Transgender people face significantly higher suicide risk, Danish study finds

By Jen Christensen, CNN

(CNN) — People who identify as transgender have significantly higher rates of suicide and suicide attempts compared with the rest of the population, according to a population-level study out of Denmark.

The study of more than 6.6 million people found that those who identified as trans had 7.7 times the rate of suicide attempts and 3.5 times the rate of suicide deaths than the broader Danish population.

Among the 3,759 survey participants who identified as transgender, there were 92 suicide attempts and 12 suicides between 1980 and 2021. However, the numbers are probably a significant undercount, as the researchers say the records they used do not always capture a person’s gender identity.

The authors of the study, published in the Journal of the American Medical Association, are careful to note that it has limitations. It can only count the number of suicides among people who have sought care from a hospital for gender identity-related medical issues, and it can only capture the number of trans people who applied for a legal change of gender. It does not detail what percentage of the population may be missed.

The study also does not pin down exactly why trans people face a higher suicide risk, but the researchers theorize that part of the problem may be “minority stress,” in which people are bullied, discriminated against, socially excluded or faced with general prejudice for who they are. The researchers say previous work has showed that 60% of transgender people in Denmark experienced abuse in the form of harassment or bullying, and 30% experienced physical violence. Trans people in Denmark also report that they face discrimination in their interactions with the health care system.

The researchers also note that the work may not reflect the situation in other countries.

Dr. Melina Wald, clinical director of the Gender Identity Program at Columbia University Medical Center, says that these kinds of large studies aren’t possible in the US because the country does not collect information on sexual orientation and gender identity at the time of death.

However, “Reports of suicidal ideation, suicidal behaviors, and non-suicidal self-injury (which are often associated with greater risk for suicide) are all significantly higher among trans individuals,” Wald wrote in an email to CNN. “Also, we know many of the correlates of suicide, such as risk for major depressive disorder, experience of trauma, family rejection, isolation, discrimination and harassment are all experienced by members of the trans community at disproportionate rates.”

Recent studies in the US show that 82% of people who identify as transgender said they considered killing themselves, and 40% have attempted suicide, with the highest numbers of suicides among trans youth.

The Trevor Project’s 2023 US National Survey on the Mental Health of LGBTQ Young People found that over half of trans or nonbinary youth had seriously considered attempting suicide in the previously year. About 20% had attempted suicide in the previous year, and about 3 in 5 transgender or nonbinary youth who wanted access to care were unable to get it.

Wald noted that family rejection is a “tremendous stressor” that “significantly increases risk for suicide.” Experiences of harassment, abuse and discrimination can also elevate suicidal ideation, she said.

Colin Quinn, president of communities at Included Health, a care navigation platform that works to tailor offerings to underserved and marginalized groups like the LGBTQ+ community in the US, said the suicide risk for trans people has increased over the past couple of years as more restrictive laws have been introduced, many of them restricting access to health care.

“States passing laws to restrict access to gender-affirming care is having a negative impact on our trans population,” he said.

However, identifying as transgender or nonbinary does not automatically put someone at risk of suicide. Recent studies also show that immediate access to gender-affirming hormone therapy can ease distress, depression and suicidal thoughts for trans adults.

Quinn says that as someone who works to make sure transgender people get access to affirming medical care, he knows how helpful such care can be to reduce the suicide risk. Individuals can also make a big difference in supporting those who identify as transgender, he said. Research from UCLA’s Williams Institute, an organization that does research on the LGBTQ+ community, found a significant drop in suicidal thoughts when people had support and acceptance from families, coworkers and classmates.

“Just being that lifeline for a trans friend, to know that they are loved or supported, that they have an affirming friend who will advocate and be there with them, that’s the most important thing,” Quinn said.

Wald says allies of the trans community should also be engaged politically “in any way that helps to oppose transphobic legislation that aims to remove inclusive practices from community spaces or bans gender affirming care” – which could include speaking at school board meetings, reaching out to state legislators and other activities. “Connecting allyship to action in our current political climate is incredibly important,” she said.

“Personally, allies can practice inclusivity in their language and behavior and ensure that others do the same,” Wald said. “It can also be helpful to ask trans friends and family you are close to how they would feel most supported by your actions.”

People who need help can chat with experts 24/7 at the 988 suicide and crisis lifeline. The Trevor Project’s crises counselors are among several other organizations that can be reached at 1-866-488-7386. Text START to 678-678 to connect via text message, or chat online here.

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