Do we actually know anything about youth trans suicide rates?
www.residentcontrarian.com
(Author’s note: I’m not sure how much of a work in progress this article is. Usually, when I post something like this, people will hit me up with things I might have missed, or errors I’ve made/they think I’ve made. I think this is an important piece to be right on, so the piece itself might change a bit as time goes on.)
You have made a relevant point about ideation and actually committing suicide, but the pro-trans argument rests on a more foundational premise. The core issue is whether social acceptance and affirming gender transitions leads to better or worse outcomes. It could be the case that transgender people commit significantly more suicide but that is because the population of trans people is not a random sample from the population but selected from a particularly suicide prone portion of it.
I remember reading Turban et al, 2020 and seeing that they recommend a treatment that there study shows a 90% probability that it increases the thing they are trying to prevent(suicide). And it may have even reached 95% if a multivalent analysis was run. That was one of the biggest abuse of hypothesis testing and 0.05 P values I have seen.
Transitioning does not seem to reduce suicide rates. This guy https://ideasanddata.wordpress.com/2021/02/07/on-transgenderism/ looked and a bunch of studies, I think all that he could find. If anything medical transitioning or socially transitioning increased the odds of suicide. Even if people report feeling better after transitioning.
I understand the focus on actual "successful" suicides, but isn't the level of misery necessary to attempt or seriously consider suicide an important consideration too? There is a world where trans suicide is no higher than the general population but the level of misery deserves intervention.
For example, the article explains the well understood phenomenon of suicidal ideation being higher in women but actual suicide being higher in men. Consider this study that concludes women are unhappier on average then men:
And the causal arrow may not go the way these studies assume - young people may be deciding they are transgender *because* they are suicidal (i.e., they loathe themselves and their bodies). So the fact that some unexpectedly high number of them have suicidal ideation may have much more to do with the reasons they think they are trans and much less to do with availability of treatment, etc.
I note there might be a definitional issue in what exactly "trans" means. Reading the first part of the article I was getting the impression that a person was called trans if they wanted to change their apparent gender, not after they had done so. That makes sense if you are looking at things like "do trans people commit suicide more if they are denied access to surgery or puberty blockers, etc.?" Then we get to the Dutch study (and others) and it seems to switch back to people being trans after they actually get the surgery or whatever to transition. Particularly with the suicide rates being ~5x higher for transwomen (former men) than transmen; people with XY chromosomes commit suicide about 5 times more frequently than people with XX, so that lines up in a nice way.
One reason this definitional variance is important is that if people who undergo actual surgery or other treatments to transition are committing suicide more the proximate cause is the transmission process itself. Maybe it goes badly, maybe it doesn't improve their life as much as they had hoped and decide they've tried everything and give up, who knows. Plus you have the issue that people who go through all the hassle of transitioning are disproportionally possessed of personality types/issues that lead to suicide.
If the definition of trans is "Would like to have different apparent gender than what they were born with" then treatment, if it lowers suicide rates (big if, apparently) becomes desirable, although one must also check that being trans doesn't have a high correlation with other mental issues that lead to suicide. E.g. a kid is a misfit at school and really depressed, and latches on to gender dysphoria as the cause and solution, not the other way around. Surveys seem really bad at sorting that sort of question out.
The cynical, or maybe realistic, side of me think that the confusion around the definitional meaning of trans is not accidental, as at best the traditional, post-transition definition with high suicide rates suggests pretty strongly that mental illness at least goes hand in hand with being trans. Being trans before getting any treatments to transition suggests the suicide rate is due to cis oppression, which is always more appealing to certain sets. It is SUPER appealing if you run a company selling puberty blockers, or a clinic or doctor performing treatments or therapy, I suspect.
Ideation correlates with attempts but suicides are the product of Attempt X Method Success Rate. Because Method Success Rate varies widely, and because different ages and genders vary widely in their choice of method, we see a weak correlation between ideation -> suicide and attempt -> suicide when looking at demographic breakdowns. Some studies attempt to get around this issue by combining suicides and hospitalizations from attempts into a single metric.
