Researcher Spotlight
January, 2025
Dr. Sarah Victor is a clinical psychologist and an Associate Professor at Texas Tech University, where she leads the Tracking Risk over Time Lab (TRTL). She completed her doctoral training at the University of British Columbia and her postdoctoral training at the University of Pittsburgh before moving to Texas Tech in 2019. Dr. Victor's work spans several areas: risk and protective factors for non-suicidal self-injury and suicide, particularly as they change over time in daily life; stigma and marginalization as drivers for self-injury and suicide among queer, trans, and disabled people; and the intersection of disability, mental illness, and experiences with suicide among psychologists and others in the field. Her research and clinical practice are informed by her training, professional work, and personal experiences.
What is a study/project you're working on?
Our team recently finished data collection for a study funded by the American Foundation for Suicide Prevention, focused on real-time risk and resilience among suicidal transgender and non-binary adults. The study used a mix of qualitative and quantitative methods to understand how gender minority stress, gender identity resilience, and psychotherapy experiences relate to changes in suicidal thoughts or behaviors over a four-week follow-up period.
What got you excited about doing this study/project?
As a cisgender, straight woman, I came to this work as an ally to a community whose experiences are often ignored, oversimplified, or weaponized. Through personal relationships, volunteer work, collaborations with trans and queer scholars, and the interests of my students, I began to develop more cross-disciplinary expertise in these areas, which led to a pilot project and, ultimately, this study. I was most interested in understanding how daily experiences of marginalization might impact suicide and self-injury risk; I was also hoping we could clarify just how common these experiences are in daily life for trans and non-binary folks, and ultimately inform work designed to prevent them or mitigate their effects. I was also excited by the opportunity to examine sources of resilience, whether internal or community-based, in buffering these harmful experiences. Finally, the study involved active collaboration with an advisory board of trans and non-binary adults, which has been some of the most valuable personal experiences I have had in this project.
What were your specific research questions and/or hypotheses?
Our hypotheses were based upon gender minority stress and resilience theory by Testa and colleagues. First, we predicted that increases in internalized transphobia would predict increased suicidal ideation among at-risk trans adults in daily life, as well as increased odds of suicidal behavior in the presence of suicidal ideation. Second, we predicted that interpersonal minority stressors, such as victimization, would have downstream effects on suicidal ideation through changes in intrapersonal processes, such as internalized transphobia. Third, we predicted that both general protective factors, such as social support, and trans-specific protective factors, such as gender identity pride, would impact within-person changes in suicidal ideation over time. Fourth, we predicted that perceived therapist negative attitudes towards trans people would be related to greater suicidal thoughts and behaviors over follow-up, as well as that more positive perceptions after specific psychotherapy sessions would help reduce suicidal thinking over time.
What did you find? Full results are pending! Stay tuned!
Was there anything that especially surprised you as you carried out the project or about the results?
Although not surprising to our advisory board members, I was dismayed to see just how common some of the gender minority stressors we asked about were in our participants’ daily lives. These data were collected from mid 2023 to mid 2024 in over 50 recently suicidal transgender and non-binary adults, who completed over 8,000 ecological momentary assessment (EMA) surveys about their experiences over 4 weeks each. Across all surveys, participants reported frequently being exposed to negative news about trans people (21% of surveys) and difficulty being perceived as their gender (29% of surveys). These were the most common gender minority stressors reported. Additionally, over 2% of surveys included reports of harassment, victimization, or assault related to gender. Unsurprisingly, these were more commonly reported at surveys when participants also reported suicidal thoughts or behaviors.
What questions do your results leave you with? Where are you curious to go next with the project?
Our study was focused specifically on suicidal thoughts and behaviors, so we only recruited participants who had these experiences recently; I would be very interested to know how commonly gender minority stressors are experienced by transgender and non-binary adults who are not struggling with suicidal thoughts, and what factors help these people cope with these experiences.
Where can people learn more about this study or about your work more broadly?
When results are published, they’ll be available on our website! We are in the process of building a study-specific page of the website that includes not just peer-reviewed papers but also conference proceedings, jargon-free summaries, infographics, and more. The hope is to have this page live by early January 2025! In the meantime, our lab website has published work and information about other research studies at sarahevictor.com.
Research Spotlight curated by Dr. Alexis May
December, 2024
Dr. Lauren Khazem is a Research Assistant Professor and clinical psychologist in the Department of Psychiatry and Behavioral Health at The Ohio State University Wexner Medical Center. Dr. Khazem’s research is focused on identifying unique drivers of suicide risk in the disability community, Veterans, and military personnel.
Dr. Khazem integrates these findings in clinical research with the goal of improving the efficacy, accessibility, and reach of suicide prevention assessments and interventions for these populations. She has received multiple awards for her work, which has been funded by the American Foundation for Suicide Prevention, and Department of Defense, among other sources.
What about the field of suicide research is more energizing to you right now?
There is an increased focus on populations who have been traditionally underrepresented in the suicide research base and, more importantly, establishing active partnerships with these communities to carry out this important research. These partnerships help ensure that the right questions are being asked and findings will directly benefit the communities taking part in research.
What in the field of suicide research do you find the most frustrating at the moment?
The topic of death with dignity is hotly contested. However—and I realize this is also a controversial point that I’m making—my thoughts about the topic tend to be the first thing other suicidologists ask me about after I present my research implicating societal views about disability and internalized negative beliefs about distality as drivers of suicide. While the topic of death with dignity is complex, I do question why this is the first question I am typically asked instead of considering ways to make life worth living for the multitude of people with disabilities who are struggling with thoughts of suicide. Given that my colleagues have demonstrated that suicide is viewed as more acceptable for people with disabilities than those without disabilities, being consistently asked this question does bring to light the ableism that the field of suicidology continues to demonstrate.
What is one finding from recent years (either your own or from someone else) that has most changed or challenged your thinking about how suicidal experiences work?
While the link between disability and suicide was well-established before I began this line of research over ten years ago, most of the research was based on the premise that having a disability itself was a driver of suicidal thoughts and behaviors. My earlier research also reflects this misconception. However, my more recent findings and those of my colleagues demonstrate that limitations that stem from a disability, form of disability, or even just having a disability itself, is not as important of a predictor of suicide-related outcomes. Instead, peoples’ beliefs about what having a disability means to them—especially of being a burden— are stronger drivers. However, positive disability identity may help bolster against risk factors for suicide. This shift has been critical for me because these findings directly inform how I approach conceptualizing suicide prevention for the disability community.
What is one of the biggest questions you have right now in the field?
The field is shifting away from a one-size-fits-all approach to suicide prevention. While we have effective interventions to prevent suicidal thoughts and behaviors, there are people that may not respond well to them, lack access to them, or may not even need a full course of a standard intervention. Instead, we should be asking which interventions work well for which individuals and when, and what are the next steps if someone does not respond to an intervention.
What topic(s) do you think are the most understudied that could have the most impact?
The disability community is now 28% of the US population, and disability is disproportionally prevalent in communities of color and the LGBTQ+ community. However, it continues to remain unclear how ableism (including lack of accessibility) contributes to suicide risk and whether specific interventions may increase resilience against these experiences, particularly in multiply marginalized populations. Some of my current research is focused specifically on answering these questions
Research Spotlight curated by Dr. Alexis May