UK review finds no increase in suicide rates among gender dysphoric youth without puberty blockers

Withholding puberty blockers from minors with gender dysphoria does not lead to higher suicide rates, according to a new medical review of data.

Results of the independent review, released last week by Louis Appleby, a professor of psychiatry at the University of Manchester with expertise on suicide prevention, were based on an audit of patient data at the UK’s Tavistock & Portman National Health Service (NHS) Foundation Trust.

Appleby was asked by new left-leaning Labour Party Health Secretary Wes Streeting to examine data following claims by LGBT activist group the Good Law Project of an increase in suicides among young gender-confused people since 2020. At that time, puberty blockers were restricted at Tavistock following a High Court decision in the case of Keira Bell v. Tavistock. 

Streeting recently affirmed his commitment to his conservative predecessor’s move to protect young people from the experimental drugs – a stance that has drawn the ire of the Good Law Project. 

“The specific aim is to examine evidence for a large rise in suicides claimed by campaigners,” Appleby wrote about the goal of his review, highlighting five conclusions he drew from the data: 

1. The data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock. 

2. The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide. 

3. The claims that have been placed in the public domain do not meet basic standards for statistical evidence. 

4. There is a need to move away from the perception that puberty-blocking drugs are the main marker of non-judgemental acceptance in this area of health care. 

5. We need to ensure high quality data in which everyone has confidence, as the basis of improved safety for this at-risk group of young people. 

“The evidence on suicide risk in children and young people with gender dysphoria is generally poor,” Appleby wrote in his report. “Most studies are methodologically weak, being based on online surveys and self-selected samples and coming from biased sources.” 

Nevertheless, Appleby noted “there are good reasons to believe that their [suicide] risk is high compared to other young people.” 

However, he continued, “[T]he evidence for ‘gender-affirming care’ in the form of puberty-blocking drugs is unreliable.” 

Despite claims by “leading journalists” and activists on social media of a “surge” or “explosion” of suicides among young people who have been denied puberty blockers, Appleby said he found in his review that, between 2018 and 2024, a total of 12 suicides occurred at Tavistock. Six of those were under 18 and another 6 were 18 or older.  

“In the 3 years leading up to 2020-21, there were 5 suicides, compared to 7 in the 3 years after,” he wrote. “This is essentially no difference, taking account of expected fluctuations in small numbers, and would not reach statistical significance. In the under 18s specifically, there were 3 suicides before and 3 after 2020-21.” 

Appleby, moreover, drew attention to the other issues facing the young people who committed suicide, including “mental illness, traumatic experiences, family disruption and being in care or under children’s services.” 

The psychiatrist concluded: 

“These figures clearly do not support the main claim that suicides have risen steeply since the High Court judgment … The information confirms the multiple factors that contribute to suicide risk in this group.” 

In the United States, Biden Department of Health and Human Services Assistant Secretary Rachel Levine (born Richard), who identifies as transgender, said during an ABC Nightline segment that aired in July 2023, that “gender-affirming care,” which encompasses social transition, puberty blockers, cross-sex hormones, and elective gender transition surgeries, is “mental health care” and “literally suicide prevention care.” 

Elaborating on his conclusions, Appleby called for a change in perspective on the issue of suicide in young people, particularly by LGBT activists with a narrow lens of protecting their political identity: 

“Suicide by any young person is a profound tragedy: it should be seen as an indictment of our society. Young people with gender dysphoria may well have experienced ostracism and abuse, and their distress is likely to be heightened if services are perceived as rejecting.  

“It is unfortunate that puberty-blocking drugs have come to be seen as the touchstone issue, the difference between acceptance and non-acceptance. We need to move away from this perception among patients, staff and the public.”