The study showed that transgender teens had a higher rate of suicidality than their cisgender peers, and that transgender females and transgender males had a higher rate of suicidal ideation and attempt than their cisgender and nonbinary peers.
Thoma says there have been few studies on the topic with primary data analysis, and they often lack the nuance needed to understand thoughts of suicide in specific subgroups of gender identity besides the umbrella label of transgender.
“Because of those limited measures of gender identity, we really had very little information about rates of suicidality within subgroups of transgender adolescents,” says Thoma. “The vast majority of studies kind of compare all transgender adolescents as this homogenous, monolithic group — which we know is not true — to cisgender adolescents and just ran their analyses that way, which is not a very nuanced way to look at the data.”
The survey used to collect data was distributed through Facebook ads, which also run on Instagram, to U.S. teens 14-18 years old. Participants indicated on the survey the gender they were assigned at birth and their current gender identity. The questions on suicidality — a term used in the research to encompass varying degrees of suicidal thoughts — were divided into categories of passive death wish, suicidal ideation, planning attempt, suicide attempt, and suicide attempt requiring medical care. It also assessed non-suicidal self-injury. (Participants who reported suicidality were provided with a suicide hotline number and other resources.)
The results indicated a higher risk in all categories for transgender participants. For example, the number of cisgender participants who reported attempting suicide was 31.4 percent, and the number of transgender participants was 50.3 percent. But the specificity of the study allows more precise comparisons. Suicide attempts requiring medical attention was higher for transgender males than for transgender females. Passive death wish, which was phrased by the survey as “have you wished you were dead?” has rates above 90 percent for all transgender teenagers, but it was also above 60 percent for all gender identities.
“I think it’s really important that future studies use these comprehensive measures of gender identity to make sure they’re accurately identifying transgender adolescents, and then also to allow them to look at rates of suicidality as well as other mental and behavioral health outcomes across these different subgroups,” says Thoma. He hopes these methods can be applied to comprehensive, annual surveys like Youth Risk Behavior Surveillance System survey conducted by the CDC, to track a larger group over a longer period of time.
Thoma also says it’s important to note that, even though his study doesn’t get into the specific causes, other studies indicate that the high rates of suicidality among transgender teens are due to social factors.
“It’s not something about this group inherently that’s causing them to have these higher rates of suicidality,” says Thoma. “But it’s the rejecting social context that they come into contact with in school and in their own homes that is making their lives more difficult and making it so they’re experiencing suicidality more often than their cisgender peers."