Groundbreaking Study: Anti-trans State Laws Increased Suicide Attempts By 72%

The study, published in Nature Human Behavior, offers critical insight into the effects of anti-trans legislation, including healthcare bans, on transgender youth and is the first study of its kind.

Ted Eytan - Creative Commons ShareAlike 4.0

In a groundbreaking study published in Nature Human Behavior on Thursday, researchers found that anti-trans bans lead to a 72% increase in suicide attempts among transgender individuals, compared to states without such legislation. The study, which surveyed over 61,000 transgender and nonbinary individuals through multiple waves of questions distributed by The Trevor Project, analyzed the state-level impact of anti-trans legislation. These bans, primarily targeting gender-affirming care, bathroom access, and school policies, had not been examined using this methodology before. The study’s findings could have far-reaching international implications as more countries face pressure to implement similar restrictions on transgender people

Due to the wide variation in laws and protections surrounding transgender individuals across the United States, roughly half of all states have enacted extreme anti-trans legislation, including bans on gender-affirming care. Meanwhile, the other half have passed no such laws, with many even expanding protections for transgender people and their healthcare. This disparity allows researchers to treat the differing outcomes as a "natural experiment," providing direct evidence that anti-trans bans cause harm in a way that few previous studies could achieve… evidence that The Trevor Project was collecting along the way.

The researchers found significant harm. States that passed anti-trans laws saw suicide attempt rates rise by up to 72% among transgender and nonbinary youth aged 13 to 17, and by 44% among those aged 13 to 24. To strengthen the evidence of causality, the researchers controlled for various factors, including state by state differences, race, age, the impact of COVID-19, and even conducted alternate placebo tests.

In explaining why youth aged 13 to 17 were more affected by anti-trans legislation, researchers highlighted healthcare bans, stating, “[They] may also rely on their parents or guardians to access gender-affirming healthcare or other vital resources. These additional complications, combined with the impact of anti-transgender legislation, likely compound for younger TGNB individuals, contributing to the effects described in this study.”

The increase is significant: according to The Trevor Project, 20% of transgender youth in America have attempted suicide at some point in their lives. Using the Williams Institute estimate of 300,000 transgender youth in America, anti-transgender legislation could account for an increase of tens of thousands of suicide attempts by transgender people.

Thanks to the large sample size, researchers were able to gather enough data on a state-by-state level to significantly analyze the impact of legislation targeting transgender youth, as demonstrated here:

Sample size By state - Nature

The findings add to a growing body of research showing that gender-affirming care saves lives, while bans on such care, along with forced outing policies in schools and bathroom restrictions, have significant impacts on transgender youth and young adults in affected states.

A Cornell review of more than 51 studies determined that trans care significantly improves the mental health of transgender people. One major study even noted a 73% lower suicidality among trans youth who began care. A similar study found a 40% reduction in actual suicide attempts over the previous year. In a recent article published in the Journal of Adolescent Health in April of 2024, puberty blockers were found to significantly reduce depression and anxiety. A randomized controlled trial in Australia, which was only possible through an innovative methodology, showed a 55% reduction in suicidality for trans men able to start testosterone. In Germany, a recent review by over 27 medical organizations has judged that “not providing treatment can do harm” to transgender youth. The evidence around transgender care led to a historic policy resolution condemning bans on gender affirming care by the American Psychological Association, the largest psychological association in the world, which was voted on by representatives of its 157,000 members.

This study, however, is likely to become a key piece of evidence in the fight against harsh anti-trans legislation, including care restrictions, due to its innovative design, large sample size, and ability to capture the direct impacts of anti-transgender laws across multiple states.

“It is without question that anti-transgender policies, and the dangerous rhetoric surrounding them, take a measurable toll on the health and safety of transgender and nonbinary young people all across the country,” said Jaymes Black (she/they/he pronouns), Chief Executive Officer at The Trevor Project in a press release. “As we get closer to critical elections this November, these young people will continue to be reduced to political talking points. I urge every adult – no matter your political beliefs – to remember that transgender and nonbinary young people are our family, our friends, and our neighbors. It’s not necessary to fully understand their experience to acknowledge that they – like all young people – deserve dignity, respect, and the ability to lead healthy and full lives.”

You can view the full article in Nature here, and the primary model result here:

Estimated impact of anti-trans legislation