identify and classify the participants regarding the presence of suicidal ideation; • To identify depression and risk factors for suicide; • To check the association between suicidal ideation, depressive states and risk factors; • To identify the social representations of participants about suicide; • To compare the social representations between participants with and without suicidal ideation.


This study is methodologically designed as a quantitative-analytical approach / qualitative exploratory research, being conducted in a non-governmental organization (NGO) of transvestites and transsexuals in Rio Grande do Norte Brazilian state.

The study sample comprised 58 transgender people associated with the referred NGO. The sample for convenience was determined applying the following selection criteria:

inclusion of 18 years old or older subjects and exclusion of subjects that are not in Rio Grande do Norte or who became associated with the NGO during data collection period.

For collecting data, we decided to adopt four specific instruments that, although technically and conceptually different, complement each other to achieve the proposed goals:

  1. Beck’s Scale for Suicidal Ideation (validated);
  2. Beck’s Depression Inventory (validated);
  3. Questionnaire with closed questions, elaborated by the authors, based on literature review to identify risk factors associated with suicidal ideation;
  4. Semi-structured interview to capture social representations.

Data collection was conducted between March and June 2016, with authors’ financing. Quantitative data will be submitted to SPSS 20.0 software and analyzed descriptively, with absolute and relative frequency, mean scores of variables and inferential analysis in variables intersections, with statistical significance level of p <0.05 and application of chi-square, Mann Whitney and Pearson correlation tests.

Qualitative data will be prepared constituting a textual corpus created with the semi-structured interviews, which will receive three types of treatment as follows: content analysis as proposed by Laurence Bardin; lexical analysis using the Analyse Lexicale par Contexte d'un Ensemble de Segments de Texte (ALCESTE) software; and the analysis of social representations, according to the theory of Serge Moscovici.

The proposed research is an Academic Master's dissertation project for Nursing Post-Graduation Program of Federal University of Rio Grande do Norte, approved by the Ethics Committee for Research with Human Beings, with assent No. 1,314,559, of November 9th 2015, respecting the norms and ethical aspects recommended by Resolution 466/2012 of the National Health Council.


We seek to identify suicidal ideation, depressive state and social representations about suicide for transvestites and transsexuals, especially with regard to promoting mental health by identifying risk factors and signs for suicide in this group, reduction of harm in the transgender experience/process and health prevention in the socio-cognitive aspects that surround the phenomenon.


  1. Botega NJ. Comportamento suicida: epidemiologia. Psicol. USP [Internet]. 2014 [cited 2016 may 30];25(3):231-36. Available from:
  2. Silva GWS, Souza EFL, Sena RCF, Moura IBL, Sobreira MVS, Miranda FAN. Cases of violence involving transvestites and transsexuals in a northeastern Brazilian city. Rev Gaúcha Enferm [Internet]. 2016 jun [cited 2016 may 30];37(2):e56407. Available from:
  3. Haas AP, Rodgers PL, Herman JL. Suicide attempts among transgender and gender non-conforming adults. Los Angeles, Califórnia: The Williams Institute e American Foundation for Suicide Prevention; 2014. [cited 2016 may 30] Available from:

All authors participated in the phases of this publication in one or more of the following steps, in According to the recommendations of the International Committee of Medical Journal Editors (ICMJE, 2013): (a) substantial involvement in the planning or preparation of the manuscript or in the collection, analysis or interpretation of data; (b) preparation of the manuscript or conducting critical revision of intellectual content; (c) approval of the versión submitted of this manuscript. All authors declare for the appropriate purposes that the responsibilities related to all aspects of the manuscript submitted to OBJN are yours. They ensure that issues related to the accuracy or integrity of any part of the article were properly investigated and resolved. Therefore, they exempt the OBJN of any participation whatsoever in any imbroglios concerning the content under consideration. All authors declare that they have no conflict of interest of financial or personal nature concerning this manuscript which may influence the writing and/or interpretation of the findings. This statement has been digitally signed by all authors as recommended by the ICMJE, whose model is available in

Received: 06/01/2016 Revised: 08/12/2016 Approved: 08/12/2016