Transgender / Transsexual Study Results: Attempted Suicide, World

Talking About Suicide & LGBT Populations (2011): Suggestions & Recommendations.

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Suicidality Studies Index: All Studies. - All Random & Special Sample Studies. - All American & Canadian Studies. - All European Studies. - Transgender Studies (This Page). - The Results of School-Based North American Youth Risk Behavior Surveys or Similar Surveys - Random Sampling - are Located at Another Location.

Other Pages: Homosexually Oriented People Are Generally at Greater Risk for the More Serious Suicidal Behaviors. - "Attempting Suicide" as Related To Gender Nonconformity & Transgender Issues. - Bell & Weinberg (1978) Homosexualities Study: "Attempted Suicide" Study Results.

Special Section: The 2013 Paper, "Suicide Risk and Sexual Orientation: A Critical Review," Reverses the Conclusions of Two Previously Published Papers. The Re-Analysis - Including Many Meta-Analyses & Using Unconditional Tests for Statistical Significance - Indicates that "Gay/Lesbian/Bisexual Adolescents Are at Risk for Suicide." - In Addition, Expanding the "At Risk" Category to Include Adolescents Known to Only Have Been Harassed/Abused - Because They Were Assumed to be Gay/Lesbian - Produces More Conclusive Results, Especially Applying for Males. This Category Represents "An Expanded Homosexuality Factor in Adolescent Suicide." - Associated Pages: Constructing "The Gay Youth Suicide Myth": Thirty Years of Resisting a Likely Truth & Generating Cohen's Effect Size "h" Via Arcsin / Arcsine Transformations.

This page contain the results of Transgender studies that have reported "attempted suicide" incidences for varied samples.

Risk Ratios (RRs) or Odds Ratios (ORs) were produced when Heterosexual or Predominantly Heterosexual individuals were also a part of a study. As a rule, homosexually oriented people have been at higher risk for attempting suicide, compared to their heterosexual counterparts, and more so for males... as a rule. (Related Information)

Study Samples have been non-random and random.

Results of mostly North American suicidality studies of sexual minority street youth, psychiatric patients have been included in this web page to highlight the need for such studies to be carried out.

Qin P, Agerbo E, Mortensen PB (2003). Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark, 1981-1997. American Journal of Psychiatry, 160(4):765-72. (Abstract) (Full Text) - "...registered [same-sex] partners included as a separate category in the analysis had an odds ratio of 4.31 (95% CI= 2.23–8.36) in the crude analysis and 3.63 (95% CI=1.71– 7.67) in analyses with adjustment for other factors in the full model [for having committed suicide compared to opposite-sex married couples]". Note: This is a First-Time Research Result! See: Frisch M, Bronnum-Hansen H (2009). Mortality among men and women in same-sex marriage: a national cohort study of 8333 Danes. American Journal of Public Health, 99(1): 133-7. Abstract. After 1995, higher risk of death in same-sex marriages occur in first 3 year of the marriage. Note: The paper does NOT mention the Qin et al (2003) suicide results (above), and suicide is only mentioned as possibly being implicated in the higher risk of death for same-sex couples.

Mathy RM, Cochran SD, Olsen J, Mays VM (2009). The association between relationship markers of sexual orientation and suicide: Denmark, 1990-2001. Social Psychiatry and Psychiatric Epidemiology. [Epub ahead of print]. From Abstract: "Using data from death certificates issued between 1990 and 2001 and population estimates from the Danish census, we estimated suicide mortality risk among individuals classified into one of three marital/cohabitation statuses: current/formerly in same-sex RDPs; current/formerly heterosexually married; or never married/registered. RESULTS: Risk for suicide mortality was associated with this proxy indicator of sexual orientation, but only significantly among men. The estimated age-adjusted suicide mortality risk for RDP men was nearly eight times greater than for men with positive histories of heterosexual marriage and nearly twice as high for men who had never married."

