Gender-affirming Care ‘Can Save Lives’ of Transgender Youth

New research co-authored by University of Massachusetts Amherst economist Duc Hien Nguyen strongly affirms the benefits of providing gender-affirming care (GAC) to transgender people, particularly youth. These treatments, which may include puberty blockers, gender-affirming hormone replacement therapy (HRT), or gender-affirming surgery, have been shown to reduce gender dysphoria—the distress related to a mismatch between an individual’s self-identified gender and their assigned sex at birth. 

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Nguyen was part of the research team that found that initiation of HRT is associated with a 14.4% decrease in the risk of ever attempting suicide if treatment started between the ages of 14 and 17. This benefit was largest when HRT was started at age 14 or 15. 

The findings are based on the 2015 wave of the U.S. Transgender Survey, the largest survey of transgender people ever collected, composed of more than 27,700 respondents across the U.S. 

“The science is showing us that gender-affirming care can save lives,” says Nguyen, who is pursuing his doctorate in economics at UMass Amherst.  

The paper’s findings come as 20 states have adopted laws or policies restricting gender-affirming care for young people and eight additional states are considering such proposals. 

“In line with existing scientific evidence, our research clearly indicates that restricting transgender youth’s access to HRT could produce harmful, even deadly, consequences,” Nguyen says. “This finding is especially pertinent given the recent surge in state-level GAC bans, many of which purposefully target transgender youth.” 

The research finds no statistically significant relationship between HRT and the risk of attempting suicide among transgender adults. While stressing that better data collection and more studies are needed in this area, Nguyen hypothesizes that this may be because some of the most at-risk transgender youth have already taken their own lives. 

“Statistically, the transgender population has one of the highest lifetime rates of attempted suicide in the U.S. We also observe in our data that the majority of first suicide attempts among transgender people occur during adolescence,” Nguyen says. “I think the dark reality is that there is an unknown number of transgender youth who could not access HRT during adolescence and took their own lives, thus never appearing in the data.”  

Nguyen collaborated on the research with lead author Travis Campbell of Southern Oregon University who earned his doctorate from UMass Amherst in 2022, Samuel Mann of Vanderbilt University and Yana van der Meulen Rodgers of Rutgers University. 

The paper, “Hormone Therapy, Suicidal Risk and Transgender Youth in the United States,” appears in AEA Papers and Proceedings. 

Nguyen’s doctoral work is supported in part by funding from the UMass Amherst Political Economy Research Institute (PERI) and the Social Sciences and Humanities Research Council of Canada (SSHRC).