Overview

Suicide figures are some of the most quoted numbers in gender medicine, and some of the most misunderstood. "40% have attempted suicide", "19 times higher risk", "gender-affirming care saves lives" and "suicides rise after transition" all circulate, often stripped of the study they came from. Each of these figures measures something different, in a different population, with different weaknesses.

This page is the quantitative companion to Suicide and Transition: The Narrative vs the Evidence, which covers the "transition or suicide" message and how it reaches families. Here the focus is narrower: what each well-known figure actually measures, what it can support, and what it cannot. It sets out the main sources side by side, summarises what can and cannot honestly be said, looks at the limited data on detransitioners, and ends with a checklist for reading any suicide statistic.

This page does not give medical advice. Every number below was checked against the original paper or report. Where a figure could not be checked, it is left out.

How suicide is measured

Thoughts, attempts and deaths

Researchers separate three outcomes that are often run together in public debate:

• Suicidal ideation: thoughts of suicide, from passing thoughts to serious consideration. It is common in many distressed groups and is usually measured by questionnaire.
• Suicide attempt: self-harm with some intent to die. It is measured by self-report ("have you ever attempted suicide?") or by hospital records of treated attempts. These two methods give very different numbers.
• Death by suicide: recorded by coroners and national cause-of-death registers. It is the most reliable measure, but also the rarest event, so studies need large populations or long follow-up to count enough deaths.

The three differ by orders of magnitude. In Denmark's national register, 3,759 transgender-identified people followed for 21,404 person-years (one person-year is one person followed for one year) had 92 hospital-recorded suicide attempts and 12 suicides (Erlangsen et al. 2023). In US online surveys, by contrast, around 39% of respondents report serious suicidal thoughts in the past year (Herman et al. 2026). Both figures can be accurate, but they describe different things. A survey figure about thoughts cannot be read as a death rate.

Self-reported attempts are also harder to interpret than they look. Biggs cites two small samples of non-heterosexual youth in which half of those who first reported a suicide attempt later clarified that they had only imagined or planned one (Biggs 2022). This doesn't make the distress any less real. It does mean that "attempt" in a survey covers a much wider range of experiences than "attempt" in a hospital record.

Surveys, clinic records and national registers

Lifetime vs past year

Lifetime figures count anything that happened at any age; past-year figures count only the last 12 months. In the 2015 US Transgender Survey (USTS), 40% of respondents reported a lifetime suicide attempt, but 7% reported one in the past year (James et al. 2016). Lifetime figures are larger and include events long before any gender-related treatment. That makes them unsuitable for judging whether any treatment helped.

Relative risk vs absolute risk

A relative risk (such as a hazard ratio, HR, or a rate ratio, RR) says how many times more often something happens in one group than in another. An absolute risk says how often it happens at all. Both matter, and either one alone can mislead.

The Swedish surgery cohort is the clearest example. Its adjusted hazard ratio (aHR) for suicide was 19.1, a striking number. It rests on 10 suicides among 324 people who had surgery, compared with 5 among 3,240 matched controls, and the 95% confidence interval (CI) runs from 5.8 to 62.9 (Dhejne et al. 2011). The risk was clearly raised. But the size of the multiplier is very uncertain, and in absolute terms suicide was still uncommon.

Base rates and the right comparison group

A rate only means something next to the right comparison. Most studies compare gender-referred people with the general population. But people referred to gender clinics carry far more psychiatric illness than the general population: in Finland, 45.7% of gender-referred youth had received specialist psychiatric treatment before referral, against 15.0% of controls (Ruuska et al.). A fairer comparison is with young people who have similar mental health problems. When the Cass Review (England's 2024 independent review of youth gender services) looked at three clinics, rates of suicidality (27% to 55%) were much higher than in the general adolescent population but similar to those in young people referred to child and adolescent mental health services (CAMHS) for other reasons (Cass 2024).

Confounding by psychiatric illness

Confounding happens when a third factor drives both the exposure and the outcome. Depression, trauma, eating disorders, autism and personality difficulties are all over-represented in gender clinics, and all independently raise suicide risk (see mental health and gender distress, trauma and autism).

Studies make different choices about this, and those choices largely decide the headline number. The Danish study deliberately did not adjust for psychiatric illness, treating it as a possible step on the causal pathway rather than a confounder. Psychiatric diagnoses were recorded for about 43% of the transgender group's follow-up time against 7% for everyone else (Erlangsen et al. 2023). The Finnish study did adjust for psychiatric treatment, and the excess suicide risk was no longer statistically significant (Ruuska et al. 2024). Neither choice is neutral. Whether mental illness is treated as a cause of gender distress, a result of it, or both is a question the data alone cannot settle.

