Executive Summary
For over two decades, research has established that the prevalence of suicide thoughts and attempts among transgender people is elevated compared to cisgender people. This report is one in a series of reports utilizing data from the U.S. Trans Survey (USTS), the largest survey of transgender people in the U.S., examining risk factors for suicide thoughts and attempts among USTS respondents. In this report, we utilize data from the 2022 USTS, including analyses for adults and those aged 16 to 17, to provide updated findings and examine age differences in risk factors that transgender people have in common with cisgender people, such as in self-reported health and substance use. We also provide new analyses of age group differences in risk factors unique to transgender people, such as family rejection and access to gender-affirming care. In addition, we provide analyses of new topics included in the 2022 USTS, such as the impacts of the COVID-19 pandemic, experiences while online, substance use and recovery, conversion therapy, violence and harassment, and the impact of state policy environments. We limit our analyses to suicide thoughts and attempts reported in the year prior to the 2022 USTS.
Overall, we find that 38.9% of all 2022 USTS respondents reported seriously thinking about suicide in the year prior to the survey, and 5.3% of respondents reported attempting suicide during that time. Our findings are consistent with prior research and confirm that the elevated prevalence of suicide thoughts and attempts among transgender people lies at the intersection of elevated exposure to common risk factors for suicide, plus exposure to added risk factors that uniquely affect transgender people.
Key Findings
- Exposure to violence resulted in the largest disparity in suicide thoughts and attempts in this report, comparing those who did and did not experience it. Those who reported being physically attacked because they are transgender in the year prior to the survey were 27.2 percentage points more likely to seriously consider suicide (65.1%) and 15.3 percentage points more likely to attempt suicide (20.0%) in the past year, compared to those who did not experience this (37.9% and 4.7%, respectively).
- Prevalence of suicide thoughts and attempts was highest among youth compared to older age groups across all topics covered. Salient risk factors for youth include rejection from families and religious communities, including exposure to conversion therapy, economic vulnerabilities, and lack of access to gender-affirming health care.
- Related to COVID-19, those who worked only in person in the year prior to the survey had a significantly higher prevalence of past-year suicide thoughts (40.5%) and attempts (5.7%) compared to those who only worked remotely (29.0% and 2.9%, respectively) or who worked a hybrid schedule (30.3% and 3.5%, respectively).
- Experiencing harassment is related to a higher risk for suicide thoughts and attempts compared to those who did not experience harassment, regardless of whether harassment occurred in person or online. We found that those who experienced harassment online were as likely to report past-year suicide thoughts (49.5%) and attempts (8.3%) compared to those who reported being verbally harassed in person (50.7% and 9.0%, respectively).
- We found that any exposure to conversion therapy, regardless of who conducted it, whether it was through therapy, counseling, or a program, religiously affiliated or not, whether it was related to gender identity or sexual orientation, resulted in a significantly higher prevalence of past-year suicide thoughts and attempts for those exposed to it. Notably, 85.4% of those aged 16 to 17 who attended a conversion therapy camp reported past-year suicide thoughts, and 36.9% in that age group who were exposed to sexual orientation conversion therapy reported past-year suicide attempts.
- We found that those who live in states that have positive public policy environments for transgender people and comprehensive non-discrimination statutes have lower prevalence of suicide thoughts compared to those residing in negative public policy states. For instance, 41.6% of those who lived in states with negative public policy environments for transgender people seriously thought about suicide in the past year, compared to 35.8% of those residing in states with the most positive policy environments.
- Those who thought about moving from states because of state laws that negatively target transgender people, but did not move, were more likely than those who never thought about moving to report past-year suicide thoughts (44.0% vs. 31.6%) and attempts (5.1% vs. 3.9%).
Findings from this report suggest that strategies to reduce suicidality among transgender people must involve reducing the heightened exposure that transgender people have to common risk factors, such as economic hardship and housing instability, as well as minority stressors and structural stigma, such as discrimination, violence, and hostile policy environments. Future research needs to include further examination of age group differences among transgender people to understand why they exist. Applying a life course perspective to transgender people’s identity development and gender affirmation milestones would help elucidate unique risk factors for different age cohorts. We also need research to provide a better understanding of the impacts of specific laws and policies (e.g., restrictive state laws) on transgender people’s health and well-being. Current research is needed on how state laws and policies are impacting transgender people’s relocation across states and how relocation from or remaining in negative state environments impacts health and well-being over time. Future research is also needed regarding the mental health impacts of remote vs. in-person work for transgender people, among other topics.