Trans teens face heightened risk of suicide attempts

S E E D E D   C O N T E N T

A new study confirms that transgender adolescents are at heightened risk of suicide.

Image credit: Jasmin Merdan/Getty Images.

• Suicide is the fourth-largest causeof death among 15- to 19-year-olds worldwide.
• Researchers from the University of Ottawa found transgender and nonbinary Canadian teens have a higher risk of thinking about and attempting suicide compared to their cisgender, heterosexual peers.
• Scientists believe their research shows the need for better support for gender and sexual minority youth.

Suicide is the fourth-largest cause of death among 15- to 19-year-olds globally each year. In Canada, suicide is the second leading cause of death for young people aged 15 to 24.

Within that age group, past research has shown that LGBT teens have a higher risk of thinking about and attempting suicide compared to heterosexual peers. However, the evidence relating to trans individuals has been very limited to date.

Now, researchers from the University of Ottawa report that Canadian teens who are transgender or nonbinary are at a higher risk of both suicidal thoughts and attempts compared to cisgender, heterosexual teens.

The study recently appeared in the Canadian Medical Association Journal.

Why a population-based study?

For this study, researchers conducted a population-based study analyzing data from the 2019 Canadian Health Survey on Children and Youth. The sample included 6,800 teens ages 15 to 17 with 99.4% identifying as cisgender and 0.6% transgender.

For the purpose of this study, researchers used the term "transgender" to describe people whose gender identity did not match their sex assigned at birth, or who reported their gender to be something other than male or female.

Within the sample, researchers classified 78.6% of individuals as only attracted to the opposite gender or heterosexual, 14.7% as attracted to multiple genders, 4.3% as unsure to which gender they were attracted to, 1.6% as females mostly or only attracted to other females, and 0.8% as males mostly or only attracted to other males.

According to Dr. Ian Colman, professor in the Faculty of Medicine School of Epidemiology and Public Health and the Norwegian Institute of Public Health in Oslo, Norway, and senior author of this study, while there have been several previous studies highlighting high rates of poor mental health and suicidality in gender and sexual minorities, the majority of those studies focused on targeted self-selected populations of youth.

"For example, many studies recruited participants through local LGBTQ+ support groups," he explained to Medical News Today.

"While such research can teach us a lot, a major limitation is that it's not clear how representative the study participants are of all gender and/ or sexual minority youth. By using data from a population-based study, we can be much more confident that our results represent all minority groups. This provides much stronger evidence," he said.

Dr. Colman said they decided to focus on the 15 to 17 age range because late adolescence is a time when children are making the transition toward adulthood.

"As they move towards more independence, it is also a time for exploration with regards to gender and sexuality," he added.

"While [ages 15-17] can be an exciting time, it is also very stressful, as adolescents experience a lot of peer pressure and can feel very isolated. This is especially true for those who express gender and sexuality in a nonconforming way."
— Dr. Ian Colman

Increased suicidal ideation and attempts

Through their research, Dr. Colman and his team found that transgender teens had a five times higher risk of suicidal ideation — thinking about suicide — than their cisgender, heterosexual peers.

Transgender adolescents were 7.6 times as likely to attempt suicide as cisgender peers.

They also found females attracted to other females were 3.6 times more likely to think about suicide and 3.3 times more likely to attempt suicide compared to heterosexual teens. Teens attracted to multiple genders had a 2.5 times higher risk of suicidal ideation and 2.8 times higher risk of attempting suicide.

Teens still questioning their sexual orientation had double the risk of attempting suicide.

The researchers also took into account reported incidents of bullying and cyberbullying by the teens in their sample.

"Gender and sexual minority youth are often targets of bullying and cyber-bullying," Dr. Colman said, adding: "We wanted to see how much of the increased suicidality in these youth could be explained by bullying and cyberbullying, and found that it only partially explained it."

"[W]hile bullying and cyberbullying is an important factor, it is not the only factor. Other factors related to feeling supported at home, at school, and in their communities are likely also very important."
— Dr. Ian Colman

Next steps in research

Overall, Dr. Colman said his team's findings clearly show that gender and sexual minority youth need better support.

"They need safe places where they can explore and express their true selves," he explained. "Furthermore, they need to be consulted and included when suicide prevention programs are designed. They know better than we do as to what will serve them best."

For the next steps in this research, Dr. Colman said a key priority will be studying how other dimensions of marginalization intersect with gender and sexual identity.

"We can't assume that all gender and sexuality minority youth have the same experiences," he said.

MNT also spoke with Dr. Jack Drescher, psychiatrist and psychoanalyst in private practice in NYC, a clinical professor of psychiatry at Columbia University, editor of the DSM-5 chapter on gender dysphoria, and a Distinguished Life Fellow of the American Psychiatric Association, about this study.

Dr. Drescher said he was not surprised by this study's findings, as previous studies show that LGBTQIA+ youth report higher rates of suicidal ideation. For future research, he suggested specifying more precisely what lies behind these numbers, rather than speculating on possible causes such as microaggressions, bullying, or family rejection.

"Less speculation and more knowledge about actual causes would help in developing programs explicitly for transgender, nonbinary, and sexual minority adolescents," he said.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

• Ask the tough question: "Are you considering suicide?"
• Listen to the person without judgment.
• Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
• Stay with the person until professional help arrives.
• Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.

Click here for more links and local resources.