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Up to half of transgender teens attempt suicide
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Between 30% and 51% of transgender teenagers have previously attempted suicide, with the highest rates reported for those who identified as transgender male and nonbinary, according to research published in Pediatrics.
“This study documents very clearly that transgender youth are at higher risk for suicidal behaviors compared to their cisgender peers, particularly those who identify as transmasculine or nonbinary,” Russell Toomey, PhD, an associate professor of family studies and human development and chair of the Youth Development and Resilience Initiative at The University of Arizona, told Infectious Diseases in Children. “In combination with prior research. our findings suggest that prevention and intervention efforts need to be aimed at mitigating the stressors that contribute to these overwhelming disparities, such as family rejection or peer bullying related to one’s gender identity.”
Toomey and colleagues examined the rates of self-reported suicide attempts among six gender identity groups, including female, male, transgender female, transgender male, nonbinary and questioning. Survey data were gathered from teenagers aged between 11 and 19 years between June 2012 and May 2015.
Of the 120,617 teenagers included in the analysis, approximately 14% had attempted suicide. Those most likely to report ever attempting suicide were transgender male (50.8%) teenagers, followed by nonbinary (41.8%), transgender female (29.9%), questioning (27.9%), female (17.6%) and male (9.8%) teenagers.
Identifying as nonheterosexual increased suicide risk for all except nonbinary teenagers, the researchers said. They found no other sociodemographic characteristics related to suicide attempts made by transgender adolescents.
“Awareness of the problem is a critical first step, yet pediatricians likely need additional information in order to work affirmatively and effectively with transgender youth populations,” Toomey said. “Lack of basic information is a critical hurdle for many pediatricians whose formal education may not have provided any or very little information about transgender people.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
Perspective
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G. Nic Rider, PhD
Existing literature on transgender and gender diverse (TGD) individuals highlight the multiple minority stressors and significant health disparities, including suicide involvement, that this community faces. Although research about TGD adolescents is gaining more attention, studies examining health outcomes across separate gender identities within the TGD community is sorely needed.
The authors of this study make a significant contribution to the scientific literature by examining suicide behavior across six gender identity groups, allowing for comparisons between binary and nonbinary gender identities. Their findings are consistent with previous studies indicating that transgender adolescents are at increased risk for suicide behavior compared with cisgender youth. More specifically, transgender, female to male and nonbinary youth appear to be at particular risk. It is crucial to be able to disaggregate data to understand and identify variability in risk across subcommunities. Importantly, results from the study by Toomey and colleagues also highlight the importance of acknowledging the power of interlocking systems of oppression and privilege and how experiences associated with particular intersecting identities may affect suicide risk behavior in different ways. Health care education, continuing education and other supplemental training opportunities need to teach about gender affirmative care (ie, all genders are seen as valid, real and nonpathological), as well as issues affecting TGD youth (eg, bullying victimization, and historical and current discrimination in health care systems).
For physicians, these heartbreaking rates suggest that screening for a history of suicidality among TGD adolescent patients is critically important. Physicians must also discuss factors that may lead to suicide involvement with their patients, including with those who engage in nonsuicidal self-injury because this may be a risk factor for a suicide attempt.
Further, connectedness to a parent, connectedness to a nonparental adult and school safety have been identified as important protective factors for TGD youth who report having both engaged in nonsuicidal self-injury and had attempted suicide. As such, it is important for physicians to identify an interdisciplinary professional network with whom they can make referrals that will include gender-competent providers such as therapists for individual and/or family therapy, community support groups and school personnel who can connect TGD youth with programs such as Gender and Sexuality Alliances. Physicians are also encouraged to identify ways to connect youth with other supportive adults including mentoring programs.
One final note, yet of significant importance, physicians must take the time to identify and offer resources that are led by and for TGD individuals, including crisis hotlines (eg, Trans Lifeline).
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