Wednesday, January 19, 2022

The Guardian reported Stonewall’s statistic that “almost half” of young transgenders “have attempted to kill themselves”; real suicidality is 0.03pct (too high, 5.5 times greater than the suicide rate of all adolescents)

Suicide by Clinic-Referred Transgender Adolescents in the United Kingdom. Michael Biggs. Archives of Sexual Behavior, Jan 18 2022.

Introduction: Surveys show that adolescents who identify as transgender are vulnerable to suicidal thoughts and self-harming behaviors (dickey & Budge, 2020; Hatchel et al., 2021; Mann et al., 2019). Little is known about death by suicide. This Letter presents data from the Gender Identity Development Service (GIDS), the publicly funded clinic for children and adolescents aged under 18 from England, Wales, and Northern Ireland. From 2010 to 2020, four patients were known or suspected to have died by suicide, out of about 15,000 patients (including those on the waiting list). To calculate the annual suicide rate, the total number of years spent by patients under the clinic’s care is estimated at about 30,000. This yields an annual suicide rate of 13 per 100,000 (95% confidence interval: 4–34). Compared to the United Kingdom population of similar age and sexual composition, the suicide rate for patients at the GIDS was 5.5 times higher. The proportion of patients dying by suicide was far lower than in the only pediatric gender clinic which has published data, in Belgium (Van Cauwenberg et al., 2021).

Suicidality in Transgender Adolescents

“About half of young trans people…attempt suicide,” declared the United Kingdom Parliament’s Women and Equalities Committee (2015). Similar figures are cited by news media and campaigning organizations. The Guardian reported Stonewall’s statistic that “almost half” of transgender young people “have attempted to kill themselves” (Weale, 2017). “Fifty percent of transgender youth attempt suicide before they are at age 21” stated the mother of the most famous transgender youth in the English-speaking world (Jennings & Jennings, 2016). As a transgender theologian has observed, “the statistic about suicide attempts has, in essence, developed a life of its own” (Tanis, 2016).

Representative surveys of students in high schools provide one source of evidence for this statistic. In New Zealand, 20% of transgender students reported attempting suicide in the past 12 months, compared to 4% of all students (Clark et al., 2014). In the United States, 15% of transgender students reported a suicide attempt requiring medical treatment in the last 12 months, compared to 3% of all students (Centers for Disease Control & Prevention, 2018; Jackman et al., 2021; Johns et al., 2019). In another American survey, 41% of transgender students reported having attempted suicide during their lifetime, compared to 14% of all students (Toomey et al., 2018).

To what extent are self-reported suicide attempts reflected in fatalities? The connection is not straightforward. Respondents who report suicide attempts are not necessarily indicating an intent to die. One survey of the American population found that almost half the respondents who reported attempting suicide subsequently stated that their action was a cry for help and not intended to be fatal (Nock & Kessler, 2006). In two small samples of non-heterosexual youth, half the respondents who initially reported attempting suicide subsequently clarified that they went no further than imagining or planning it; for the remainder who did actually attempt suicide, their actions were usually not life-threatening. To an extent, then, “the reports were attempts to communicate the hardships of lives or to identify with a gay community” (Savin-Williams, 2001). Although such elaborate survey methods have not been used to study transgender populations, there is anecdotal evidence for a similar disjuncture. The pediatric endocrinologist who established the first clinic for transgender children in the United States stated that “the majority of self-harmful actions that I see in my clinic are not real suicide attempts and are not usually life threatening” (Spack, 2009).



How reliable are these estimates? The chief uncertainty about the numerator is whether the fourth death will be ruled as suicide when the inquest is eventually held. It could be speculated that there were further suicides unknown to the Tavistock and to the National Confidential Inquiry into Suicide and Safety in Mental Health. All that can be said is that the single suicide by a GIDS patient from 2014 to 2016 is not out of line with comprehensive mortality data on suicides by transgender adolescents in the United Kingdom which counted five suicides in a longer age range and wider geographical area. The denominator for the annual suicide rate, however, is pieced together from various series and so is inevitably approximate. Statistics from the early 2010s are less reliable, though they make only a small contribution to the grand total; the last three years contribute more than half of the total number of patient-years. The most significant limitation is the lack of information on the age and sex of all the patients who committed suicide.

Direct comparison can be made with the Belgian pediatric gender clinic (Van Cauwenberg et al., 2021). Its annual suicide rate was about 70 times greater than the rate at the GIDS. This is especially puzzling because patients at the Belgian clinic scored better, on average, than those at the GIDS on tests of psychological functioning (de Graaf et al., 2018). The explanation for the huge disparity in suicide is not clear. The Amsterdam’s clinic annual suicide rate was four times greater than the rate at the GIDS. The higher rate is not surprising, however, because the Dutch clinical population was dominated by older adults: the median age at first visit was 25 (Wiepjes et al., 2020). Suicide rates peak in middle age, and so a population of older adults would be at higher risk than a population of adolescents.

