Negotiating multiple minoritised identities: An Interpretative Phenomenological Analysis (IPA) exploring the complex intersection of sexual orientation, gender identity, and suicidality among transgender and gender-diverse young adults

Background: Transgender and gender-diverse young adults, the vast majority of whom identify as lesbian, gay, bisexual, or queer, encounter considerable health, social, and systemic inequalities, resulting in increased rates of trauma exposure, mental health difficulties, and suicidality compared to their heterosexual and cisgender peers. The complex relationship between sexual orientation, gender identity, and suicidality has thus generated much discussion, primarily from quantitative research focused on risk narratives, rather than an individual’s lived experiences or specific healthcare needs. Aim: The aim was to explore the lived experiences of transgender and gender-diverse young adults, highlighting the impact of navigating multiple minoritised identities, exposure to trauma, victimisation, unmet healthcare needs, suicidal distress, and barriers and facilitators to accessing mental health services and gender-affirming care.Method: Six young adults from Northern Ireland (UK) took part in semi-structured interviews which were analysed using Interpretative Phenomenological Analysis (IPA). Results: Five group experiential themes were identified: 1) Delicate peace, delicate progress; 2) Queer suffering, safety and otherness; 3) Queerness shaping ones’ worldview; 4) Unresolved trauma, and unmet healthcare needs; 5) Suicidal distress, and recovery. The findings elucidated two central narratives; the psychosocial impact of negotiating multiple minoritised identities in a heteronormative and cisnormative society and navigating suicidal distress by regaining a sense of control over your life. Conclusion: The findings provide valuable insights into the unique lived experiences, and specific healthcare needs of this population. Clinical implications are discussed, including the importance of trauma-informed care, cultural competence among healthcare practitioners, and tailored suicide prevention strategies for LGBTQ+ youth.