In a recent essay defending her controversial views on sex and gender issues, author J.K. Rowling writes:

The argument of many current trans activists is that if you don’t let a gender dysphoric teenager transition, they will kill themselves. In an article explaining why he resigned from the Tavistock (an NHS gender clinic in England) psychiatrist Marcus Evans stated that claims that children will kill themselves if not permitted to transition do not ‘align substantially with any robust data or studies in this area. Nor do they align with the cases I have encountered over decades as a psychotherapist.’

Are gender dysphoric teens more likely to kill themselves if they are not permitted to transition?


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    Related: skeptics.stackexchange.com/q/45904/37236 (though there are some limitations with the answer) – Laurel Jun 11 at 13:51
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    It seems like there could be other significant factors here even if the correlation were true. A home or cultural environment that isn't understanding in general could be what leads gender dysphoric teenagers to consider suicide, with the prevention of transitioning being a symptom of that environment. – PC Luddite Jun 11 at 16:31
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    I think the question is flawed in so far as the generic question "Are teenagers more likely to take their lives if they are not allowed <something they really want> ?" would almost certainly have a "yes". Studies only focusing on teenagers denied a gender treatment they want would need to compare against e.g. teenagers denied a relationship with someone of a "conventional" opposite gender they became involved with. This would be the only way to see if the "gender denial" issue had a specific difference compared to other "significant denial" issues in teenagers. – StephenG Jun 11 at 18:55
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    @Tim: I'm less interested in what Evans is said to have claimed (i.e. that there is or isn't robust evidence) and more interested in the claim that Rowling is making (i.e. that the argument that denial of permission leads to higher risk of suicide is false) To answer that on this site, it is implied that you need evidence, so it could well be that an answer cites Evans, if Evans has published a literature review showing there is no robust evidence. [I am genuinely ignorant about whether he has.] Hmmm... This seems a clumsy explanation to me. Is that clearer? – Oddthinking Jun 11 at 20:07
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    @PCLUddite: Agreed, but some randomised-controlled experiments are clearly beyond-the-pale unethical, so correlation - perhaps with confounding variables eliminated through modelling - is the best we can hope for. – Oddthinking Jun 11 at 20:13

A recent study found a high rate of suicidal ideation & a decrease in gender dysphoria in children & teenagers when treated with hormones - Psychiatric Co-Morbidities, Sexual Orientation, and Impact of Therapeutic Interventions in a Gender Non-Conforming Pediatric Practice:

The prevalence of psychiatric co-morbidities, suicidal ideation, and self-injuring behavior is high among GNC youth, but in this population, significantly worse among affirmed males. Both groups had significant improvement in the degree of dysphoria after beginning hormonal treatment.

Referencing a 2015 study, the Williams Institute found a direct link between hormone therapy and lowered suicidal thoughts & attempts (in adults):

Those who wanted, and subsequently received, hormone therapy and/or surgical care had a substantially lower prevalence of past-year suicide thoughts and attempts than those who wanted hormone therapy and surgical care and did not receive them.

The study Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation found the same to be true for trans teenagers:

There is a significant inverse association between treatment with pubertal suppression during adolescence and lifetime suicidal ideation among transgender adults who ever wanted this treatment. These results align with past literature, suggesting that pubertal suppression for transgender adolescents who want this treatment is associated with favorable mental health outcomes.

Other studies have shown a decrease in depression and increase in overall functioning outcomes with puberty-blockers.

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    @Colin "allowed to transition" is rather vague, but I'd certainly include puberty blockers among that. If it's only about social transition instead, I'm not sure what "allowed" would mean. – tim Jun 11 at 9:38
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    These are a few studies that point in one direction, but how representative are these? Are there more or less studies that show the opposite? – Alex Jun 11 at 15:04
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    @Alex that's a question that's best answered by a meta-analysis or systematic review, and as far as I can tell, none has yet been done on this topic. The best I can find is ncbi.nlm.nih.gov/pmc/articles/PMC5010234, which looks at adults rather than teens, and concludes that: "Hormone therapy interventions to improve the mental health and quality of life in transgender people with gender dysphoria have not been evaluated in controlled trials. Low quality evidence suggests that hormone therapy may lead to improvements in psychological functioning." – James_pic Jun 11 at 15:19
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    I definitely see what they mean by low quality evidence in that meta-study. The first and the third study don't use control groups (so it's impossible to tell apart the influence of the hormone treatment vs the passing of time) and the second study only asked people who, in fact, are transsexual as grown-ups (which is, presumably, or at least potentially, very different from being gender-dysphoric as a teenager.) – sgf Jun 11 at 20:58
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    @GwynethLlewelyn That's a bit like saying that there's no valid reason to postulate that retirees experience heart attacks more frequently, since "retiree" is not a biological category. Teenhood is the time you construct most of your identity, and your identity is at a special sort of turmoil at that time. Sure it doesn't overlap precisely with the end of legal childhood, but that's only a reason to be more fine-grained with your age categories (< 13, 13-21, 21-40 or whatever you like) rather than to dismiss them altogether. – sgf Jun 12 at 9:39

There's NO epidemiological evidence that showcases improved mood through transitioning.

Their suicide rate/attempts remain the same.

The Washington Post reports nearly HALF of trans male adolescents try to take their own life.

New evidence of the need for such services arrived this week in a study in the September issue of Pediatrics, the flagship journal of the American Academy of Pediatrics. It shows that transgender adolescents attempt suicide at a much higher rate than young people whose gender identity matches the sex on their birth certificates.

Fifty-one percent of transgender male adolescents reported at least one suicide attempt — the highest rate in the study. The second highest was among young people who are nonbinary — those who do not identify exclusively as male or female — at 42 percent, while 30 percent of transgender female adolescents reported attempting suicide.

The suicide attempt rate among transgender persons ranges from 32% to 50% across the countries.

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    It's not clear what portions of your answer are being supported by that single source. Can you please edit and make some quotes more clear? It's also not clear if you're answering the question. It's not in dispute whether trans people have a high suicide rate, but rather whether that suicide rate is decreased in "transitioned" persons. You seem to be making a simple rhetorical argument "because trans is mental illness, transitioning won't help". – fredsbend Jun 12 at 20:14
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    I agree with fredsbend. 1) Most of this doesn't answer the question & the parts that do are unsourced and 2) The implication that being trans is a mentally illness is false, not relevant, and against the code of conduct. – tim Jun 12 at 20:25
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    "There's NO epidemiological evidence that showcases improved mood thru transitioning. Their suicide rate/attempts remain the same." Is there epidemiological evidence that their suicide rate/attempts remain the same even if they transition? Because that's what the question is actually asking, and you haven't provided that evidence. – F1Krazy Jun 12 at 20:35
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    I have edited away a lot of the unsourced personal views. But that still leaves the first two sentences which are NOT supported by the only reference provided (except that it does note suicide rates drop with age, which is a confounding factor). – Oddthinking Jun 12 at 21:18
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    I suggest you read the Welcome to Skeptics to understand better why your original answer is unacceptable here. – Oddthinking Jun 12 at 21:19

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