The suicide rate of the GIDS patients is not necessarily indicative of the rate among all adolescents who identify as transgender. On the one hand, individuals with more serious problems (and their families) would be particularly motivated to seek referral and more likely to obtain it, and so the clinical subset would be more prone to suicide. One study suggests that a child who frequently attempted suicide was more readily referred to the GIDS (Carlile et al., 2021). On the other hand, young people facing hostility from their families would be less able to seek referral, and this hostility could make them especially vulnerable to suicide.

Taking into account these limitations, the estimated suicide rate at the GIDS provides the strongest evidence yet published that transgender adolescents are more likely to commit suicide than the overall adolescent population. The higher risk could have various causes: gender dysphoria, accompanying psychological conditions, and ensuing social disadvantages such as bullying. Studies of young people referred to the GIDS in 2012 and 2015 found a high prevalence of eating disorders, depression, and autism spectrum conditions (ASC) (Holt et al., 2016; Morandini et al., 2021)—all known to increase the probability of suicide (Simon & VonKorff, 1998; Smith et al., 2018). Eating disorders and depression could be consequences of transgender identity and its ensuing social repercussions, but this is implausible for ASC insofar as it originates in genes or the prenatal environment. From a sample of over 700 referrals to the GIDS in 2012 and 2015, 14–15% were diagnosed with ASC (Morandini et al., 2021). This compared to 0.8–1.1% of students in England (Department for Education, 20122015). The association between autism and gender dysphoria is found in many populations (Socialstyrelsen, 2020; Warrier et al., 2020). Autism is known to increase the risk of suicide mortality, especially in females (Hirvikoski et al., 2016; Kirby et al., 2019; Socialstyrelsen, 2020). To some extent, therefore, the elevated suicide rate for transgender youth compared to their peers reflects the higher incidence of ASC. The same holds for other psychiatric disorders associated with gender dysphoria (Dhejne et al., 2016). Ideally, the suicide rate for patients of the GIDS would be compared to the suicide rate for patients in contact with other NHS mental health services, but the latter rate is not available.

One final caveat is that these data shed no light on the question of whether counseling or endocrinological interventions—gonadotropin-releasing hormone agonist or cross-sex hormones—affect the risk of suicide (Biggs, 2020; Turban et al., 2020). Although two out of the four suicides were of patients on the waiting list, and thus would not have obtained treatment, this is not disproportionate: the waiting list contributed nearly half of the total patient-years.

Hookups reflect extended sexual adolescence, an average of seven additional pre-marital years of youthful singlehood during which many young people are celibate while many others experiment with short-term pairings

Kettrey, HH and AD Johnson. “Hooking Up and Pairing Off: Correlates of College Students’ Interest in Subsequent Hookup and Romantic Relationships with Other-Sex and Same-Sex Hookup Partners,:” Journal of Sex Research (2021) 58:915. DOI: 10.1080/00224499.2020.1766403

Abstract: Contrary to popular media claims that college hookup culture has made romantic relationships obsolete, research indicates many college students see hookups as a pathway to relationships. However, relatively few college hookups actually produce relationships. This study used a sex market framework to explore correlates of college students’ interest in future hookups and relationships with hookup partners across other-sex and same-sex hookup markets. Using Online College Social Life Survey data (N = 10,141) we explored variables classified in the following contexts that may shape choices in a sex market: demographic characteristics, the hookup dyad, the hookup event, post-hookup reactions, attitudes toward hookup partners, and hookup opportunity structures. Logistic regression analyses indicated post-hookup reactions (e.g., satisfaction, emotional responses) explained the highest percentage of variance in interest in a subsequent hookup (56% to 61% across markets) and interest in a relationship (35% to 45% across markets). Although past research suggests there are different markets for other- and same-sex hookups, these findings suggest similarity in contexts that may shape interest in relationship formation among other-sex and same-sex hookup markets. Suggestions for fostering positive relationship development on campuses are discussed.

Popular version: New Insights Into Young Adult Casual Sex Hookups. Michael Castleman. Jan 15 2022.


In this study, we explored correlates of college students’ interest in a subsequent hookup or romantic relationship with their most recent hookup partner. We paid particular attention to the sex composition of hookup dyads and broke down findings as they applied to four different hookup markets: women with other-sex hookup partners, men with other-sex hookup partners, women with same-sex hookup partners, and men with same-sex hookup partners. Findings from this study are especially important because most research on college hookups has (1) employed a risk framework with minimal attention to positive outcomes of hookups and (2) focused on hookups among other-sex dyads, with the few studies that do exist on same-sex hookups suggesting these encounters are part of a distinct hookup culture (Pham, 2017; Watson et al., 2017).