Selection, survivorship and loss to follow-up

• Selection bias: online surveys reach people who are connected to trans community networks and motivated to respond. The USTS authors themselves note that the 2022 survey "was drawn using non-probability sampling" (Herman et al. 2026).
• Survivorship bias: cross-sectional surveys only hear from people who are alive and still identify as trans. Those who died, or who detransitioned and left trans networks, are missing.
• Loss to follow-up: clinics lose track of people who stop attending. In Littman's survey of 100 detransitioners, only 24% had told their clinicians that they had detransitioned (Littman 2021). A clinic that never hears from a patient again cannot count their outcome.

The commonly cited figures

The table below sets out the figures most often quoted in debates about suicide and gender medicine, checked against the original sources. Scroll sideways on small screens.

Newer studies (2025–2026)

Several large register studies have appeared since 2025. They add size, but not the controlled comparisons that are needed to judge treatment:

• Taiwan (Hsu et al. 2025). Among 3,906 people with repeated gender identity disorder diagnoses, the hazard ratio for suicide was 4.07 compared with matched controls. Depressive disorders were recorded in 40.8% of the transgender-identified group against 5.7% of controls. In comparisons with their own siblings, suicide risk was still elevated (HR 2.57), and adjusting for psychiatric conditions reduced the excess but did not remove it (Hsu et al. 2025).
• Australia (Saxby et al. 2026). This study used national health and death records from 2012 to 2023 to identify people who had started cross-sex hormones: 9,713 females and 19,347 males. Compared with the general population, suicide hazard ratios were 11.73 for females on testosterone and 4.02 for males on oestrogen (Saxby et al. 2026). Because the whole cohort was on hormones, the study shows that a high relative risk persists among people receiving treatment. It cannot say whether that risk is higher or lower than it would have been without treatment.
• Sweden (Clark et al. 2026). Among 9,038 adults diagnosed with gender dysphoria from 2001 to 2023, all-cause mortality was almost twice that of matched controls (mortality rate ratio, MRR, 1.9) (Clark et al. 2026). The authors describe suicide as a leading contributor to excess deaths in this literature. This page does not quote a suicide-specific ratio from the study because one could not be verified from the published abstract.

What we can and can't say

The Finnish result deserves a careful reading in both directions. After psychiatric adjustment, the suicide hazard ratio was 3.2 (95% CI 1.0–10.2) for referred young people who did not go on to medical transition, and 0.8 (0.2–4.0) for those who did. Some people read this as evidence that transition protects. But the confidence intervals overlap widely, the study recorded only 7 suicides in the whole referred group, and the authors concluded that neither group differed significantly from controls (Ruuska et al. 2024). Their own conclusion is that the findings do not support claims that medical transition is necessary to prevent suicide.

Detransitioners and suicidality

What surveys of detransitioners measured

Very little published research measures suicidality in people who have detransitioned, and none measures suicide deaths.

• Littman 2021 (100 detransitioners). The survey did not ask about suicide, but it asked about non-suicidal self-injury (NSSI) before gender dysphoria began. This was reported by 27.5% of the 69 females and 16.1% of the 31 males (Littman 2021). The same survey found that only 24% had told their clinicians they had detransitioned. This is the main reason registers and clinics cannot see this group.
• Littman, O'Malley, Kerschner & Bailey 2024 (78 young adults who had stopped identifying as transgender). The survey asked about self-harm (cutting, burning or picking) in three periods. Lifetime self-harm was 79%. It was reported by 71% for the period before trans identification, 64% while identifying as trans, and 23% after stopping, a significant drop (Littman et al. 2024). The measure is self-harm, not suicide attempts, and it relies on recall. About 45% of participants were recruited via r/detrans.
• Vandenbussche 2022 (237 detransitioners). The survey did not measure suicidality. Some respondents raised suicide prevention as an unmet need (Vandenbussche 2022).

Together these show that self-harm and psychiatric diagnoses are very common in detransitioner samples, often before transition, and that some respondents report improvement after stopping. The samples are small, self-selected and recruited online. They cannot tell us how common suicidality is among all people who detransition.

Figures from the detrans.ai stats

The detrans.ai stats cover 3,094 r/detrans stories from users who confirmed that they had detransitioned or desisted. An AI model reads each person's public posts and judges whether the story describes each feature, and a feature is counted only when the model is at least 80% confident.

The same dataset shows mental health as somewhat or much better after detransition in 68% of stories, about the same in 22%, and somewhat or much worse in 10% (n = 3,094) (detrans.ai stats).

