9/26/2024
People in the United States who identify as transgender or nonbinary make up only a tiny fraction of the population, but they’ve been the targets of an outsized share of negative attention from lawmakers, a new study says — and those laws can have potentially deadly consequences.
The study, published Thursday in the journal Nature Human Behaviour, found that when anti-trans legislation becomes state law, suicide attempts among transgender and nonbinary young people rise, with increases of up to 72% among teens who live in states where those bills become law.
Surveys show that most Americans say they oppose discrimination against the LGBTQ+ community, including people who identify as transgender, an umbrella term for those whose gender identity is different from the sex they were assigned at birth.
However, experts say anti-trans legislation became more common after a 2015 US Supreme Court decision overturned same-sex marriage bans.
In 2024 alone, politicians in US states introduced 658 anti-trans bills, triple the record set the year before, according to Trans Legislation Tracker, an independent research group.
For the new study, researchers looked at information from 2018 to 2022, when 48 anti-transgender bills became law in 19 states. These included bans on trans-specific health care, bathroom access and sports participation, as well as bans that kept people from updating their identification to reflect their true gender. The researchers surveyed people throughout the United States who identified as LGBTQ+ and who were between the ages of 13 and 24. Responses from young people who identified as transgender or nonbinary were singled out, for a total of 61,240 people from all 50 states.
The study found that self-reported suicide attempts among these young people did not seem to increase while these bills were under debate in their state. But once the bills became law, the researchers saw a statistically significant increase in suicide attempts among young trans and nonbinary people who lived in those states.
With many of the laws targeting young people, the researchers say, it should come as no surprise that the effect was bigger for 13- to 17-year-olds than among the full sample of young people ages 13 to 24.
“We’ve long known that the associations between anti-transgender policies and negative health outcomes for LGBTQ+ young people exist, but this is the first time any study has shown this causal relationship,” said study co-author Dr. Ronita Nath, vice president of research at the Trevor Project, a national organization that provides crisis intervention and suicide prevention services to LGBTQ+ young people. All the study authors are current or former employees of The Trevor Project.
“We knew if we were able to show this, it would be a breakthrough for using definitive scientific evidence to support calls for protective and affirming policies for trans and nonbinary young people and to help, ultimately, save their lives.”
The study cannot pinpoint the exact connection, but the researchers write that the creation of “anti-transgender laws may signal a broader societal rejection of their identities, communicating that their identities and bodies are neither valid nor worthy of protection.”
In other words, the laws themselves may not prompt suicide attempts but rather add to young people’s overall stress. Regardless of a person’s identity, suicide is one of the leading causes of death among all teens in the US.
“So laws restricting access to gender-affirming bathrooms, ending participation in sports activities that align with one’s gender, may lead to experiences of rejection, social isolation, bullying,” Nath said.
Laws that restrict access to gender-affirming health care can also contribute to suicide risk; research has shown that access to such care leads to better mental health outcomes, including decreased suicide risk.
Laws that ban a person from updating their identification documents to align with their gender may lead to less access to vital resources and may create more opportunities for discrimination and harassment at places like the airport or the voting booth.
“Enacted anti-transgender laws may really be a source of increased minority stress that leads to increased suicide risk or other mental health issues,” Nath said.
“We’re talking about real young people’s lives,” she added. “Trans people are family members, our friends, our neighbors, and they deserve a lot better than this.”
Teens who identify as trans or nonbinary generally have an elevated rate of suicide attempts, studies have shown. When legislation is affirming of a member of the community, research shows, suicide attempts decrease.
Research has also found an association between state-level policies and negative mental health consequences. In August, a smaller study of nearly 800 transgender adults in Washington showed that those concerned that their rights might be taken away had significantly higher risks of depression and anxiety.
The new study is “a very clear step forward documenting the harms of this kind of restrictive legislation,” said Dr. Alex Keuroghlian, a clinical psychiatrist and associate professor of psychiatry at Harvard Medical School who is also the director of the Division of Education and Training at the Fenway Institute, a health organization that helps sexual and gender minorities.
Mental health professionals have been predicting that anti-transgender legislation would have significant negative consequences, particularly for young people, said Keuroghlian, who was not involved with the new report.
“These laws seek to effectively erase transgender and nonbinary people from society, and if the state you live in is passing legislation to restrict your basic rights and freedoms, including access to medically necessary evidence-based care, that significantly undercuts the hope you have as a young person in the future,” he said. “So it’s not surprising that these laws we now see are demonstrated to have an association with risk of suicide attempts.”