Frisch M, Simonsen J (2013). Marriage, cohabitation and mortality in Denmark: national cohort study of 6.5 million persons followed for up to three decades (1982-2011). International Journal of Epidemiology, 42(2): 559-578. Abstract. "Results: HRs for overall mortality changed markedly over time, most notably for persons in same-sex marriage. In 2000-2011, opposite-sex married persons (reference, HR = 1) had consistently lower mortality than persons in other marital status categories in women (HRs 1.37-1.89) and men (HRs 1.37-1.66). Mortality was particularly high for same-sex married women (HR = 1.89), notably from suicide (HR = 6.40) and cancer (HR = 1.62), whereas rates for same-sex married men (HR = 1.38) were equal to or lower than those for unmarried, divorced and widowed men. Prior marriages (whether opposite-sex or same-sex) were associated with increased mortality in both women and men (HR = 1.16-1.45 per additional prior marriage)... Of note, mortality among same-sex married men has declined markedly since the mid-1990s and is now at or below that of unmarried, divorced and widowed men, whereas same-sex married women emerge as the group of women with highest and, in recent years, even further increasing mortality.

Social exclusion of young lesbian, gay, bisexual and transgender (LGBT) people in Europe
(By Judit Takács, ILGA-Europe and IGLYO, PDF Download)

Suicide Risk: Transsexual Populations
Study	Transsexual Suicide Risk Factors	Study Information
Asscheman et al. (1989)	303 Male-to-Female Transsexuals (MtF) Suicide: 3 (0.63-8.8) vs. 0.208 Age When Hormone Treatment Began: Median: 32.0 Years, Range: 16-67 Attempted suicide by MtF before the start of sex reassignment treatment: 14% 122 Female-to-Male Transsexuals (FtM) No Suicides Age When Hormone Treatment Began: Median: 25.4 Years, Range: 16-54	425 Transsexual Patients With Cross-Gender Hormone Treatment (1972-1986, Free University Hospital clinic, Amsterdam, The Netherlands).Compared With Average Population. "The observed and the expected mortalities in male to-female transsexuals treated with estrogens and cyproterone acetate are shown in Table 1. The total number of deaths in the treatment group represented a 2.5- to 9-fold increase over the general population. The increased mortality was in particular due to an increase of suicides and of deaths by unknown cause." "The increased number of deaths by unknown cause does raise concern. Two of these three deaths might have been suicide, according to friends and relatives."
van Kesteren et al. (1997)	SMR: Standard Mortality Ratio (MtF) Suicide Risk Compared to Average Population: 13 Suicides - SMR: 4.9<9.3<15.9. No Suicide: Female to Male (FtM) Transsexuals. Attempted suicide by MtF before the start of sex reassignment treatment: ? %. After?	Suicide Risk in 816 Male-to-Female Transsexuals Treated With Oestrogens and Anti-Androgens at Free University Hospital clinic (Amsterdam, The Netherlands) from 1977 to 1994. Mean Age (MtF): 41 (18-860 Years Mean Age (FtM, N = 282): 34 (17-70) Years
