Study: Transgender Industry’s ‘Transition or Die’ Youth Suicide Narrative ‘Factually Inaccurate and Ethically Fraught’

A recent study finds the often “inaccurate” and “incomplete” informed consent process engaged in by transgender industry clinicians is propped up by the activist “alarmist” narrative whereby parents are told their failure to approve their child’s transgender medical treatments could likely result in his or her suicide.

In the study published in the Journal of Sex & Marital Therapy, Dr. Stephen B. Levine, of the Department of Psychiatry at Case Western Reserve University, and his colleagues note the “unprecedented rise in the numbers of children and adolescents seeking gender transition” in under a decade.

In “Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults,” Levine et al state that what is known as “gender-affirmative care,” i.e., social, medical, and surgical interventions in response to gender dysphoria, is “still based on very low-quality evidence.”

“The many risks of these interventions, including medicalizing a temporary adolescent identity, have come into a clearer focus through an awareness of detransitioners,” they assert, adding that while the lack of high-quality evidence for the success of these interventions should demand a comprehensive informed consent about their “risks and long-term outcomes,” the process is restricted by “erroneous professional assumptions; poor quality of the initial evaluations; and inaccurate and incomplete information shared with patients and their parents.”

While the researchers’ goal is to improve the informed consent process for parents, their children, and clinicians, they cite clear obstacles, one of which is the high level of transgender ideology activism that has been allowed to influence medical issues, including the initial mental health evaluations:

The poor quality of mental health evaluations has been a point of significant discontent for a growing number of parents of gender-dysphoric youth. Increasingly, parents have formed dozens of support groups in North America, Europe, Australia and New Zealand, united in their objections to the idea that the best or the only treatment for their gender-dysphoric children is affirmation (Genspect, 2021). These distressed parents, recognizing that their son or daughter may eventually decide to present to others as a trans person, want a psychotherapeutic investigation to understand what contributed to the development of this identity and an exploration of noninvasive treatment options. Frequently, they cannot find anyone in their community who does not recommend immediate affirmation.

Perhaps an area that is finally receiving more attention has been what appears to be transgender activist-induced fear in parents that pushes them to be immediately “gender-affirming,” or else risk a child who commits suicide.

“The question of suicide is inappropriately handled,” Levine et al write:

Suicide among trans-identified youth is significantly elevated compared to the general population of youth (Biggs, 2022; de Graaf et al., 2020). However, the “transition or die” narrative, whereby parents are told that their only choice is between a “live trans daughter or a dead son” (or vice-versa), is both factually inaccurate and ethically fraught. Disseminating such alarmist messages hurts the majority of trans-identified youth who are not at risk for suicide. It also hurts the minority who are at risk, and who, as a result of such misinformation, may forgo evidence-based suicide prevention interventions in the false hopes that transition will prevent suicide.

“The ‘transition or die’ narrative regards suicidal risk in trans-identified youth as a different phenomenon than suicidal risk among other youth,” Levine and his colleagues note. “Making them an exception falsely promises the parents that immediate transition will remove the risk of suicidal self-harm.”

Levine et al point to “biased online samples that rely on self-report” that have warned of an “alarmingly high risk of suicide.” Among the reporters of such “evidence” is The Trevor Project, an LGBTQ activist organization that was recently cited in an interview by transgender U.S. Assistant Secretary for Health Dr. Rachel (born Richard) Levine at National Public Radio (NPR).

The Biden top health official claimed there is “no argument among medical professionals – pediatricians, pediatric endocrinologists, adolescent medicine physicians, adolescent psychiatrists, psychologists, et cetera – about the value and the importance of gender-affirming care,” which includes puberty-blocking drugs, cross-sex hormones, and surgeries, such as elective double mastectomies, for young people.

“Trans youth in particular are being hounded in public and driven to deaths of despair at an alarming rate,” Levine told NPR “in prepared remarks” at the end of April.

Condemning state legislation intended to curb child gender transition, Levine cited The Trevor Project for statistics:

Fifty-two percent of all transgender and nonbinary young people in the U.S. seriously contemplated killing themselves in 2020. Think about how many of them thought it was better to die than to put up with any more harassment, scapegoating and intentional abuse.

The Trevor Project’s “research,” and that conducted by others often cited by activists, “frequently conflates suicidal thoughts and non-suicidal self-harm with serious suicide attempts and completed suicides,” Stephen Levine and his colleagues state, adding:

Until recently, little was known about the actual rate of suicide of trans-identified youth. However, a recent analysis of data from the biggest pediatric gender clinic in the world, the UK’s Tavistock, found the rate of completed youth suicides to be 0.03% over a 10-year period, which translates into the annual rate of 13 per 100,000 (Biggs, 2022). While this rate is significantly elevated compared to the general population of teens, it is far from the epidemic of trans suicides portrayed by the media.

Interestingly, Britain’s Tavistock & Portman National Health Service (NHS) gender clinic, which has led the way in prescribing puberty blockers for young children, recently announced it is shutting down following a review that cited accusations the clinic has been “rushing teenagers into life-altering treatment on hormone-blocking drugs,” The Times of London reported.

The news of Tavistock’s closure follows similar announcements in Sweden and France citing “low quality” evidence for hormone treatment for gender dysphoric youth and the need for emphasis on the risks of transgender medical interventions and “their irreversible nature.”

Heritage Foundation Senior Research Fellow Jay Greene, Ph.D. also released a study in June that indeed found, contrary to the claims of the Biden administration and other proponents of transgender ideology, states that have allowed easier access by young people to puberty-blocking drugs and cross-sex hormones have not reduced suicide rates among this population.

“In fact, it likely leads to higher rates of suicide among young people,” Greene said, noting the expansion in 2010 in both the use of puberty-blocking drugs in youth and the higher suicide rates among young people in states that allowed greater access to these interventions without parental consent:

In the past several years, the suicide rate among those ages 12 to 23 has become significantly higher in states that have a provision that allows minors to receive routine health care without parental consent than in states without such a provision. Before 2010, these two groups of states did not differ in their youth suicide rates. Starting in 2010, when puberty blockers and cross-sex hormones became widely available, elevated suicide rates in states where minors can more easily access those medical interventions became observable.

In her review of Levine et al’s study, attorney and researcher Jane Robbins wrote at The Public Discourse transgender industry clinicians “bear responsibility for their actions” when informing parents about undertaking such significant alterations in the bodies and minds of their children.

“They are highly trained professionals,” she noted, adding:

They know how to uncover and evaluate research, and they have an ethical obligation to do that before administering experimental interventions that may destroy lives. They have an ethical obligation to exercise common sense, to pay attention to warning signs, and to exercise the basic gumption to recognize and properly address obvious mental disturbances.

While Robbins acknowledges Levine et al’s “valuable blueprint for navigating the trans morass in the limited subcategory of informed consent,” she observes the authors fail to draw the wider conclusion.

“[T]hat ‘gender affirming treatment’ is a fundamentally flawed concept that should not be on the table, any more than diet pills and liposuction should be considered appropriate treatment for anorexics,” she asserted. “Perhaps all focus should be on changing the mind to match reality, not the other way around.”

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Susan Berry, PhD, is national education editor at The Star News Network. Email tips to [email protected].

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