Mental health disorders are main predictor of suicide in teens with gender dysphoria, study says

Gender dysphoria in young people is not predictive of suicide when other mental health issues are accounted for, researchers say in a new study published at BMJ Mental Health. 

The Finnish study used national data from a cohort of 2,083 “gender-referred” young people under the age of 23, along with 16,643 matched controls.  

Of the 55 deaths that occurred in the study population, 20, or 36% were suicides. However, gender dysphoria “does not seem to predict neither all-cause nor suicide mortality in gender-referred adolescents,” found researchers Ruuska S-M, Tuisku K, Holttinen T, et al. 

The primary predictor of death in gender-dysphoric young people is “psychiatric morbidity,” say the researchers. “Medical gender reassignment does not have an impact on suicide risk.” 

“In this nationally representative, register-based, long-term, follow-up study, the all-cause mortality of gender-referred adolescents did not statistically significantly differ from that of matched population controls,” the authors explained, noting that while death from suicide first seemed to be much higher among the “gender-referred” young people, “the association was fully explained by psychiatric treatment history”: 

In fact, the novel contribution of this study is showing that suicide mortality associates with increased psychiatric needs; this is an important finding if we consider the failure of previous studies on mortality among patients with GD [gender dysphoria] to account for psychiatric morbidities. In light of our findings, experiencing GD significant enough to seek GR [medical gender reassignment] appears to not be associated with increased suicide mortality, but suicides appear to be explained by psychiatric morbidities. 

The researchers stress the importance of the primary finding in their study: that mental health disorders from a variety of sources need to be appropriately evaluated and treated to prevent suicide in young people exhibiting signs of gender dysphoria. 

“It is of utmost importance to identify and appropriately treat mental disorders in adolescents experiencing GD to prevent suicide,” they write. “Health policies need to ensure that accurate information is provided to professionals along these lines.” 

In contrast, the use of the “transition or die” narrative by transgender activists in the medical industry is often cited as sparking fear in parents faced with a child demanding medical gender transition with puberty blockers, cross-sex hormones and surgeries. 

In February 2023, Rachel (born Richard) Levine, the transgender assistant secretary for health for the Department of Health and Human Services (HHS) repeated her claim to staff of the Connecticut Children’s Medical Center’s (CCMC) “gender-affirming care” clinic, saying, “numerous peer-reviewed journals have noted that there is nothing inherent with being transgender that predisposes youth to negative mental health outcomes.”  

Levine encouraged “gender-affirming care” for young people as a means to prevent suicide, asserting any mental health issues that might be prevalent in GD youth are due to the “bullying, the harassment, and discrimination that transgender youth face that leads to these conditions.” 

“…[G]ender-affirming care is suicide prevention care,” the Biden administration official claimed. 

But in a March 2022 study published in the Journal of Sex & Marital Therapy, Dr. Stephen Levine (no relation) and his colleagues denounced the “alarmist” use of suicidality by LGBTQ activists, asserting the question of suicide is “inappropriately handled”: 

[T]he “transition or die” narrative, whereby parents are told that their only choice is between a “live trans daughter or a dead son” (or vice-versa), is both factually inaccurate and ethically fraught. Disseminating such alarmist messages hurts the majority of trans-identified youth who are not at risk for suicide. It also hurts the minority who are at risk, and who, as a result of such misinformation, may forgo evidence-based suicide prevention interventions in the false hopes that transition will prevent suicide. 

In a January 2023 review of the two Dutch studies that established the foundation for the practice of youth gender transition medicine, Abbruzzese, Levine, and Mason noted one of the “unique” features of the transgender medical field is that “a number of clinicians tasked with caring for gender-distressed have taken on the role of political campaigners—and in doing so, have traded wisdom and nuance for blunt activism.” 

While other nations are backing away from the immediate recommendation of invasive medical intervention for GD youth in favor of psychological treatment, they said, the American medical establishment “appears to be taking a different approach,” i.e., merely renaming it “holistic care.”  

Abbruzzese et al call on the American Academy of Pediatricians, which has supported “gender-affirming care,” to “endorse noninvasive psychosocial interventions as first line of treatment—instead of inappropriately conflating psychotherapy for gender dysphoria with ‘conversion’” therapy. 

Meanwhile, the American College of Pediatricians (ACPeds), recently published its own report saying “gender-affirming therapy” [GAT] provides “no demonstrable, long-term benefit” for the mental health of adolescents with gender dysphoria. 

In a review of the pertinent literature, ACPeds found that, both before and after GAT, “adolescents who have gender-identity incongruence are at higher risk for psychopathology than their peers who identify with their biological sex.” 

The pediatricians alert clinicians to assess prior “adverse childhood experiences” of GD youth which, they say, “may play a major role in that psychopathology.” 

“Because of the risks of social, medical, and surgical interventions, many European countries are now cautioning against these interventions while encouraging mental health therapy,” ACPeds observed.