Suicide Risk and Gender Transition: The Facts

July 23, 2021

As a graduate student in my early twenties, I volunteered on a suicide hotline. The calls I received while working on the hotline certainly included the suicidal person, but they also came from concerned family members, friends, and coworkers.  When advising people who wanted to keep someone safe, it was essential to give them tools not only to speak with the person of concern, but to also underscore that the person they seek to help has a choice in the matter.  Of course, the goal was to save lives, but we wanted to communicate to the helping party that, ultimately, they are not responsible for another person’s decision should their loved one choose to follow through with their threat of suicide.

While suicide is a very serious issue, it doesn’t mean that the helper should be controlled by the threat.  For example, after years of counseling with domestic violence survivors, I can recall countless stories of women who were told by an abusive spouse or partner, “if you leave me, I’ll commit suicide.”  Again, suicidal thoughts and gestures should be assessed and evaluated, and underlying causes need to be properly addressed. However, tying such requests to expressions of suicide can prove to be, in some cases, controlling. That’s what I communicated to domestic violence survivors who felt demands placed on them to sacrifice their safety, and in some instances, their lives, because of the threats expressed by the person abusing them.      

Unfortunately, the “threat” of suicide is what is being used against responsible leaders trying to protect children from harmful and often unknown risks associated with gender transition procedures. In the wake of the news that a federal judge in Arkansas blocked that state’s Save Children from Experimentation Act (which would protect children from receiving unnecessary and invasive medical interventions aimed at treating a psychological condition characterized by confusion over one’s biological sex) from going into effect, we’ve seen a resurgence in claims of the risk of suicide, without reference or examination to a range of likely underlying and co-occurring conditions.

When appealing to the judge several days ago to temporarily enjoin Arkansas’ law, Chase Strangio of the ACLU claimed: “These families, like hundreds of others across the state, are terrified . . . There has already been a spike in suicide attempts since this legislation was passed.” Court filings read: “For some transgender youth, the prospect of losing this critical medical care, even before the legislation is in effect, is unbearable . . . In the weeks after the bill passed, at least six transgender adolescents in Arkansas attempted suicide.” 

Within the ACLU’s claims, there is no reference to the other factors that might affect these adolescents’ decisions to attempt suicide. We are simply led to believe that legislative decisions alone are prompting suicidal thoughts in these teenagers.

Similar assertions implying that this legislation will only increase the risk of suicide were sprinkled throughout other’s reports on the issue.  Some involved in the case went on to argue that these medical practices “save lives” and are necessary for the transgender population that tends to be vulnerable to depression and suicide.

The high suicide rate in the transgender identifying population, in fact, has been repeatedly given as the reason to support treatments that stop puberty in developing children, to start kids on a lifetime supply of the opposite-sex’s hormones, and to allow surgeries that remove healthy sexual organs. These claims are misplaced, and frankly, dangerous.

That said, suicide is a real threat, and it should be addressed. The underlying causes that are leading to this threat should also be investigated so that this population can be properly treated. But, at this time, there is no evidence that suicidality abates after transgender medical procedures are performed. To the contrary, the available evidence shows a rise in completed suicides following medical interventions. Why? Clearly, the real psychological pain behind the suicidality is not being addressed by medical interventions.

The problem here is that suicide should never be used as a tool, by any group, to strong-arm policymakers and the psychological and medical communities into both allowing and providing questionable practices that have somehow gained a monopoly on “standards of care” for gender dysphoria.  Especially when those practices involve onboarding children, who have not fully developed physiologically, psychologically, and neurologically, to potentially irreversible and sterilizing treatments. 

In response, public policy makers should focus on protecting citizens, particularly vulnerable children. Further, policies that inform public health and safety should be firmly grounded in solid empirical research, such as:

  • There is no evidence that transgender medical treatments reduce the psychological distress and mental health issues associated with gender dysphoria.
  • There is no long-term investigation into the psychological and physiological consequences of transgender medicine performed on children.

The credible and available evidence indicates:

  • There are significant health risks to transgender medicine. Some of these include cardiovascular disease, high blood pressure, diabetes, & blood clots.
  • In a 30-year longitudinal study, gender reassignment surgery patients had a 19 times higher rate of completed suicide than the general population.

A few known underlying conditions that are not addressed by transgender medicine:

  • A recent study showed 45 percent of transgender identifying persons experienced childhood sexual abuse.
  • Higher rates of substance abuse have been found in this population by comparison to the general population.

For more information on this topic, see FRC’s issue analysis.

Jennifer Bauwens is Director of the Center for Family Studies at Family Research Council.