Gender dysphoria does not appear to be predictive of suicide when psychiatric treatment history is accounted for.
A groundbreaking new study found that suicide among gender-dysphoric youth is extremely rare and most likely driven by underlying psychological problems, undercutting the activist narrative that the gender medicalization of minors constitutes “lifesaving care.”
Published earlier this month in BMJ Mental Health, the research paper produced by a group of Finnish scientists reveals that clinical gender dysphoria does not appear to be predictive of suicide or other causes of death when psychiatric-treatment history is accounted for.
The study found that suicide rates for Finns under the age of 23 who were referred to gender clinics from 1995 to 2019 was just 0.3 percent. The proportion of suicides was higher among gender-referred adolescents than among the control group, which had a suicide rate of 0.1 percent and consisted of youth of the same age and municipality of birth who did not have gender dysphoria. But there was no statistically significant difference between the two groups after adjusting for serious psychiatric comorbidities.
The scientists factored in preexisting mental issues among gender-dysphoric youth vs. their peers by counting psychiatric visits to hospitals. In Finland, only severe psychiatric illness is treated in hospitals.
Using data from the Care Register for Health Care, which is provided by the Finnish Institute for Health and Welfare, the scientists discovered that psychiatric treatment was more common among gender-referred youth than among the controls. Of the gender-referred, 38.2 percent proceeded to undergo hormone treatment or surgery. The study did not specify the psychiatric conditions experienced by the sample individuals, likely for confidentiality reasons.
Female detransitioner Prisha Mosley told National Review that before developing gender dysphoria and beginning medical transition at 17, she was diagnosed with psychotic major depression, ADHD, bipolar one and two, mania, anorexia, and borderline-personality disorder.
Laura Becker, another female detransitioner, told National Review that she was diagnosed with autism at age eleven, which caused her to struggle with emotional regulation, socialization, and sensory issues many years before the onset of her severe gender dysphoria and body dysmorphia.
Mosley’s and Becker’s testimony revealed, and the Finnish study supports, that psychiatric distress could be an antecedent to gender dysphoria, rather than a by-product. The study solidified that comorbid psychiatric conditions, a well-known risk factor for suicide, are prevalent in gender-dysphoric youth.
“Psychiatric disorders are associated with increased burdens of somatic illnesses and suicide,” the paper said. “In fact, the novel contribution of this study is showing that suicide mortality associates with increased psychiatric needs; this is an important finding if we consider the failure of previous studies on mortality among patients with GD [gender dysphoria] to account for psychiatric morbidities.”
Severe gender dysphoria that led to medical transition had no notable relationship to increased suicides, likely explained by psychiatric comorbidities, according to the study.
The study’s conclusions also appear to invalidate the all-or-nothing threat of suicidality that trans activists wield to silence debate on so-called gender-affirming care for kids.
The study cited a 2022 paper by University of Oxford researcher Michael Biggs on clinic-referred transgender adolescents in the United Kingdom. Biggs said the gender activists’ rhetorical strategy has for years overshadowed any holes in the literature, such as the potential role of psychiatric comorbidities.
“The claim that ‘if we don’t give this treatment to the kids, they won’t even live,’ . . . in some ways it justifies a lot of uncertainty about the data and uncertainty about side effects,” Biggs told National Review. ‘The side effects of puberty blockers are horrific, but the point is they’re going to kill themselves if we don’t give them puberty blockers, so let’s not even bother investigating the side effects on bone density and so on, because this is lifesaving treatment, anything is better than a kid committing suicide.’”
“That kind of panic about the need to urgently put a child on gender treatment is shown to be false by this study,” he added.
Gender activist and researcher Dr. Jack Turban criticized the Finnish study this week for its adjusting for psychiatric visits in its testing of suicide outcomes among gender-dysphoric youth.
“This is either very stupid or intentionally misleading,” Turban tweeted. “In any event, the data show that gender-referred young people had a dramatically increased risk of suicide (HR=4.3, 95%CI 1.7-10.7, p=.002), when you don’t include this nonsense adjustment for something in the causal pathway for suicide. This is a horrifying disparity statistic.”
In Turban’s view, psychiatric problems among gender-dysphoric kids are directly connected to “minority stress,” the theory that societal stigmatization and peer or parent refusal to affirm their gender identity harms their mental health. Turban rejected in a 2018 paper the idea that autism-spectrum disorder could underlie transgender identity, suggesting instead that minority stress can cause autism-like symptoms.
Minority stress is an easy blanket explanation, but that doesn’t make it scientifically sound, Biggs said.
“It’s completely circular, because there’s no measure of minority stress. It’s just used as an explanation for when people have other problems,” Biggs said. “It’s not a very good analysis, because we know that the variation in psychiatric problems, even self-reported problems, doesn’t accord. There are big disparities that cannot be explained by minority stress.”
As for the particular merits of the Finnish study, according to Biggs, it uses real data on individuals seeking psychiatric treatment. The U.S. transgender survey, which Turban has repeatedly used for analysis, is based on self-reported entries from the trans community.
“The Finnish study is definitely the best thing that’s been published in transgender medicine, because they’ve got objective data on the entire population with no sampling problems, no online surveys,” Biggs said. “Turban should be thinking much harder about how to do good research in America rather than coming up with these absurd criticisms.”
Turban did not immediately respond to request for comment.
Biggs did acknowledge that there are some limitations in the Finnish study, such as its failure to adjust for how long a patient had been in the study.
“If you’d only been in the study for one year, . . . going to a psychiatrist five times is actually much worse than if you’d been in the study for 15 years and you’d gone 15 times to a psychiatrist,” Biggs said. “That’s much less a level of comorbidity. They didn’t adjust for the duration of the time.”
But the scientists’ decision to exclude that information might have been due to confidentiality constraints, not a conscious choice, Biggs said.
Ultimately, the Finnish study provides the best evidence yet that the popular gender-activist narrative is oversimplified, potentially dangerously so.