Do Gender Transition Procedures Prevent Suicide?

March 24, 2021

Transgender advocates often claim that gender transition procedures are the cure to suicide risk among transgender-identifying youth, and that legislation restricting gender transition procedures on minors causes suicide. But a closer look at suicide studies (see pp. 11-12) reveals several problems with those claims:

  • The 2015 U.S. Transgender Survey published by the National Center for Transgender Equality did find elevated risk of suicide among people who identify as transgender during their lifetime:
    • Forty percent (40%) have attempted suicide in their lifetime, nearly nine times the rate in the U.S. population (4.6%).
    • Seven percent (7%) attempted suicide in the past year—nearly 12 times the rate in the U.S. population (0.6%).
  • However:
    • This did not account for untreated mental illness, perhaps because transgender advocates resist any association between gender incongruity and mental illness; and
    • This was drawn from a “convenience sample” (an online poll of volunteers).
    • A survey that used more scientific methods, the California Health Interview Survey, found that among “highly gender non-conforming” youth, only 3% of girls and 2% of boys reported having attempted suicide.

Furthermore, although such statistics are often cited as evidence that minors should pursue gender transition, these numbers do not prove causality. Even if the elevated rates are legitimate, the data often do not indicate when the suicidal thoughts or actions occurred—before or after gender transition.

  • For example, a 2020 article in the journal Pediatrics examined the link between taking puberty-blocking hormones and nine different mental health outcomes. Although it found that those who received puberty blockers had a lower rate of “lifetime suicidal ideation,” it also found that those who received puberty blockers were twice as likely to have had a suicide attempt resulting in inpatient care (i.e., hospitalization) in the last 12 months as those who did not (45.5% vs. 22.8%). (Neither finding rose to the level of statistical significance in the study.)
  • A 2011 Swedish study (in which the authors were able to examine the medical records of every person in Sweden who underwent gender reassignment surgery over a 30-year period) found a number of physical and mental health problems were elevated among this population, including a rate of completed suicides among those who completed transition that was 19 times higher than the general population.
  • A comprehensive review of the literature on the subject by the U.S. Centers for Medicare & Medicaid Services declared about the Swedish study that “we cannot exclude therapeutic interventions as a cause of the observed excess morbidity and mortality.” In other words, not only does gender reassignment surgery (and other “therapeutic interventions” such as hormone therapy) not demonstrably benefit those who identify as transgender (including by reducing their risk of suicide)—it may actively harm them, and increase that risk instead.

When you combine these facts with findings that the “desistance” rates (the rate at which transgender-identifying adolescents cease to identify as the opposite sex) range from 70 percent to 97.8 percent in biological males, and from 50 percent to 88 percent in biological females, the picture becomes clear. For most transgender-identifying youth, puberty is the cure, not the cause, of gender incongruence. Even among those who continue to identify as transgender, there is evidence that transitioning causes more harm than good, at least as measured by rates of suicide attempts resulting in hospitalization and rates of completed suicide. Furthermore, these studies include populations from Sweden and California, two jurisdictions that are arguably very supportive of gender transition policies.

For a full report on the dangers of gender transition procedures, see FRC’s Do Not Sterilize Children: Why Physiological Gender Transition Procedures for Minors Should Be Prohibited