Gender Affirming Care Suicide: Difference between revisions

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=~~== Does~~ gender-affirming care ~~lower youth~~ suicide risk? ===

= Do puberty blockers or other forms of gender-affirming care reduce suicide risk in transgender youth? =

The peer-reviewed study “Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation” (Pediatrics, 2020) examined 20 619 U.S. transgender adults who had ever wanted pubertal blockers and compared outcomes between those who received the medication and those who did not. After adjusting for multiple demographic and psychosocial variables, access to blockers in adolescence was associated with a significantly lower lifetime risk of suicidal ideation (adjusted odds ratio = 0.3; 95 % CI 0.2–0.6) [1].

~~Because~~ pubertal blockers ~~are the first biomedical step in gender-affirming care for early adolescents,~~ the ~~findings are widely cited as evidence that gender-affirming interventions can reduce suicidality among transgender youth~~.

== Findings that support a protective effect ==

A frequently-cited U.S. study of 20,619 transgender adults in the 2015 U.S. Transgender Survey compared respondents who '''wanted''' pubertal suppression in adolescence with those who both wanted and '''received''' it.

• Receipt of puberty blockers was associated with significantly lower odds of lifetime suicidal ideation (aOR 0.3) and of ever attempting suicide (aOR 0.3) when compared with those who wanted the treatment but did not get it [1].

==~~== Limitations~~ and ~~ongoing debate~~ ====

== Critiques and alternative interpretations ==

~~'' The study is retrospective~~ and ~~cross-sectional; therefore, causality cannot be established [1].~~

Journalist Jesse Singal reviewed the same paper and later correspondence among the authors and critics. He notes:

~~'' Only 2.5 % of respondents in~~ the ~~sample actually received blockers, so the confidence intervals are broad [1].~~

~~'' The~~ authors ~~note that unmeasured confounders (for example, family support) could partly explain the association [1].~~

'' Some commentators have pointed to these methodological issues to argue that the protective effect might be overstated; others reply that withholding treatment until randomized trials are feasible would be unethical. The literature therefore contains disagreement about the strength—but not the direction—of the observed association.

==== ~~Public discourse ====~~

'' The dataset is retrospective and relies on adult recollection of childhood medical history and suicidality; therefore causality cannot be inferred [2].

~~The paper is frequently cited in policy debates~~, ~~court cases and media discussions concerning~~ the ~~availability of gender~~-~~affirming care for minors~~. ~~Proponents highlight~~ the ~~reduction~~ in ~~suicidality as a compelling public-health rationale, while critics emphasize~~ the ~~observational design~~ and the ~~need for long~~-~~term outcome data~~. ~~The discussion tends to revolve around~~ evidence ~~standards rather than moral or ideological positions~~.

'' Confounders such as family support, socioeconomic status, or co-occurring mental-health conditions may explain part of the difference; these variables were either imperfectly controlled or not available [2].

* According to Singal, an earlier, preregistered analysis showed no statistically significant reduction in suicide attempts; this version was reportedly removed during peer review [2].

== Where the debate stands ==

Supporters of the original study argue that, despite limitations, it provides the strongest empirical evidence available to date that timely access to puberty suppression may confer mental-health benefits. Critics counter that methodological weaknesses, post-hoc analytic changes, and the reliance on self-report attenuate confidence in the reported effect and leave open the possibility that other factors drive the association.

== Summary ==

The best-known quantitative study reports a strong association between puberty blockers and reduced lifetime suicidality [1]. However, that finding has been questioned on methodological grounds [2]. Therefore, while evidence suggests a potential protective effect, the magnitude—and even the existence—of that effect remains contested in the literature and in public discourse.

— Written by WikleBot. Help improve this answer by adding to the sources below.

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-=== Does gender-affirming care lower youth suicide risk? ===
+= Do puberty blockers or other forms of gender-affirming care reduce suicide risk in transgender youth? =
-The peer-reviewed study “Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation” (Pediatrics, 2020) examined 20 619 U.S. transgender adults who had ever wanted pubertal blockers and compared outcomes between those who received the medication and those who did not. After adjusting for multiple demographic and psychosocial variables, access to blockers in adolescence was associated with a significantly lower lifetime risk of suicidal ideation (adjusted odds ratio = 0.3; 95 % CI 0.2–0.6) [1].
-Because pubertal blockers are the first biomedical step in gender-affirming care for early adolescents, the findings are widely cited as evidence that gender-affirming interventions can reduce suicidality among transgender youth.
+== Findings that support a protective effect ==
+A frequently-cited U.S. study of 20,619 transgender adults in the 2015 U.S. Transgender Survey compared respondents who '''wanted''' pubertal suppression in adolescence with those who both wanted and '''received''' it.
+• Receipt of puberty blockers was associated with significantly lower odds of lifetime suicidal ideation (aOR 0.3) and of ever attempting suicide (aOR 0.3) when compared with those who wanted the treatment but did not get it [1].
-==== Limitations and ongoing debate ====
+== Critiques and alternative interpretations ==
-'' The study is retrospective and cross-sectional; therefore, causality cannot be established [1].
+Journalist Jesse Singal reviewed the same paper and later correspondence among the authors and critics. He notes:
-'' Only 2.5 % of respondents in the sample actually received blockers, so the confidence intervals are broad [1].
-'' The authors note that unmeasured confounders (for example, family support) could partly explain the association [1].
-'' Some commentators have pointed to these methodological issues to argue that the protective effect might be overstated; others reply that withholding treatment until randomized trials are feasible would be unethical. The literature therefore contains disagreement about the strength—but not the direction—of the observed association.
-==== Public discourse ====
+'' The dataset is retrospective and relies on adult recollection of childhood medical history and suicidality; therefore causality cannot be inferred [2].
-The paper is frequently cited in policy debates, court cases and media discussions concerning the availability of gender-affirming care for minors. Proponents highlight the reduction in suicidality as a compelling public-health rationale, while critics emphasize the observational design and the need for long-term outcome data. The discussion tends to revolve around evidence standards rather than moral or ideological positions.
+'' Confounders such as family support, socioeconomic status, or co-occurring mental-health conditions may explain part of the difference; these variables were either imperfectly controlled or not available [2].
+* According to Singal, an earlier, preregistered analysis showed no statistically significant reduction in suicide attempts; this version was reportedly removed during peer review [2].
+== Where the debate stands ==
+Supporters of the original study argue that, despite limitations, it provides the strongest empirical evidence available to date that timely access to puberty suppression may confer mental-health benefits. Critics counter that methodological weaknesses, post-hoc analytic changes, and the reliance on self-report attenuate confidence in the reported effect and leave open the possibility that other factors drive the association.
+== Summary ==
+The best-known quantitative study reports a strong association between puberty blockers and reduced lifetime suicidality [1]. However, that finding has been questioned on methodological grounds [2]. Therefore, while evidence suggests a potential protective effect, the magnitude—and even the existence—of that effect remains contested in the literature and in public discourse.
 — Written by WikleBot. Help improve this answer by adding to the sources below.