Does Gender-Affirming Care Reduce Suicide Risk? An Evidence-Backed Guide for Families

TransHealthHub

Sep 15

4 min read

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If a young person in your life is struggling, support is available right now. The 988 Suicide and Crisis Lifeline (call or text 988) and The Trevor Project (1-866-488-7386) are confidential and staffed around the clock. Our crisis support page lists more.

Key Takeaways

Does gender-affirming care reduce suicide risk? Studies consistently link access with lower suicidality, but all are observational, so researchers describe an association, not a proven cause.
In U.S. hospital records of 3,414 young people, those on hormone therapy had a 43.6% lower risk of a suicidality diagnosis.
In a survey of transgender and nonbinary youth under 18, hormone therapy was linked to lower odds of a past-year suicide attempt than among peers who wanted it but did not get it.
A 2023 systematic review of interventions found evidence quality low, bias risk high.
The American Psychological Association's 2024 policy supports unobstructed access to evidence-based care for transgender children and adolescents.
Transgender young people are not inherently prone to suicide risk. Researchers attribute elevated rates to stigma, rejection, and mistreatment.
You may see this called gender-affirming care, transition-related care, or supportive care. The terms describe the same thing.

The short answer

Research links gender-affirming care to lower suicide risk among transgender young people, and no study can yet show the care is the cause. Every study here is observational, and young people who receive this care differ from those who do not in ways research cannot separate out, including family support.

At TransHealthHub, we think the honest version serves a worried parent better than either confident one.

What the research measures

Suicidality covers thoughts of suicide and suicide attempts. It is not the same as death by suicide, which is far rarer, and the three are not interchangeable.

No randomized trial exists, and for practical and ethical reasons, one is unlikely. Records and surveys show two things occurring together, not which caused which.

What U.S. studies of young people found

Three studies carry most of the weight, and point the same way.

Study	What it looked at	What it found
Nunes-Moreno, 2025	3,414 U.S. youth, hospital records	43.6% lower suicidality risk on hormone therapy
Green, 2022	Survey of transgender and nonbinary youth	Lower odds of a past-year attempt under 18
Christensen, 2023	Systematic review, 17 studies	Evidence quality low, bias risk high

A 2025 paper in LGBT Health by Marissa Nunes-Moreno and colleagues drew on PEDSnet, a pediatric records database. Among 3,414 transgender and gender-diverse young people aged 8 to 18, those prescribed hormone therapy had a 43.6% lower risk of a suicidality diagnosis in emergency or inpatient settings, a hazard ratio of 0.564 (0.36 to 0.89). For puberty-pausing medication, the result did not reach significance, reflecting how few in the sample received it, not evidence it does not help.

Amy Green and colleagues at The Trevor Project surveyed 34,759 LGBTQ young people aged 13 to 24 in 2020, publishing in the Journal of Adolescent Health in 2022. Among those under 18, hormone therapy was associated with lower odds of a past-year suicide attempt, an adjusted odds ratio of 0.62, compared with a comparison group who wanted this care and did not get it. These are Trevor's self-reported data from a non-probability sample.

Why researchers stop short of proof

Because the studies that exist are graded low-certainty. A 2023 systematic review in Child Psychiatry and Human Development by Julia Christensen and colleagues covered 17 studies of interventions meant to reduce suicide risk in transgender youth. Five showed promise, including clinic-based care, school connectedness, and family work. The authors reported that the overall quality of evidence was low and the risk of bias high.

Low certainty means important questions are open. It is not a finding that the care harms. The American Psychological Association, in a policy approved in February 2024, supports unobstructed access to evidence-based clinical care for transgender, gender-diverse, and nonbinary children, adolescents, and adults.

What else is linked to risk

Care is one factor among several, and the surrounding environment matters. Writing in Nature Human Behaviour in 2024, Wilson Lee and colleagues at The Trevor Project applied a difference-in-differences design to cohorts of 35,196 young people aged 13 to 17 and 61,240 aged 13 to 24, reporting that state laws restricting transgender young people increased past-year suicide attempts by 7% to 72%. That causal claim rests on their design, not on settled consensus.

Elevated risk among transgender young people is attributed to stigma, rejection, and mistreatment rather than to being transgender, which is why family support recurs in these studies. Our youth mental health statistics page has more.

Frequently asked questions

So does gender-affirming care reduce suicide risk? The research consistently links access with lower suicidality. Researchers call that an association, because available designs cannot rule out other causes.

Is the evidence weak? Limited in certainty, not contradictory. Findings point the same way across settings; the missing piece is a design that settles causation.

What helps most? No single answer fits a particular young person. Support at home shows up as consistently as any medical step, and clinical decisions belong with a clinician.