Throughout much of the suicide literature, statistical methods for predicting suicide risk have employed techniques that are oftentimes insensitive for generating meaningful conclusions or inappropriate due to varying amounts of follow-up in longitudinal studies. Previous studies investigating risk factors for suicide among transgender individuals have also suffered from similar methodological and statistical limitations. With use of survival analytic techniques, the present study aimed to establish the temporal relationship between risk factors and suicide attempts for this population. This study constituted a secondary analysis of retrospective data gathered from 2005 to 2006 through the Virginia Transgender Health Initiative Survey and was limited to two subgroups within the overall sample of 350 participants: trans women (n = 179) and trans men (n = 92). Utilizing Cox proportional hazards models with time-dependent covariates, the effect of physical violence, sexual violence, illicit substance use, and problematic drinking behavior on risk of first suicide attempt was examined. It was found that past physical violence, sexual violence, and illicit drug use more than doubled the risk of first suicide attempt. Further, both past physical violence and illicit drug use were found to be independent risk factors in the multivariable Cox proportional hazards model, corresponding to a substantial increase in risk when both factors were present. The effect of identified risk factors on subsequent suicide attempts was assessed using logistic regression analysis. Only exposure to past sexual violence significantly affected risk of subsequent suicide attempts. Differences between trans women and trans men subgroups were also investigated in relation to suicide risk but did not yield significant findings. Post-hoc analyses explored the potential protective effect of living full-time in their gender identity of choice as well as the impact of prior physical violence, sexual violence, and/or illicit drug use on first suicide attempt among transgender youth. By quantifying the magnitude of the effect of various risk factors on suicide attempts, a rationale is provided for developing programs aimed at risk prevention and early intervention. Further, recommendations are proposed to promote culturally competent suicide risk assessment and management strategies among clinicians assisting transgender individuals.