New study: Trans youth not at elevated risk of suicide

Link to article here.

Study cited by the article here.

Text of article summarizing the study follows:

A new study challenges the common assertion that gender-dysphoric youth are at elevated risk of suicide if not treated with “gender affirming” medical interventions. If it’s true, it ought to have a seismic impact on the accepted medical approach to gender-confused youth.

Reported in the BMJ, the study examines data on a Finnish cohort of gender-referred adolescents between 1996 and 2019, and compares their rates of all-cause and suicide mortality against a control group. While suicide rates in the gender-referred group studied were higher than in the control group, the difference was not large: 0.3% versus 0.1%. And — importantly — this difference disappeared when the two groups were controlled for mental health issues severe enough to require specialist psychiatric help.

In other words: while transgender identity does seem to be associated with elevated suicide risk, the link is not very strong. What’s more, the causality may not work the way activists claim.


The association between gender dysphoria and mental illness is well-documented by both providers of “gender-affirming care” and trans advocacy groups and clinical psychology research. But one less well-evidenced claim, based on this association, is that these difficulties are caused not by being transgender, but by the political and social stigma associated with it. Gender dysphoria, we are to understand, is not in itself a mental health issue. What causes mental health issues in transgender youth — up to and including suicide — is the wider world’s rejection of their identity, and of the metaphysical frame of “gender identity” as such.

This is the root of the oft-repeated social media assertion that anyone who demurs about trans identity, however mildly, is complicit in “trans genocide”. The same assertion that invalidating trans youth makes them kill themselves is also behind the rhetorical question routinely used to browbeat parents into consenting to social and medical transition for their gender-confused offspring: “Would you rather have a live daughter or a dead son?”

It’s behind the prohibition on “trans conversion therapy” already in force in several countries, and promised by the Labour Party in England too. Such measures forbid therapists from exploring with their clients whether there is any link between their gender dysphoria and — for example — life trauma or other mental health issues. For logically, if the cause of distress and suicidality in trans people is not being accepted for who they are, any therapist who seeks to explore links between gender dysphoria and other biographic or psychiatric issues is complicit in just this kind of non-acceptance, and is thus not helping but harming their client.

But as the study puts it: “Clinical gender dysphoria does not appear to be predictive of all-cause nor suicide mortality when psychiatric treatment history is accounted for.” Rather, what predicts risk in this population is “psychiatric morbidity”. And contra the activists, transitioning does nothing to reduce it: “medical gender reassignment does not have an impact on suicide risk.”

Every suicide is a tragedy, and leaves grieving loved ones behind. No one wants to be complicit in pushing a young person down that path. So the suggestion that questioning someone’s gender beliefs may have this effect serves as a powerful emotional cudgel. But if the Finnish study is correct, this whole rhetorical, legislative, and medical edifice may be built on sand. If the elevated risk of suicidality in trans youth disappears when you control for other psychiatric difficulties, this suggests strongly that trans youth are not more at risk due to transphobia or invalidation, but due to the well-documented fact that gender dysphoria tends to occur in people who are disturbed and unhappy more generally.

It ought to follow from this that the way to manage suicide risk in trans-identified young people is not to affirm their gender identity and whisk them off for medical interventions, but to watch for and treat psychiatric comorbidities. Ultimately, though, the claims of gender ideology are less scientific than metaphysical. So don’t expect scientific evidence that contradicts its prescriptions to have much impact on trans advocates. Even if “following the science” would make a real difference to suicide risk in gender-dysphoric youth.
 
Of course the youth is not going to kill themselves, they don't know any better. It's those who hit the midlife crisis (which seems to get younger with time) who are more likely to neck themselves for various selfish reasons. The only exception to this selfish perspective is those who transitioned in their youth, coerced into it by their munchie mothers and teachers who always despised kids and wanted to hurt them. When it hits them later in their adult life that the risks and rewards of adulthood were stolen from them before they even had a chance to pursue them, they will pull the trigger.

Therefore, youth suicide rates don't rise and actually won't. It'll be those in their 30s, 40s, maybe late-20s, once it hits them they never had an option to live their own lives and had been lied to.

Wait another ten years before we start seeing a spike in suicide rates.
 
Narcissists will always suicide bait but never go through with it. More news at 11.
 
"I'm not sad because I'm transgender, I'm sad because everyone else is oppressing me", if you ask why they think they are being oppressed, they'll say "because I'm trans".
They take the pick-n-mix approach. To troon activists, being trans is a lifesaver, but also an increased suicide risk. It's the best thing in the world and the worst burden to bear. The premise that this article is undercutting, that trans identity itself if the root of increased suicide risk, is the idea of 'life affirming care', which is how activists justify the shit they pull with kids.
 
eh thats a lot of words for a simple clarification of semantics.

because there is no such thing as a "trans youth", they cannot be at high risk for suicide. something has to exist for it to commit suicide
 
Good. Now they can STFU about how fragile and above harmful criticism, they are.

