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Does gender affirming care lower youth suicide risk?

Based on a significant and growing body of research, the consensus among major medical and mental health organizations is that gender-affirming care is associated with a lower risk of suicide and improved mental health outcomes for transgender and gender diverse (TGD) youth.

Here is a comprehensive breakdown of the evidence, the mechanisms involved, and the consensus view.

The Evidence from Key Studies

Multiple studies have investigated the link between access to gender-affirming care and mental health. The findings consistently point towards a protective effect against suicidality.

1. The Trevor Project’s National Survey: The Trevor Project, a leading suicide prevention organization for LGBTQ youth, conducts large-scale annual surveys. Their 2023 U.S. National Survey on the Mental Health of LGBTQ Young People found that transgender and nonbinary youth who received gender-affirming care reported significantly lower rates of recent suicide attempts. Specifically, receiving gender-affirming hormones was associated with a nearly 25% reduction in the odds of a recent suicide attempt.

2. JAMA Network Open Study (2022): A landmark longitudinal study published in JAMA Network Open followed a cohort of TGD youth aged 13-20. The study (Tordoff et al.) found that receiving gender-affirming medical interventions, such as puberty blockers or hormones, was associated with:
   • 60% lower odds of moderate to severe depression.
   • 73% lower odds of suicidality over the 12-month follow-up period. The longitudinal design of this study is particularly strong, as it observed changes in the same individuals over time.

3. Pediatrics Study (2021): A study published in the journal Pediatrics (Green et al.) examined the impact of access to puberty-blocking medication. It found that among transgender adults who had wanted puberty blockers when they were adolescents, those who had received them experienced lower odds of lifetime suicidal ideation compared to those who did not.

4. Social Affirmation Studies: Gender-affirming care is not limited to medical interventions. Social affirmation—such as using a young person’s chosen name and pronouns—is a critical component. A 2018 study in the Journal of Adolescent Health found that when TGD youth were able to use their chosen name at school, at home, with friends, and at work, they experienced:
   • 71% fewer symptoms of severe depression.
   • 34% decrease in reported suicidal ideation.
   • 65% decrease in suicide attempts.

How Gender-Affirming Care Reduces Suicide Risk

The protective effect of gender-affirming care is understood through several interconnected mechanisms:

• Alleviation of Gender Dysphoria: Gender dysphoria is the significant distress or impairment a person may experience when their gender identity does not align with the sex they were assigned at birth. This distress is a primary driver of depression, anxiety, and suicidality. Gender-affirming care, whether social or medical, directly addresses and alleviates this core source of pain by helping a person’s body and social presentation align with their internal sense of self.

• The Minority Stress Model: TGD youth face high levels of minority stress, which stems from stigma, discrimination, family rejection, and violence. This chronic stress contributes to poor mental health outcomes. Gender-affirming care acts as a powerful buffer against minority stress. It provides validation, fosters a sense of authenticity and self-worth, and can improve family and social support, all of which are protective factors.

• Improved Functioning and Well-being: By reducing dysphoria and buffering stress, gender-affirming care allows youth to engage more fully and positively in their lives. They may experience improved relationships with family and peers, better performance in school, and a greater sense of hope for the future—all of which reduce the risk factors for suicide.

Consensus of Major Medical and Mental Health Organizations

There is a strong and widespread consensus among virtually every major medical and mental health association in the United States and internationally that gender-affirming care is medically necessary, safe, and effective for treating gender dysphoria and improving the well-being of TGD individuals.

Organizations that support and endorse gender-affirming care for youth include:

• American Medical Association (AMA)
• American Academy of Pediatrics (AAP)
• American Psychological Association (APA)
• American Psychiatric Association
• The Endocrine Society
• World Professional Association for Transgender Health (WPATH)

These organizations base their support on the extensive body of scientific evidence. The AAP states, “for gender-diverse youth, who are at increased risk of suicide and depression, gender-affirming care is life-saving.”

Conclusion

In summary, the available evidence strongly indicates that access to gender-affirming care is a crucial factor in reducing suicide risk for transgender and gender diverse youth. Studies consistently find that various forms of affirmation—from using correct pronouns to providing medical interventions like puberty blockers and hormones—are associated with significantly lower rates of depression, suicidal ideation, and suicide attempts. This conclusion is supported by the unified position of leading medical and mental health professional organizations worldwide, which recognize this care as evidence-based and medically necessary.