These figures need careful handling:

• They count what people chose to write about in public posts. A story that never mentions suicidality is counted as "not described", not as "no suicidality", so the true figures could be higher.
• The many "uncertain" cases, especially for the during-transition item, mean the 80% threshold is conservative.
• r/detrans users are a self-selected group, and people who died are by definition absent. These percentages are not rates for everyone who detransitions, and they cannot be compared directly with clinical or register data.
• AI extraction can contain errors.

What they do show is that suicidality after detransition is described in a noticeable minority of stories. This matches accounts of the distress of regret, lasting physical changes and loss of community. It is one reason detransitioners need follow-up care and support rather than being lost to the system.

Why there are no detransition suicide data

No country records detransition in its health registers, and there is no diagnostic code for it. Registers identify people by gender-related diagnoses or legal gender change, so a person who detransitions usually stays classified as transgender. Any later death is counted in the "transgender" group, or is never linked to transition at all. Some detransitioners point this out:

Most of the time when a detrans person suicides it's recorded as a trans death, because a lot of the time people won't even know the real story behind it. —UniquelyDefined, detrans male

This is a real gap in the data, but it cuts both ways. Without records, nobody can say how often suicide follows regret. The claim that detransition causes suicide is unproven, and so is the claim that it doesn't happen.

How the numbers get misused

Inflating risk to push transition

The most common misuse turns self-reported survey figures into predictions of death. Biggs documents a UK parliamentary committee stating that "about half" of young trans people attempt suicide, and similar claims from campaigners and media (Biggs 2022). The step from "40% report a lifetime attempt" to "your child will die without treatment" has no support in the death data. Yet detransitioners describe hearing it from clinicians:

I thought I was going to be at risk of suicide if I didn't transition. For years I lived with that fear, making myself go through transition and experience incredible suffering, because it was better than killing myself...which my therapist made out to be the inevitable consequence of not transitioning. —NefariousnessLate375, detrans female

Statistics presented to parents can override what the young person says about their own safety:

It didn't matter how many times I told him that I'm not a danger to myself, he just couldn't believe me because as far as he was concerned I was too mental to know how depressed I was, and all of the information and media he could find on the matter was confirming his fears. It was all suicide statistics… —Hedera_Thorn, detrans male

Another detrans female recalled her doctors and surgeon "telling my parents about the suicide statistics" in front of her, and only later realising "how manipulative this is" (LostSoul1911). A desisted male described being shown "authoritative studies that I couldn't refute" claiming that suicides fall after transition (human1023). Since then, a major correction (Bränström and Pachankis) and several systematic reviews have weakened those claims.

Correlations in surveys are also presented as proof of cause. For example, the Trevor Project's 2025 finding that young people who could not get hormones reported more suicide attempts (15% vs 8%) comes from a single cross-sectional survey. It cannot separate the effect of hormones from family support, mental health or any other difference between the two groups.

Inflating risk to oppose transition

The opposite misuse is real too, and this site's readers should watch for it. Common examples:

• Citing Dhejne's hazard ratio of 19.1 as proof that surgery causes suicide. The study compared people who had surgery with the general population, not with people who did not have surgery, so it cannot answer that question.
• Saying that "more people kill themselves after transition" without a source.
• Generalising from a personal circle of friends to a population rate.
• Treating every "trans suicide" as hidden regret.

None of these is supported by the data, however plausible each may feel from personal experience. Some trans commenters also object to how suicide figures are used against them:

the suicide stuff just ends up getting used to mock us or to prove we're "mentally ill" and thus can't be trusted about anything. —pervocracy, trans man (FTM)

The cost of misuse

Both kinds of misuse treat suicide as an argument rather than a clinical problem. Appleby's review for the UK government said it plainly: "Suicide should not be a slogan or a means to winning an argument" (Appleby 2024). He also warned that social media claims about suicides "do not meet basic standards for statistical evidence" and went against safe-reporting guidance. Suicide-prevention media guidelines warn against presenting suicide as inevitable or as having a single cause, because that can increase risk in vulnerable readers (see suicide contagion and safe messaging on the parent page). Exaggerated figures in either direction can worsen distress in the young people they claim to protect.

Some readers notice the gap between the alarming headlines and what studies measure:

Most studies only talk about suicidal tendencies which can be as much as someone thinking about suicide. —Ruqayyah2, desisted female

How to read a suicide statistic

Before accepting or repeating a figure, check:

1. What outcome? Thoughts, self-reported attempts, hospital-treated attempts, or deaths? These can differ a hundredfold.
2. What time frame? Lifetime, past year, or per person-year of follow-up? Lifetime figures include events before any treatment.
3. Who was counted? A convenience survey, one clinic's patients, or a whole national population? Who was left out, such as people on waiting lists, people who left the clinic, detransitioners or those who died?
4. Compared with whom? The general population, matched controls, siblings, or people with similar psychiatric problems? Is there any group that did not receive the treatment being discussed?
5. Relative or absolute? If you are told "X times higher", ask how many events it rests on and how wide the confidence interval is.
6. Was psychiatric illness accounted for? If not, ask whether depression, trauma or autism could explain the difference.
7. Does the design allow a causal claim? A cross-sectional survey or a single cohort without controls can show association, not cause, whichever way the claim points.
8. Who is quoting it, and what has changed? Check whether the study was corrected (Bränström and Pachankis was), and whether a quoted figure is actually from the source.
9. Is it presented safely? Figures framed as inevitability ("will die without…") go against suicide-prevention guidance, whatever the cause being argued.

