Summary

Sociologist Michael Biggs estimated how many young patients of England's national youth gender clinic (GIDS) died by suicide between 2010 and 2020. Using hospital board papers and Freedom of Information requests, he found four known or suspected suicides, two of them among young people still on the waiting list, out of roughly 15,000 patients. That works out to about 13 suicides per 100,000 patients per year. This is around 5.5 times the rate for UK teenagers of similar age and sex mix, but still very rare (0.03% of patients). Biggs argues this shows higher risk, but also that claims that about half of trans youth attempt suicide give a misleading picture of how many die. Because it rests on four deaths, an estimated patient count and no data on other conditions, it is a rough figure. It says nothing about whether treatment raises or lowers risk.

Key findings

• Fire GIDS-patienter var kendt eller mistænkt for at være døde ved selvmord i 2010-2020. To stod på ventelisten, og to var blevet set; ét dødsfald afventede stadig en retsundersøgelse.
• Ud af omkring 15.032 patienter svarer fire dødsfald til 0,03 %. Det er langt under de omkring 40-50 % ‘forsøg’ i løbet af livet, der ofte citeres fra undersøgelser og kampagnegrupper.
• Over anslået 30.080 år med patienter under klinikkens pleje var den årlige selvmordsrate omkring 13 pr. 100.000, selvom det sande tal kunne ligge alt fra omkring 4 til 34.
• Efter hensyntagen til klinikkens overvejende kvindelige patienter (69 %) var raten cirka 5,5 gange så høj som hos alle britiske teenagere i alderen 14-17 år (2,7 pr. 100.000).
• GIDS-raten var cirka 70 gange lavere end rapporteret for Belgiens kønsklinik for unge (5 af 177 patienter) og cirka fire gange lavere end for den overvejende voksne klinik i Amsterdam.
• Ventetid udgjorde 41 % af den optalte tid, og halvdelen af selvmordene skete blandt patienter på ventelisten, nogenlunde i tråd med den andel.
• Forfatteren bemærker, at autisme (14-15 % af GIDS-henvisninger sammenlignet med omkring 1 % af engelske skoleelever), depression og spiseforstyrrelser sandsynligvis forklarer en del af den højere risiko.

Conclusion

Data from the world's largest clinic for transgender youth over 11 years yield an estimated annual suicide rate of 13 per 100,000, 5.5 times greater than the overall suicide rate of adolescents of similar age after adjusting for sex composition. The estimate demonstrates elevated suicide risk among adolescents who identify as transgender, albeit without adjusting for accompanying psychological conditions such as autism. The proportion of patients who died by suicide (0.03%) is orders of magnitude smaller than the proportion of transgender adolescents who report attempting suicide in surveys. That deaths were so rare should provide some reassurance to transgender youth and their families, though it does not detract from the distress caused by non-fatal self-harm. The author argues it is irresponsible to exaggerate the prevalence of suicide, as this may itself increase the vulnerability of transgender adolescents.