Transgender People Face Higher Suicide Risk

People who identify themselves as transgender are significantly more likely to attempt to take their own lives and die from suicide, according to a Danish study.

The new study that appeared in JAMA Network compared the rates of suicide between transgender individuals, defined as people whose gender identity or gender expression does not conform to that assigned at birth, and non-transgender individuals.

The researchers used data from all 6,657,456 Danish-born people aged 15 years or older who lived in Denmark between January 1, 1980, and December 31, 2021. Of those, 3,759 people (0.06%) were identified as transgender.

Over the course of 42 years, there were 92 suicide attempts and 12 suicides among transgender individuals. The study found that the suicide attempt rate was 7.7 times higher, and the suicide rate was 3.5 higher for transgender people compared to the non-transgender Danish population.

Moreover, suicide-unrelated mortality and all-cause mortality rates were also higher for transgender people.

Although the study did not investigate the causes of suicidal behavior, the authors say minority stress may at least partly contribute to it. According to an earlier study, 60% of transgender individuals in Denmark had experienced abuse in the form of bullying or harassment, whereas 30% reported episodes of physical violence. Nevertheless, the country ranks 8th in the Global Acceptance Index, a measure of the relative social acceptance of LGBTI people and rights in each country.

The transgender suicide mortality rate observed in the study compares to the data from neighboring countries. For example, transgender individuals attending a clinic for gender dysphoria in Amsterdam, the Netherlands, were found to be more likely to commit suicide compared to the general Dutch population. An even higher suicide mortality rate was reported for Swedish transgender individuals undergo gender-affirming surgery.

Researchers say that suicide rates among transgender individuals could be addressed with direct measures, such as encouragement to seek help in situations of personal distress. In contrast, general measures could include the reduction of structural discrimination. This could be achieved by training and best practice guidelines among healthcare professionals and the broader use of gender-neutral public bathrooms and locker rooms.

The authors acknowledge that the findings may not be generalizable to trans individuals who have never received hospital care for gender identity–related issues or applied for a legal change of gender. As the study included only Danish-born individuals, the findings may not necessarily apply to transgender people born elsewhere.

Studies show that in the United States, 82% of transgender people have considered killing themselves, and 40% have attempted suicide, with the highest suicide numbers among transgender youth.

However, being transgender does not automatically increases the risk of suicide if people have access to gender-affirming care. A 2021 study suggests that surgery may reduce suicidal ideation by 44%, while eight in 10 trans adults reported in a recent survey that transitioning made them "more satisfied" with their life.

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