Where to go from here

The overall picture is consistent across countries and designs. Distress and suicidality are high in this population, deaths are rare, much of the excess risk tracks psychiatric illness, and there is no good evidence that any single treatment, transition included, reliably changes suicide risk. In practice, that points towards assessing and treating depression, trauma and other conditions directly, as the Cass Review and the Finnish authors recommend.

For the wider debate, see Suicide and Transition: The Narrative vs the Evidence and evidence reviews in gender medicine. For alternatives to medical pathways, see gender-exploratory therapy. For recovery after detransition, see healing and recovery. The studies are collected in the study archive and detransition timelines in the /r/detrans statistics. If you or someone you know is in crisis, contact local emergency services or a crisis line, and see the support directory.

References

• Appleby, L. (2024). Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report. Department of Health and Social Care. source.
• Biggs, M. (2022). Suicide by Clinic-Referred Transgender Adolescents in the United Kingdom. Archives of Sexual Behavior 51, 685–690. source.
• Bränström, R. & Pachankis, J. E. (2019/2020). Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study. American Journal of Psychiatry 177(8), 727–734. source; correction.
• Cass, H. (2024). Independent review of gender identity services for children and young people: Final report. study page.
• Clark, K. D. et al. (2026). Nationwide estimates of all-cause and cause-specific mortality among individuals with gender dysphoria in Sweden, 2001–2023: a register-based cohort study. eClinicalMedicine 98, 104088. source.
• Dhejne, C. et al. (2011). Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden. PLoS ONE 6(2): e16885. source.
• Erlangsen, A. et al. (2023). Transgender Identity and Suicide Attempts and Mortality in Denmark. JAMA 329(24), 2145–2153. source, full text.
• Herman, J. L., Kopparam, R. & Scheim, A. I. (2026). Suicide Thoughts and Attempts Among Transgender People: Findings from the 2022 US Trans Survey. Williams Institute. source.
• Hsu, C. W. et al. (2025). Mortality among transgender persons: a Taiwan matched-population and sibling-comparison cohort study. Lancet Regional Health – Western Pacific 64, 101715. source.
• James, S. E. et al. (2016). The Report of the 2015 U.S. Transgender Survey. National Center for Transgender Equality. source.
• Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Archives of Sexual Behavior. study page.
• Littman, L., O'Malley, S., Kerschner, H. & Bailey, J. M. (2024). Detransition and Desistance Among Previously Trans-Identified Young Adults. Archives of Sexual Behavior. study page.
• Miroshnychenko, A. et al. (2025a). Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis. study page.
• Miroshnychenko, A. et al. (2025b). Gender affirming hormone therapy for individuals with gender dysphoria aged <26 years: a systematic review and meta-analysis. study page.
• Ruuska, S.-M., Tuisku, K., Holttinen, T. & Kaltiala, R. (2024). All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study. BMJ Mental Health 27(1), e300940. source.
• Ruuska et al. Psychiatric Morbidity Among Adolescents and Young Adults Who Contacted Specialised Gender Identity Services in Finland in 1996–2019: A Register Study. Acta Paediatrica. study page.
• Saxby, K. et al. (2026). All-cause and cause-specific mortality among transgender and gender diverse people: a nationwide cohort study in Australia. Lancet Regional Health – Western Pacific 67, 101813. source.
• Straub, J. J. et al. (2024). Risk of Suicide and Self-Harm Following Gender-Affirmation Surgery. Cureus 16(4): e57472. study page.
• The Trevor Project (2024, 2026). U.S. National Survey on the Mental Health of LGBTQ+ Young People (2024 and 2025 surveys). 2024, 2025.
• Vandenbussche, E. (2022). Detransition-Related Needs and Support: A Cross-Sectional Online Survey. Journal of Homosexuality. study page.
• Wiepjes, C. M. et al. (2020). Trends in suicide death risk in transgender people: results from the Amsterdam Cohort of Gender Dysphoria study (1972–2017). Acta Psychiatrica Scandinavica 141(6), 486–491. source.
• detrans.ai (2026). Detransition statistics from /r/detrans stories. stats page.