Dhejne et al. (2011)	Adjusted Hazard Ratios (aHR) Suicide: 19.1 (5.8–62.9) - 1973 to 2003 Attempted Suicide 4.9 (2.9–8.5) - 1973 to 2003 7.9 (4.1–15.3) - 1973 to 1988 2.0 (0.7–5.3) - 1989 to 2003	324 sex-reassigned persons (191 male-to-females: MtF, 133 female-to-males: FtM) in Sweden, 1973–2003. Study Entry Age: MtF: 36.3 (10.1, 21–69), FtM: 33.3 (8.7, 20–62) Random population controls (10:1) matched for birth year and sex (Table 2). Outcomes: Post Sex-reassignment Hazard Ratios Calculated on basis of Outcome incidence rates per 1000 person-years, 1973–2003
	Adjusted Hazard Ratios (aHR), 95% CI Suicide MtF (N=191): 13.9 (3.9-49.6) FtM (N=133) 40.0 (4.5-357.9) MtF & MtF (N=324) 19.1 (6.5-55.9) Attempted Suicide MtF (N=191): 15.4 (7.9-30.2) FtM (N=133) 2.9 (1.3-6.8) MtF & MtF (N=324) 7.6 (4.7-12.4)	Matched With Birth Sex and Birth Year: Table S1 (Separate Download) Outcomes: Post Sex-reassignment Hazard Ratios Calculated on basis of Outcome incidence rates per 1000 person-years, 1973–2003
	Adjusted Hazard Ratios (aHR), 95% CI Suicide MtF (N=191): 60.0 (7.2-498.4) FtM (N=133) 5.4 (1.6-18.6) MtF & MtF (N=324) 12.1 (4.8-30.8) Attempted Suicide MtF (N=191): 10.9 (5.9-20.0) FtM (N=133) 4.9 (2.0-12.1) MtF & MtF (N=324) 8.4 (5.1-13.8)	Matched With Final Sex and Birth Year: Table S2 (Separate Download) Outcomes: Post Sex-reassignment Hazard Ratios Calculated on basis of Outcome incidence rates per 1000 person-years, 1973–2003
Asscheman et al. (2011)	SMR (Standard Mortality Rate) for Suicide: MtF: n = 17 Suicides SMR: 5.70 (4.93–6.54), 95% CI FtM: n = 1 Suicide SMR: 2.22 (0.53–6.18), 95% CI ( Related Article)	Netherlands: VU University Medical Center All transsexual subjects referred to our outpatient department since 1975. 966 (72.6%) MtF transsexuals, with a mean age of 31.4 years at the start of cross-sex hormones (range: 16–76 years), with 18 678 patient-years of follow-up, and 365 (27.4%) FtM transsexuals, with a mean age 26.1 years (range: 16–57 years) at the start of hormone therapy with 6866 patient-years of follow-up.
Blosnich et al. (2014a)	"The study population consisted of VHA patients identified as having any one of four diagnosis codes indicating transgender status (n = 5,117) gathered from the VA National Patient Care Database. Mortality data were gathered from the National Death Index from 2000–2009 for 1,277 veterans with transgender-related ICD-9-CM diagnoses."	"Approximately 9.3% (n = 309) veterans with transgender-related ICD-9-CM diagnoses died across the study period... The crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses across the 10-year period was approximately 82/100,000 person-years, which approximated the crude suicide death rates for other serious mental illness in VHA (e.g., depression, schizophrenia). The average age of suicide decedents was 49.4 years... The crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses is higher than in the general population, and they may be dying by suicide at younger ages than their veteran peers without transgender-related ICD-9-CM diagnoses. Future research, such as age-adjusted rates or accounting for psychiatric co-morbidities, will help to better clarify if the all-cause and suicide mortality rates are elevated for veterans with transgender-related ICD-9-CM diagnoses."
* MtF: Male to Female - FtM: Female to Male

