State Gender-Intervention Bans Show No Teen Suicide Increase

The Effect of State Bans on Gender Interventions for Minors on Teen Suicide Rates

Cohort & registry studies Mental health & suicide Guidelines & policy

Authors: Jay Greene, Ian Kingsbury
Journal: Do No Harm (report)
Year: 2026
Source: donoharmmedicine.org/wp-content/uploads/DNH-Suicide-Rates-GAC-Bans-Paper.pdf

Summary

Opponents of state bans on medical transition for minors warned the bans would lead to more teen suicides. Researchers at Do No Harm, a group that campaigns against these treatments, tested this using US death records for 2018–2024. They compared suicide rates among all 15–19-year-olds in the 23 ban states with other states, and tracked national monthly rates for 13–17-year-olds. All three methods found changes close to zero, small enough to be chance. The report also criticises studies used to argue that the treatments prevent suicide. The finding is real but limited: it rules out a large rise across all teens in the first one to three years. Trans teens who lost treatment are a tiny share of all teens, so a meaningful rise among them could go unseen, as an economist who repeated the analysis pointed out. It was not checked by outside experts.

Key findings

The report used US national suicide records for 2018–2024. Bans took effect in 2 states in 2022, 15 in 2023 and 6 in 2024, giving one to three years of data after each ban. Laws blocked by courts were only counted once actually in force.
The main method compared how suicide rates among 15–19-year-olds changed in ban states with how they changed in other states, allowing for suicide rates among 20–24-year-olds, national trends, each state's usual rate and income. It found a change of −0.3%, which could easily be chance.
A second method, designed for bans that started in different years, found an average change of under 1%, no different from zero.
A third method tracked national monthly suicide rates for 13–17-year-olds against the share of trans-identifying teens living under a ban. The estimated effect rounded to zero.
The report measures deaths by suicide across the whole age group. It does not measure suicide attempts, or suicides among trans youth or those seeking treatment, the group the bans directly affect.
The report also criticises studies used to support the claim that treatment prevents suicide. These include Tordoff et al. 2022, where the untreated group shrank from 93 to 7 people, and a 2024 Trevor Project study of anti-trans laws.
The authors admit the results could change with more years of data and that other methods could give different answers. They publish their analysis code.

Abstract

The following study examines the widespread belief that banning so-called gender-affirming care for minors increases suicide rates among gender-dysphoric youth. It finds no evidence that such prohibitions have any such effect. Across three analyses employing three distinct modeling approaches, we find no statistical support for the claim that state bans on gender interventions for minors have led to a spike in suicide rates.

Conclusion

This study finds no evidence that state prohibitions on surgeries, puberty blockers, or cross-sex hormones for minors with gender dysphoria have increased suicide rates. Across three analyses employing three distinct modeling approaches, the results clearly and consistently show no effects. There is no evidence to support the claim that state bans on gender interventions for minors led to a spike in suicide rates. The authors note that the debate is unlikely to be resolved by this analysis, that results could change with additional years of data, and that different modelling techniques could produce different findings, and they publish their STATA code for transparency.

Methodological limitations

Not checked by outside experts: This is a self-published report from Do No Harm, not a journal article, and no independent experts have reviewed its methods.
Effect diluted across all teens: The report looks at suicide among all 15–19-year-olds (or 13–17 nationally), but the bans directly affect a very small group of trans youth on or seeking hormones (around 0.2% of insured 8–17-year-olds in Oregon had a recorded hormone prescription). Economist Travis Campbell repeated the analysis and said the results are too imprecise to rule out real harm in that small group (The College Fix, October 2026).
Doesn't show what it can rule out: The report gives single estimates but no range of likely values and no statement of the smallest rise it could detect. Readers can't tell how big an increase the data could exclude. A result that 'could be chance' is not proof of no effect.
Short follow-up: Data only run to 2024, so most ban states have one or two years after the ban, and 2024 states effectively one. That is too short to see delayed effects (the authors agree results could change).
Age groups don't match the bans: The 15–19 age band includes 18- and 19-year-olds not covered by most bans. The 20–24 comparison group may itself be affected by related policies, which could push results toward zero.
State averages can't track individuals: State suicide rates cannot show what happened to the young people who actually lost treatment. Campbell suggests linking death records to health records to follow youth diagnosed before the bans.
Questions about the method: The main analysis adjusts for each state's average suicide rate across all of 2018–2024, including years after the bans. It is unclear how this differs from the standard approach, and the usual check that ban and non-ban states had similar trends beforehand is not reported.
Measures deaths, not attempts: The report covers suicide deaths only, while much of the research it criticises (for example Lee et al., 2024) is about suicide attempts or suicidal thoughts. So it does not directly disprove those findings.
Written by campaigners: Both authors work for Do No Harm, which campaigns for these bans, and Kingsbury has publicly called opponents the 'transgender industrial complex'. Its criticism of opposing studies is selective and is not a full review of the research.
Author's past work disputed: Greene's 2022 Heritage Foundation report claimed easier access to blockers and hormones raised youth suicide, and was criticised by Jack Turban and Jesse Singal for claiming cause and effect. This shows how much such state-level studies depend on method choices.
Second method poorly reported: The result of the second method is given only as a graph and 'under 1%', with no exact figure or margin of error in the text.

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Summary

Key findings

Abstract

Conclusion