We employed a sex market framework (Ellingson et al., 2004), to theorize different markets, or hookup cultures, for other-sex and same-sex hookup dyads. More specifically, we examined correlations between contexts that can shape preferences for subsequent hookups or relationships with hookup partners in a given hookup market. We examined the relationship between the following contexts and interest in a subsequent hookup or relationship with hookup partners: demographic characteristics, the hookup dyad, the hookup event, post-hookup reactions, attitudes toward hookup partners, and hookup opportunity structures.

Through this study, we sought to answer two main research questions. First, we asked which contexts were the strongest predictors of interest in a subsequent hookup or relationship with hookup partners. Second, we sought to explore the similarities and differences in predictors of interest in a subsequent hookup or relationship with hookup partners across hookup markets (i.e., women with other-sex hookup partners, men with other-sex hookup partners, women with same-sex hookup partners, men with same-sex hookup partners).

Although previous research suggests there are separate sex markets, or hookup cultures, for women and men with other-sex or same-sex partners, our analysis suggests there is great similarity in the degree to which the contexts that compose those markets may facilitate relationship formation. Across all four hookup markets, we found post-hookup reactions to be most strongly correlated with the two outcomes in our study (i.e., interest in a subsequent hookup and interest in a relationship with hookup partners). The variables in this context collectively explained between 35% and 62% of the variance in the two outcomes across the four hookup markets. The second strongest context to correlate with the outcomes across the four contexts was the hookup dyad. The variables in this context collectively explained between 12% and 22% of the variance in the two outcomes across markets.

These findings point to the importance of how college students feel about their hookups – as well as their history and familiarity with hookup partners – in facilitating future hookups and romantic relationships. That is, our findings suggest that being familiar with a specific hookup partner and experiencing positive feelings after a hookup are the best predictors of subsequent interest in that partner. This is the case for both men and women with other-sex and same-sex partners. In other words, the same contexts matter across markets. However, this is not meant to diminish variation within contexts across markets. For example, hookup enjoyment was a significant predictor of subsequent interest in hookup partners across all four markets; however, women with same-sex hookup partners reported the highest level of hookup enjoyment.

Limitations and Directions for Future Research

Findings from this study should be interpreted within the confines of important limitations pertinent to its theoretical conceptualization and methodological implementation. Regarding the conceptualization of the study, as previously noted, the hookup market contexts that we examined represents a classification of variables that the larger body of research indicates can shape interest in a future hookup or relationship with one’s partner. These contexts are not meant to be exhaustive, as it is not possible to account for every variable that might be associated with college students’ post-hookup interest in partners. Rather, it is meant to provide a rough template for understanding interest in the formation of romantic relationships among college students across hookup markets.

Additionally, a number of methodological limitations are worth noting. First, the sample for this study was nonrandom and composed of college students enrolled in sociology classes. Thus, respondents’ hookup preferences and behaviors may not be representative of those among general college students. Second, OCSLS data were collected at a single point in time and, thus, findings from this study are correlational. It is not clear whether the predictor variables (i.e., variables corresponding to each of the contexts) influenced participants’ post-hookup interest in their partners or whether post-hookup interest influenced participants’ reporting of these variables.

Relatedly, although the OCSLS dataset is widely used in analyses of college hookup attitudes and behaviors, readers should be mindful of the fact that the survey was administered between 2005 and 2011. Thus, findings from this analysis may not accurately represent the dynamics of relationship formation among current college students.

Finally, the outcome variables in this study measured respondents’ interest in a subsequent hookup or romantic relationship with their most recent hookup partner. They do not indicate whether the hookups in question actually resulted in a subsequent hookup or relationship. The OCSLS did not measure the actual incidence of future commitment from hookup partners and, even if it did, the numbers would presumably produce a much smaller number of positive cases for analysis.

To address these limitations, future research should include qualitative investigations that capture narrative accounts of college students’ hookup experiences – as well as their longitudinal trajectories with particular hookup partners (e.g., how and under what conditions hookups yield relationships). This could involve recruiting a sample of college students who are asked to complete journals chronicling their hookup experiences across an academic year. Those who report hookups with serial partners could be invited to participate in follow-up interviews to discuss emerging interests in these partners. Ideally, some of these interviews should include participants’ partners, as the body of research would benefit from studies that use hookup partner dyads (instead of individual college students) as the unit of analysis.