No, Not Letting Kids Transition Won't Cause Them to Commit Suicide

Putting an end to this nefarious lie

Edmontonians and NDP MLAs protesting Alberta Premier Danielle Smith’s proposed policies on Feb. 3, 2024. PHOTO BY DAVID BLOOM /Postmedia

Whenever the topic of “trans kids” comes up, the specter of suicide is not far behind. We are told that a lack of access to “gender-affirming care” will cause kids to take their own lives, and parents are frequently presented with the choice between a live trans child and a dead one by amoral activists and clinicians. This is emotional blackmail—but it’s so much worse than that. Those who push this lie are sickeningly desperate for it to be true so that they can use it to further a political agenda.

But it isn’t true. This oft-repeated lie is based on nothing but online, self-report surveys that rely on convenience samples and that equally conflate suicidal thoughts, self-harm, and serious suicide attempts with suicidality. This bad data coupled with activist fervor has created the perfect storm of fear and manipulation.

So, what is the truth? Well, let’s see what the research says.

One recent study that has helped shed some light on the issue came out of Denmark and asked the question, “Do transgender individuals have higher rates of suicide attempt and mortality than nontransgender individuals?”

Despite the fact that trans-identified people in Denmark have wide accessibility to “gender-affirming care,” the study found that they do have an elevated risk of suicide—though not anywhere near as high as activists claim:

The absolute risk of death by suicide among transgender-identified individuals was estimated as 75 suicides per 100,000 patient-years (standardized adjusted rate). A clinician would need to treat 1,333 transgender-identified patients for a year to encounter one patient death by suicide (100,000/75). Compared to the general population, transgender-identified individuals were 7-8 times more likely to attempt suicide, 3.5 times more likely to die by suicide, and twice as likely to die from non-suicide related causes.

The authors focused solely on “minority stress” as a possible contributing factor to these elevated suicide rates, overlooking a crucial piece of the puzzle: that suicidality is strongly linked to psychiatric illnesses, which are strongly linked to the development of a transgender identity. Failing to discuss this has not done trans-identified adults or youth any favors.

And we have known this fact for a long time. A 2011 study out of Sweden took a look at mortality following “sex-reassignment” surgery, matching 324 “sex-reassigned persons” with random population controls. The study concluded that:

Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.

This again shows that access to “gender-affirming care” is not the key to preventing suicidality in trans-identified people, and it gave us an early hint about the importance of taking psychiatric morbidity into account.

The fact that supposed “gender-affirming care” doesn’t deliver its promises for adults should have us very concerned for youth, and the research bears this out as well.

In a 2022 study, sociologist Michael Biggs took a look at the issue of suicide by clinic-referred transgender adolescents in the United Kingdom. By his estimates, the suicide rate for patients accessing the Gender Identity Development Service (GIDS) in the UK was higher than the general population but was again nowhere near the levels suggested by activists:

From 2010 to 2020, four patients were known or suspected to have died by suicide, out of about 15,000 patients (including those on the waiting list). To calculate the annual suicide rate, the total number of years spent by patients under the clinic’s care is estimated at about 30,000. This yields an annual suicide rate of 13 per 100,000 (95% confidence interval: 4–34). Compared to the United Kingdom population of similar age and sexual composition, the suicide rate for patients at the GIDS was 5.5 times higher.

Biggs also discussed the issue of comorbid psychiatric diagnoses, noting that young people referred to GIDS had a “high prevalence of eating disorders, depression, and autism spectrum conditions (ASC) —all known to increase the probability of suicide.” He specifically pointed out that, “Autism is known to increase the risk of suicide mortality, especially in females,” and concluded:

To some extent, therefore, the elevated suicide rate for transgender youth compared to their peers reflects the higher incidence of ASC. The same holds for other psychiatric disorders associated with gender dysphoria.

Biggs also pointed out that the data shed no light on whether providing youth with endocrinological interventions (puberty blockers and cross-sex hormones) affected their suicide risk. He concluded that “transgender youth and their families” should be reassured by the fact that suicides are so rare and he cautioned that exaggerating the prevalence of suicide is irresponsible and may exacerbate the vulnerability of trans-identified youth.

The increased prevalence of mental health issues in trans-identified youth must not be overlooked and in fact has been known for some time.

A 2018 study found that adolescents referred to gender identity services have a prevalence of autism spectrum disorders varying from ~6% to over 20%, compared to a prevalence of less than 1% in the general population. “Among children and early adolescents with ASDs,” the authors wrote, “gender variance is >7-fold more common than among non-referred controls.”

Another 2018 study compared the mental health of “transgender and gender nonconforming youth” compared to their peers and found that:

Common diagnoses for children and adolescents were attention deficit disorders (transfeminine 15%; transmasculine 16%) and depressive disorders (transfeminine 49%; transmasculine 62%), respectively. For all diagnostic categories, prevalence was severalfold higher among TGNC youth than in matched reference groups.

I also came across an interesting paper published just this March comparing mental health symptom severity between adolescents admitted to an inpatient psychiatric hospital who wished they were of a different sex and those who did not. The authors found that “There were no significant differences in measures of depression, anxiety, suicide risk, and nighttime sleep quality at admission.” The only difference found was that trans-identified adolescents had more emotion regulation problems.

Yet the authors still begin the abstract claiming that “Transgender youth are at an increased risk of suicide, substance use, experiencing violent assaults, and reporting major depressive episodes and greater psychological distress compared to their cisgender counterparts.”

They have evidence staring them right in the face that when other psychiatric problems are controlled for, the “transgender” identity might not be the deciding factor in these young peoples’ problems. But, somehow, when “gender identity” comes into the mix, sense is thrown out the window.

Why is this all so important? Because, as we’ve seen, many of the conditions that are comorbid with a transgender identity are themselves associated with suicidality, making it irresponsible to attribute the increased risk of suicidality simply to the trans identity itself. Worse, focusing solely on “gender dysphoria” creates the very real risk that the actual reasons for someone’s suicidality are not being addressed.

This is exactly what was discovered in a recently published study out of Finland that should shake every thinking person out of the myth that “gender-affirming care” prevents suicide.

The purpose of the study was to “examine all-cause and suicide mortalities in gender-referred adolescents and the impact of psychiatric morbidity on mortality.” It compared a Finnish nationwide cohort of “all <23 year-old gender-referred adolescents in 1996–2019 (n=2083) and 16 643 matched controls.”

The researchers of this large-scale study found that, when they controlled for psychiatric treatment needs, sex, birth year, and differences in follow-up times, there was no difference in suicide rates between gender-referred participants and controls. These findings did not support the claim that hormonal and surgical interventions are necessary to prevent suicide or to reduce suicidal ideation.

They concluded:

Clinical gender dysphoria does not appear to be predictive of all-cause nor suicide mortality when psychiatric treatment history is accounted for.

Anyone interested in actually helping distressed, gender-confused youth needs to realize that they do young people no favors by attributing their distress to “gender identity.” These young people deserve high-quality care, but they are not getting it because activists and clinicians would rather cling to a popular, progressive ideology than to think.

Worse yet, constantly telling young people that they are at risk of suicide if they cannot access hormonal and surgical interventions is so shockingly irresponsible, I have a hard time believing activists genuinely want what is best for these kids at all. We know that suicide can be socially contagious. By encouraging young people to believe that they should be suicidal if denied the body-altering services they demand, activists are trying to create more victims in order to push a political agenda.

Gender-confused children deserve care for the mental health conditions that actually increase their suicide risk. It’s time to stop letting “gender identity” obscure these issues and prevent them from receiving real help.