Mick Hartley

Well, this blows a hole in the old "danger of suicide if not given immediate gender-affirming care" line. From Mary Harrington at UnHerd:

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.

That is, "gender-dsyphoric" youth have a greater risk of suicide anyway – transition or no transition. Which, frankly, is what you'd expect.

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.