Obviously this is not true, as we all know mental illness and troonery go hand-in-hand. We've been laughing at %41 for years, they've been crying about %41 for year. So, which is it? Is being a tranny a curse, so horrible I am legally obligated to play pretend a 250lb sexpest is a woman? Or... They are perfectly mentally fit and can handle the reality of my criticism? Tell me which one, I'll still be laughing, you'll still be dying.
 
This was pretty clear. Especially in an era where ~99 out of 100 troons are transtrenders!

But even when selecting down to only the truly ill (<0.2%), gender confusion, a developmental disorder known and treated for a long time, has never supported the theory that there was any major statistical risk of self harm. It has been the political TRA and gender activists who basically invented this out of thin air because they needed stakes.

Remember that their own studies can't even show that so-called "gender conforming" treatments improve the mental state of sufferers,.... at all! Using sleight of hand tactics to quietly compare the after group (which test the same as the full pre group) with a handful of people so mentally and emotionally i'll that they didn't (ethically or safely) qualify for treatment. Then they say "ha look.. GC treatment improved mental health greatly over the group that didn't get it!" Despite scoring EXACTLY the same as before "treatment"!

They are able to obscure the details of the outcome by basically turning all but the most messed up participants into GC patients! Leaving no true control at the end. Pretty much anything will get someone recommended for the treatment group.. on "ethical and safety grounds." This is one of the reasons studies on this are gatekept to the extreme, which is also why they are so few in number and rare. Even mental health experts aren't allowed to really study it outside the direct control (at all stages/levels) of TRAs and troons. With veto power the first time they see something they don't like or researchers putting patients "at risk" (non-treatment) etc.

Additionally, something that is never studied in these rare larger studies, but still makes itself clear.. Is that there is not an epidemic of suicide or even self harm. Only claims of "thoughts" about it when questioned. (another of those once common sense rules about evaluating mental health ignored in this ONE case)
 
Having read the paper I found this pretty well done. Of course there are limitations (e.g. it was not designed to elucidate cause and effects) but as a whole the researcher's findings are compelling.

Things that I think warrant further investigation:
  • The study was not designed to find out which mental illnesses are associated with youth suicide. The researchers used "numbers of contacts to specialist-level psychiatric care" as the proxy measure of severity of mental-health disturbances. While it is reasonable, one would like to know about what kind of conditions are at greater risk of suicide.
  • The incidence of non-suicide deaths among the gender confused are on par with the control group (0.30 per 1000 person-years vs. 0.28 per 1000 person-years, calculated from the figures on the right upper corner of Page 3). We believe that troons are disproportionately exposed to behaviors that carry mortality risks, such as drug use and prostitution, but the figures seems to cast doubt on this picture. Perhaps a finer classification of non-suicide deaths can make it clearer.
 
We believe that troons are disproportionately exposed to behaviors that carry mortality risks, such as drug use and prostitution, but the figures seems to cast doubt on this picture.
Well I mean, the study was in Finland. I doubt many Finns of any stripe end up perforated and/or gay-bashed like Brazilian streetwalking tranny hookers.
 
Transsexuals are starting to control the narrative, insinuating that one of the researchers is associated with anti-trans groups.
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You can disregard Antony "Erin" Reed because he is dumb as shit, but if you want to dumb down your brain, here is his 37-part screed.
 
Wonder how the parents who consented to surgeries and puberty blockers will feel about this news.

Shut up NAZI etc

You know exactly how they will respond: total denial, reverse uno card attack. Assuming you can force them to read it at all, of course.

None of these people are in it for the truth.
 
