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

• Four GIDS patients were known or suspected to have died by suicide in 2010–2020. Two were on the waiting list and two had been seen; one death was still awaiting an inquest.
• Out of about 15,032 patients, four deaths equal 0.03%. This is far below the roughly 40–50% lifetime 'attempt' figures often quoted from surveys and campaign groups.
• Over an estimated 30,080 years of patients under the clinic's care, the yearly suicide rate was about 13 per 100,000, though the true figure could be anywhere from about 4 to 34.
• After allowing for the clinic's mostly female patients (69%), the rate was about 5.5 times that of all UK teenagers aged 14–17 (2.7 per 100,000).
• The GIDS rate was about 70 times lower than reported for Belgium's youth gender clinic (5 of 177 patients), and about four times lower than for the mostly adult Amsterdam clinic.
• Waiting-list time made up 41% of the time counted, and half the suicides happened among waiting-list patients, roughly in line with that share.
• The author notes that autism (14–15% of GIDS referrals compared with about 1% of English pupils), depression and eating disorders probably explain part of the higher risk.

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.