Mental Health is Political: Issue 6
A newsletter about the intersection of mental health and politics.
It is officially Pride Month – a month designed to celebrate the LGBTQ+ community and reflect on the history of LGBTQ+ rights in the U.S. I initially planned on writing my regular newsletter with each section dedicated to Pride and LGBTQ+ issues in the news — and that will come next week. However, after seeing Nikki Haley’s deeply disturbing comments at a town hall this weekend, I decided to use this week to deep dive into the topic she got so, so very wrong.
In case you missed it, Nikki Haley, a 2024 Republican presidential contender, participated in a CNN town hall over the weekend. During the town hall, Haley strongly suggested that allowing trans youth to participate in sports aligned with their gender (and thus use locker rooms aligned with their gender) is to blame for high rates of suicidal thoughts and behavior among teen girls. This comment is wildly inappropriate and inaccurate.
So let’s break it down.
What do we know about suicide risk in teen girls?
Every two years, the CDC conducts a nationwide survey of high school age teens called the Youth Risk Behavior Survey. The survey covers a broad range of behaviors and outcomes, including questions about whether the teen has experienced suicidal thoughts or made a suicide attempt in the past 12-months. You can find the full report from the 2021 YRBS survey, including trends from 2011-2021, here.
And we are right to be concerned about the numbers from the 2021 survey — they are alarming! Results find that approximately 13% of female teens reported they made a suicide attempt in the past year (compared to 7% of male teens), and approximately 30% reported they had seriously considered attempting suicide in the past year (compared to 14% of male teens).1
What do we know about suicide risk in trans teens?
The YRBS provides national data on LGBQ+ teens, finding that rates of suicidal thoughts and suicide attempts are much higher among LGBQ+ teens (45% and 22%, respectively) compared to straight teens (15% and 6%, respectively). However, not until relatively recently have some states begun to incorporate gender identity questions into their YRBS surveys, providing us with some insight into how gender minority high school students fare compared to cisgender teens.
And the numbers for trans teens are even more concerning. Data from the 2017-2019 YRBS across 15 states found that trans teens are more likely to report seriously considering attempting suicide, with approximately 44.8% endorsing thoughts in the past year, and attempting suicide, with approximately 30% reporting attempts in the past year, compared to cisgender teens. The Trevor Project also conducts a national survey of LGBTQ+ Youth Mental Health among teens and young adults ages 13-24. Data from their 2022 survey similarly finds that rates of suicidal thoughts and suicide attempts are extremely high among trans youth.
What contributes to high rates of suicidal thoughts and attempts in teens?
Suicide risk is complicated. Decades of research shows that there is no single factor that causes someone to experience suicidal thoughts or attempt suicide. There are many risk factors that may increase the likelihood that someone is suicidal. Research suggests a person’s history of mental health problems, physical health conditions, experiences of life stressors (especially those that are interpersonal in nature), feelings of hopelessness or isolation, and both being a victim of and perpetrating violence can increase suicide risk, though this is by no means an exhaustive list of risk factors. Importantly, sharing space (like a bathroom or locker room) with trans people is most definitely not on the list.
As highlighted above, trans teens are at significantly greater risk for suicidal thoughts and suicide attempts than their cisgender peers. But why? Research shows that trans teens are faced with the same risk factors that cisgender teens experience — plus additional stressors that are specific to their experience as a trans person. The minority stress model — a model first proposed by Dr. Virginia Brooks and further popularized by Dr. Ilan Meyer — highlights how LGBQ+ people experience additional sexual minority specific stressors. The minority stress model has since been expanded upon to capture stress specific to gender minority identities. These additional experiences of stress — which can often take the form of gender-related discrimination and victimization — contribute to greater risk for suicide.
(It’s also important to highlight that creating gender affirming environments for teens, including access to gender affirming care and supportive school and home environments, can mitigate mental health risk and promote psychological resilience.)
Why is it patently false to claim that trans teens are to blame for high rates of suicide risk in female teens?
There is absolutely no scientific evidence or theory that supports the idea that trans teens contribute to female teens’ mental health challenges or suicide risk. People who peddle this extremely dangerous lie have only one agenda — to stoke fear for political gain and power. When politicians are not willing to provide people with what they really need — e.g., accessible and affordable housing and healthcare, living wages, family leave and child care — they resort to fueling unfounded fear as a tool to win votes. To be very clear: Trans people are not a threat. Instead, trans people’s lives are actively being threatened by an onslaught of discriminatory legislation nationwide.
Nikki Haley’s comments made one thing clear — she does not actually care about addressing the teen suicide crisis in the U.S. It’s critical now more than ever that we call out these harmful lies and show our unequivocal support for the trans community.
Last week, I attended a webinar hosted through The Association for Behavioral and Cognitive Therapies where Dr. Jae Puckett discussed resilience in trans and gender diverse communities. Sometimes it can feel like all we read about is the bad stuff that trans people have to endure while simply trying to exist. So I’ll end with a reminder that the trans community is also one filled with much joy — and trans teens deserve to experience that joy and grow up to be happy, healthy, joyful adults.
Thank you for reading, sharing, and subscribing to Mental Health is Political. Share your thoughts, questions, or things you’d like to read more about in the comments!
Every state that participates in the YRBS assesses teens’ biological sex, but not all states assess gender identity.