Transgender boys face the highest risk for suicide among adolescents of all genders, suggest results from a study published in Pediatrics.

It is well established that transgender people face a disproportionate risk for suicide, with studies reporting lifetime rates of suicide attempt up to 52%. The authors of this study took an interest in variability within the transgender population, citing findings from smaller studies that suggested adult transgender men are at particularly high risk.

The authors used data from the Profiles of Student Life: Attitudes and Behaviors survey collected between June 2012 and May 2015, comprising 120,617 children ages 11 to 19 years. The survey included a question about whether the respondent had attempted suicide, with 4 options: no, not ever; yes, 1 time; yes, 2 times; and yes, >2 times.

Overall, 14.6% of youth respondents in 2015 reported a plan to attempt suicide and 8.6% reported a suicide attempt. The proportion of students who identified themselves as transgender, nonbinary, or questioning was 1.4%, in line with data from previous surveys and studies.

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In their analyses, the authors examined the suicide attempt rates of 6 groups: cisgender females, cisgender males, transgender females, transgender males, nonbinary adolescents, and questioning adolescents. Transgender boys (50.8%) reported the highest rate of attempted suicide, followed by nonbinary adolescents (41.8%), transgender girls (29.9%), questioning adolescents (27.9%), cisgender girls (17.6%), and cisgender boys (9.8%).

Possible limitations of the study included the use of self-reported data and the use of a dichotomized interpretation of the survey question about lifetime suicide attempt — although some adolescents reported a greater number of attempts. The strength of the study was bolstered by the Profiles of Student Life’s development of an inclusive, clearly written question about gender identity.

Although the disproportionate suicide rate among transgender youth may be daunting, the authors reminded readers that “family acceptance and support are associated with diminished disparities in depression between transgender and cisgender children.”

Reference

Toomey RB, Syvertsen AK, Shramko M. Transgender adolescent suicide behavior [published online September 11, 2018]. Pediatrics. doi:10.1542/peds.2017-4218