Transsexuals are starting to control the narrative, insinuating that one of the researchers is associated with anti-trans groups.
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You can disregard Antony "Erin" Reed because he is dumb as shit, but if you want to dumb down your brain, here is his 37-part screed.
This is interesting because a complaint that's coming up is "small sample size", but this is literally a sample of every single young person referred to Finnish gender identity clinics across 23 years diagnosed with F64.0 (Transsexualism), F64.2 (Gender identity disorder of childhood), F64.8 (Other gender identity disorders), and F64.9 (Gender identity disorder, unspecified). These were the ICD codes used up to 2019 when this study was conducted - Tony's seething about it is irrelevant, because he's talking about the DSM (which is American).
This study comprised a register-based follow-up of individuals who entered nationally centralised gender identity clinics in Finland from 1996 to 2019 before turning 23 years. The follow-up for each participant (later also a gender-referred individual) began when they entered the gender identity teams, that is, during their first appointment at the gender identity services and according to the subsequent provision of the following diagnoses: F64.0, F64.2, F64.8 or F64.9 (the index date). The follow-up period was extended until death or until June 2022, when the dataset was compiled. We did not restrict the upper age limit of the study sample to 18 years, as is common in many previous adolescent studies, because the identity development of young people continues beyond reaching legal adulthood.
This resulted in a study looking at 2,083 people across 23 years who were referred to gender clinics at the age of 23 or younger, of which 55 died (20 by suicide). Only 38.2% had proceeded to gender reassignment (defined as anything from HRT to masectomy). That might not be a massive sample size, but it is literally everyone referred to a gender clinic as a young person across three decades.
The other argument is that this doesn't capture trans kids who didn't have supportive parents who'd take them to a gender clinic, but there's no proposed method for identifying these trans children other than I guess self-reported studies which are open to abuse. Tony also complains a lot of the data comes from a time when "gender dysphoria wasn't a diagnosis" - he is right, the ICD-11 now recognises these conditions as "gender incongruence", but you can't do a long term study on healthcare outcomes based on a diagnostic label that's only been in use for 2 years.
Each patient was matched with 4 controls, two male and two female, matched to age and also to municipality of birth - they were being compared to people born in the same time and place. Then they looked at overall mental health -
The number of contacts with specialist-level psychiatric care was extracted from the CRHC. The number of contacts, excluding the specialised gender identity assessment, was used in the analyses and classified as follows: none, 1–5, 6–25, 26–100 and 101+.
Their metric is seeing how often they accessed mental health treatment, ignoring anything specifically related to gender identity - so if they were also seeing a psychiatrist for depression, for example, and how long they saw a psychiatrist for that.
One of the breakdowns here indicates -
There were 55 deaths in the study population, including 20 suicides. In bivariate analyses, all-cause mortality did not statistically significantly differ between gender-referred individuals and controls; however, the proportion of suicides was higher in the gender-referred group (0.3% vs 0.1%; p=0.004). P
People who'd been referred to a gender clinic seemingly did not really die in general more than people who had not. The study does note, for example, that transgender Finns do not seem to have elevated rates of substance abuse compared to their non-trans counterparts, and likewise don't have an elevated HIV/AIDS burden. The findings do show that there's a 4-and-a-quarter increased likelihood of suicide mortality in people referred to the gender clinic compared to people who were not (0.51 per 1000 person-years vs 0.12 per 1000 person-years) and this gets even more pronounced in males if you control for age and sex. But if you control for psychiatric appointments, the stats level out and it's just "people who go to a psychiatrist a lot are really significantly more likely to die from suicide", and going to a gender clinic does not have meaningful impact on outcome.

One valid thing they do flag is they don't really explore the breakdown of "people who went to the gender clinic age 23 or younger and medically transitioned" and "people who went to the gender clinic age 23 or younger and did not medically transition" are not really interrogated. The paper does note the difference in hazard ratios -
To explore the role of GR, models accounting for sex, year of birth and psychiatric treatment were repeated by dividing the GR group into those who had and those who had not proceeded to GR. Adjusted HRs for all-cause mortality were 1.4 (95% CI 0.6 to 3.3; p=0.5) in the GR− group and 0.7 (95% CI 0.2 to 2.0; p=0.5) in the GR+ group, as compared with the controls. Adjusted HRs for suicide mortality were 3.2 (95% CI 1.0 to 10.2; p=0.05) and 0.8 (95% CI 0.2 to 4.0; p=0.8), respectively
These are not statistically significant, which means the difference could have been random chance. That difference would actually indicate 3.2/0.8 = 4 times greater likelihood of suicide mortality from "people who went to the gender clinic age 23 or younger and did not medically transition". This is being framed as "young people denied gender affirming care are 4 times more likely to kill themselves", when obviously we don't know why these people did not proceed to medically transition, it could just be "people who aren't trans who still end up getting referred to a gender clinic at a young age must be all kinds of fucked up". It could also be "the people who were far too crazy for the gender clinics to treat were so crazy they all killed themselves". The authors don't discuss it because they're focused on the statistically significant findings.

I will concede though that to me, this paper isn't necessarily as open-and-shut as the paper presents itself as. The absolute bombshell would have been that if you control for age, sex and psychiatric illness, medical transition has no discernible impact on suicide mortality outcomes. But this isn't that. All this paper really establishes is that trans people aren't more likely to kill themselves because they're trans, they just tend to be crazy in lots of other ways and people with that sort of crazy tend to kill themselves more. Unlike what Tony and co are arguing, it doesn't demonstrate that gender affirming care reduces suicide because the results aren't statistically significant and also we don't have the breakdown available of who did-and-didn't get the treatment and why. But we might be able to make a reasoned guess.
statbreakdown.png
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I like charts, charts are easier. Basically in the sample the percentage of non-referred people who had ever had any psychiatric treatment whatsoever was about 25.9%, which was less than the percentage of trans-referred people who'd seen psychiatrists for other things over 100 times. I think if a teenager turns up to a gender clinic and gets denied treatment because they're completely schizophrenic and, frothing at the mouth, announce they are (for example) a CPU Goddess who can manifest a dimensional merge with a land inhabited by magical talking Electric Hedgehog Pokémon... giving them hormones probably isn't going to change the odds of them eventually committing suicide.

Basically, the criticisms Tony-and-co are launching don't refute the paper or prove the counterfactual, all this really demonstrates is we don't have a solid scientific grounding that giving children HRT reduces the likelihood of them killing themselves or how effective this is. That's something highly relevant to a country like Finland, which has socialised healthcare and so has to focus on making cost-effective decisions around treatment (which is why a lot of European troons seethe that they don't get free boob jobs or FFS, because there's no evidence this has a significant impact on mental wellbeing, it's just something they want).
 
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