Evidence indicates that school-based mental health services are urgently needed to protect against suicidal thoughts among transgender students.

Nearly 35% of transgender youth in California reported suicidal thoughts in the past year, almost double that of non-transgender youth, reports a study published in the September 2017 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).

Transgender youth and adults have received unprecedented public attention regarding their lives and well-being in the last year. In the context of public debates about bathrooms, armed services, and other legal protections, there has been growing concern about discrimination and mental health for transgender youth in the US. Yet there has been little high-quality, population-based research on transgender youth, which is necessary to accurately document the health and well-being of this population.

This study is the first to use statewide representative data from the US to document significantly higher risk of suicidal thoughts among transgender students in California. Data came from over 910,000 high school students that participated in the 2013-2015 California Healthy Kids Survey (CHKS), and a weighted subsample of nearly 36,000 youth representative of the Californian student population. The CHKS is administered biennially by WestEd with support from the California Department of Education. Nearly 35% of transgender youth in California reported suicidal thoughts in the past year, compared to 19% among non-transgender youth. “It is crucial that studies of adolescent health include measures of gender identity alongside sexual orientation to better understand and create programs to address the needs of these youth across the United States,” said Amaya Perez-Brumer, MSc, lead author of the study.

The study also reports that higher rates of depression and victimization among transgender youth compared to non-transgender youth partly explain higher risk of suicidal thoughts among transgender students. According to Stephen Russell, PhD, another study author: “Like all students, transgender youth deserve to be safe and supported at school. These results show that reducing depression and victimization for transgender students should significantly reduce their suicide-related risk.”

The authors underscore that the results of the study should be understood as a first step in detailing the complexity of suicidal thoughts among transgender youth. While findings support the need for school-based interventions that address depression and victimization, more research is also needed to understand the relationship between co-occurring psychosocial risk factors (e.g., anxiety, substance abuse) and suicidal thoughts. The authors also caution that these results may represent an underestimate of the gender identity-related disparity in suicidal thoughts given that the sample was limited to youth who were currently attending school in California; youth who have been expelled or dropped out of school may be a more vulnerable population at risk of suicidality.

Notably, while transgender-specific mental health services are scarce and often inaccessible for adults, this barrier is often magnified among youth. This study highlights the urgent need to develop and implement school-based interventions that address victimization, train faculty and staff on the needs of transgender youth, and provide access to gender-affirming healthcare and mental health services.

Source: Elsevier
Full bibliographic information:
The article is “Prevalence and Correlates of Suicidal Ideation Among Transgender Youth in California: Findings From a Representative, Population-Based Sample of High School Students,” by Amaya Perez-Brumer, Jack K. Day, Stephen T. Russell, and Mark L. Hatzenbuehler. It appears in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 56, issue 9 (September 2017), published by Elsevier.