You have made a relevant point about ideation and actually committing suicide, but the pro-trans argument rests on a more foundational premise. The core issue is whether social acceptance and affirming gender transitions leads to better or worse outcomes. It could be the case that transgender people commit significantly more suicide but that is because the population of trans people is not a random sample from the population but selected from a particularly suicide prone portion of it.
How to communicate, to both political sides, the things that needs to be known:
1. Examine the trans suicide ideation rate vs success rate (direct data for reference, since we do not know the latent causes for transition)
2. Examine the incel suicide ideation rate vs success rate (control for the "incel to trans pipeline" and "AGP" hypothesis)
3. Examine the male homosexual suicide ideation rate vs success rate (control for the "HSTS" and gender conformity hypothesis)
4. Examine the male heterosexual suicide ideation rate vs success rate (control for normalcy)
5. Cross-check against cultural norms (inequality, in-group affiliation) and aggression.
I remember reading Turban et al, 2020 and seeing that they recommend a treatment that there study shows a 90% probability that it increases the thing they are trying to prevent(suicide). And it may have even reached 95% if a multivalent analysis was run. That was one of the biggest abuse of hypothesis testing and 0.05 P values I have seen.
Transitioning does not seem to reduce suicide rates. This guy https://ideasanddata.wordpress.com/2021/02/07/on-transgenderism/ looked and a bunch of studies, I think all that he could find. If anything medical transitioning or socially transitioning increased the odds of suicide. Even if people report feeling better after transitioning.
I understand the focus on actual "successful" suicides, but isn't the level of misery necessary to attempt or seriously consider suicide an important consideration too? There is a world where trans suicide is no higher than the general population but the level of misery deserves intervention.
For example, the article explains the well understood phenomenon of suicidal ideation being higher in women but actual suicide being higher in men. Consider this study that concludes women are unhappier on average then men:
https://www.nber.org/papers/w29893#fromrss
And the causal arrow may not go the way these studies assume - young people may be deciding they are transgender *because* they are suicidal (i.e., they loathe themselves and their bodies). So the fact that some unexpectedly high number of them have suicidal ideation may have much more to do with the reasons they think they are trans and much less to do with availability of treatment, etc.
I note there might be a definitional issue in what exactly "trans" means. Reading the first part of the article I was getting the impression that a person was called trans if they wanted to change their apparent gender, not after they had done so. That makes sense if you are looking at things like "do trans people commit suicide more if they are denied access to surgery or puberty blockers, etc.?" Then we get to the Dutch study (and others) and it seems to switch back to people being trans after they actually get the surgery or whatever to transition. Particularly with the suicide rates being ~5x higher for transwomen (former men) than transmen; people with XY chromosomes commit suicide about 5 times more frequently than people with XX, so that lines up in a nice way.
One reason this definitional variance is important is that if people who undergo actual surgery or other treatments to transition are committing suicide more the proximate cause is the transmission process itself. Maybe it goes badly, maybe it doesn't improve their life as much as they had hoped and decide they've tried everything and give up, who knows. Plus you have the issue that people who go through all the hassle of transitioning are disproportionally possessed of personality types/issues that lead to suicide.
If the definition of trans is "Would like to have different apparent gender than what they were born with" then treatment, if it lowers suicide rates (big if, apparently) becomes desirable, although one must also check that being trans doesn't have a high correlation with other mental issues that lead to suicide. E.g. a kid is a misfit at school and really depressed, and latches on to gender dysphoria as the cause and solution, not the other way around. Surveys seem really bad at sorting that sort of question out.
The cynical, or maybe realistic, side of me think that the confusion around the definitional meaning of trans is not accidental, as at best the traditional, post-transition definition with high suicide rates suggests pretty strongly that mental illness at least goes hand in hand with being trans. Being trans before getting any treatments to transition suggests the suicide rate is due to cis oppression, which is always more appealing to certain sets. It is SUPER appealing if you run a company selling puberty blockers, or a clinic or doctor performing treatments or therapy, I suspect.
Ideation correlates with attempts but suicides are the product of Attempt X Method Success Rate. Because Method Success Rate varies widely, and because different ages and genders vary widely in their choice of method, we see a weak correlation between ideation -> suicide and attempt -> suicide when looking at demographic breakdowns. Some studies attempt to get around this issue by combining suicides and hospitalizations from attempts into a single metric.