The Science Says It: Gender-Affirming Care Saves Young Trans Lives

As more states move to ban or restrict gender-affirming care for transgender youth, a new study adds more evidence to back up what LGBTQ+ advocates have been pointing out for years: This care saves lives.

A research team found that initiation of hormone replacement therapy is associated with a 14.4 percent decrease in the risk of ever attempting suicide if treatment started between the ages of 14 and 17. This benefit was largest when HRT was started at age 14 or 15.

The study, “Hormone Therapy, Suicidal Risk, and Transgender Youth in the United States,” appeared in the May issue of AEA Papers and Proceedings, a publication of the American Economic Association. It uses data from the 2015 U.S. Transgender Survey, the largest survey of transgender people ever collected, composed of more than 27,700 respondents across the U.S.

“The science is showing us that gender-affirming care can save lives,” University of Massachusetts Amherst economist Duc Hien Nguyen, a coauthor of the study, said in a UMass press release.

“In line with existing scientific evidence, our research clearly indicates that restricting transgender youth’s access to HRT could produce harmful, even deadly, consequences,” he added. “This finding is especially pertinent given the recent surge in state-level [gender-affirming care] bans, many of which purposefully target transgender youth.”

Twenty states, primarily in the South and Midwest, have banned or limited this care for trans youth, with most of the laws enacted this year. This means 30.9 percent of trans youth aged 13-17 are living in states where they can no longer access such care, according to the Human Rights Campaign. Last week, Texas became the latest and most populous state to approve a ban, and bans are awaiting governors’ actions in two more states, Missouri and Louisiana. Legislation is pending in several other states.

Proponents of the bans have called gender-affirming care experimental, when in fact it has been around for years and is endorsed by every major medical association. They also claim young people are somehow coerced into these procedures and act if they are undertaken lightly, neither of which is true. They often highlight stories of “transition regret,” but this is extremely rare.

The research found no statistically significant relationship between hormone therapy and the risk of attempting suicide among transgender adults. Nguyen notes that better data collection and more studies are needed in this area, but he hypothesizes that this may be because some of the most at-risk transgender youth have already taken their own lives.

“Statistically, the transgender population has one of the highest lifetime rates of attempted suicide in the U.S. We also observe in our data that the majority of first suicide attempts among transgender people occur during adolescence,” Nguyen said. “I think the dark reality is that there is an unknown number of transgender youth who could not access HRT during adolescence and took their own lives, thus never appearing in the data.”

Nguyen, who is pursuing his doctorate at UMass, collaborated on the research with lead author Travis Campbell of Southern Oregon University, Samuel Mann of Vanderbilt University, and Yana van der Meulen Rodgers of Rutgers University.

If you are having thoughts of suicide or are concerned that someone you know may be, resources are available to help. The 988 Suicide & Crisis Lifeline at 988 is for people of all ages and identities. Trans Lifeline, designed for transgender or gender-nonconforming people, can be reached at (877) 565-8860. The lifeline also provides resources to help with other crises, such as domestic violence situations. The Trevor Project Lifeline, for LGBTQ+ youth (ages 24 and younger), can be reached at (866) 488-7386. Users can also access chat services at TheTrevorProject.org/Help or text START to 678678.