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Trans Youth More Likely To Attempt Suicide With Conversion Therapy Than With Hormone Treatment

If you are struggling or having suicidal thoughts, help is available. Call or text the 988 Suicide & Crisis Lifeline or chat at 988lifeline.org. The Trans Lifeline (1-877-565-8860) and The Trevor Project (phone 1-866-488-7386, text 678-678, or chat thetrevorproject.org) also offer crisis support.

As states continue to introduce laws that restrict access to gender-affirming care or limit protections against conversion therapy, questions have arisen about the effectiveness of interventions intended to help transgender youth. In this political climate, gold-standard evidence is more important than ever.

Prior research has been unable to tease out cause and effect between health outcomes and gender-affirming care like hormone therapy or gender-denying interventions like conversion therapy, largely because of a lack of longitudinal data or an appropriate control group. To establish whether something causes an outcome, researchers typically rely on randomized control trials—experiments that randomly assign people to a treatment or a placebo. Random assignment is a trusted way to create two equal groups to compare. However, because it is unethical to withhold treatment or administer potential harmful interventions, randomized controls trials are off the table in this case.

In lieu of randomized control trials, researchers often retrospectively compare people who have received an intervention with those who did not. Studies using this approach have linked hormone therapy with positive mental health outcomes for trans teens. However, because this treatment requires parental approval, teens who receive hormone therapy may have more supportive families than those who do not. The mental health improvement they experienced may partially be due to living in a gender-affirming family environment rather than the effects of hormone therapy alone.

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Our research team was able to address these study design issues directly. Along with our colleagues Duc Hien Nguyen and Yana Rodgers, we are economics and health policy researchers who study the health and economic outcomes of marginalized populations, including LGBTQ+ communities. To assess cause and effect, we used a method commonly used in economics, policy analysis and health policy research called an event study. We analyzed data from the 2015 U.S. Transgender Survey, which includes responses from over 27,000 trans adults

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