"Attempted Suicide" Incidences/Risks Transgender (TG) Populations: 2000 to 2017
Study	Sample Size (N) TG	Compa- rison Group	Attempted Suicide % (n / N)	Sampling Information Risk Ratio, p Odd Ratios, Specified
Xavier (2000) Washington D.C.	252 *MTF: 189	None	16%	70% African-American, 22% Latino/a, 8% Others. Age Range: 13 to 61 Years Nearly 80% = 36 years and under
** Nemoto (2001) San Francisco	MTF: 245	None	32%	MTF Of Color
	?		51%	African American
	?		31%	Latina
	?		18%	Asian / Pacific Islander
Nemoto et al. (2002) San Francisco	MTF: 332	None	29%	MTF Of Color ***8
	112		41%	African American - Mean Age: 36.5***
	110		45%	Latina - Mean Age: 32.9
	110		15%	Asian/Pacific Islander - Mean Age: 32.9
Mathy (2002b) Additional Results North American	73 TG 61 TG = Canadians 12 TG = Americans	1,083	23.3% vs 11.4%	TG vs. Random Heterosexual Females 2.9, p < .01
		1,077	23.3% vs 5.0	TG vs. Random Heterosexual Males 4.7, p < .001
		73	23.3% vs 11.0%	TG vs. Matched Females 2.1, p < .05
		73	23.3% vs 4.1%	TG vs. Matched Males 5.7, p < .001
		256	23.3% vs 16.0%	TG vs. Random Homosexual Females 1.5, ns
		356	23.3% vs 8.7%	TG vs. Random Homosexual Males 2.7, p < .001
Kenagy (2005) Philadelphia	All MTF: 182	None	30.1%	Volunteers: Face-to-Face Interview or Questionnaire - 41.3: African American, 33.0% white, 10.1% multiracial, 6.1& Hispanic, 5.6% biracial, 3.9% others. See also: Kenagy (1998)
	MTF: 113		32.4%
	* FTM: 69		26.2%
Operario & Nemoto (2005) San Francisco	MTF: 110 Asian Pacific Islanders	None	15% Same Sample as in Nemoto et al. (2002)	Volunteers: San Francisco **** Mean Age: 33, Range: 18 to 57 Years 46% of FTM = Filipino, 9% Laotian, 7% Vietnamese, 4% Hawaiian, remainder identifying as other Asian/PI ethnicities.
Clements- Nolle et al. (2006) San Francisco Additional Results	All TG: 515	None	32.2%	63.7% Non-White, 36.3% White
	MTF: 391	MTF vs. FTM	32.5%	OR = 1.04 (0.67, 1.6) ns, No Controls OR = 1.1 (0.59, 1.9), 9 Controls
	FTM: 123	MTF vs. FTM	31.7%
	White: 188	White vs. Non- White	37.8%	OR = 1.5 (1.02, 2.2), No Controls OR = 1.5 (0.92, 2.4), 9 Controls
	Others: 323	White vs. Non- White	28.8%
	< 25 Yrs: 66	< 25 vs 25 + Yrs	47.0%	OR = 2.1 (1.2, 3.5), No Controls OR = 2.17 (1.17, 4.01), 9 Controls
	25+ Yrs: 449	< 25 vs 25 + Yrs	30.1%
Zians (2006)	TG: 136	None	17.6% (24 / 136)	San Diego, California Mean Age: 38.3 (SD: 13.1) Age Range: 9 to 79 Years 48.3% White, 16.2% Latino, 14% African American, 10.3% Biracial
Kim et. al. (2006)	MTF: 43	49 Matched non-FTMs	62.8% (27 / 43)	Presenting at compulsory military service in 3 Korean Cities. Age Range: 19 to 23 Years
Taylor (2006)	TG: 73	None	28%	Winnipeg, Manitoba, Canada 49 Born Male, 21 Born Female, 3 Intersexed. 20 Aboriginal Age Range: 18 to 60+
Grossman & D'Augelli (2007)	31 MTF Mean Age: 17.5	None	6 / 31 19.3%	Volunteer Sample via two New York City GLBT Community Service Organizations. Age: 15-21 years Suicide Attempters were asked where, how, why, and lethality of suicide attempt(s) also determined. 50% Attempted at Age 15-16 years, Age Range: 10-17 Years. Note: These are serious suicide attempts as determined for GLB youth by D'Augelli et al. (2005): For NYC similarly sampled GLB Individuals, Attempted Suicide Incidence = 14.8%
Grossman & D'Augelli (2007)	24 FTM Mean Age: 19.5	None	8 / 24 33.3%
Xavier et al. (2007)	MTF & FTM N = 350	None	25.4%	'With participants from 60 of the 136 cities and counties in the State of Virginia, this is the first truly statewide needs assessment survey of a transgender population in the U.S.' Not given and cannot be calculated exactly from given results. Note*: Same sample as Testa et al. (2012) & Goldblum et al (2012) below
	MTF n = 229	None	< 25.4%*
	FTM n = 121	None	> 25.4%*
Malavé Lebrón & González Rivera (2009)	MTF n = 31	None	8 / 31 = 25.8%	Puerto Rico Volunteer transgender - transsexual (masculine to feminine). Ages of 20-45 years (MD= 29 years).
McNeil et al. (2012)	MTF, FTM + N = 581 ?	None	35% Once. 25% More Than Once.	See Information Table Below.
Testa et al. (2012)	MTF & FTM N = 350 Study Sample: 271	None	-	Odds Ratio, having attempted suicide if also exposed to physical violence: FTM OR: 5.1 -- MTF OR: 3.5 Odds Ratio, having attempted suicide if also exposed to physical violence: FTM OR: 5.0 -- MTF OR: 3.6 Note: Same online sample as Xavier et al. (2007) above & Goldblum et al (2012) below. State of Virginia study sample.
	MTF n = 179	None	26.3%
	FTM n = 92	None	34.0%
Goldblum et al. (2012)	MTF & FTM N = 350 Study Sample: 290	None	28.5%	Odds Ratio, having attempted suicide if also exposed to in-school gender-based victimization (GBV).: FTM OR: 4.5 -- MTF OR: 3.1 Note: Same online sample as Xavier et al. (2007) & Testa et al (2012) above. State of Virginia study sample.
	MTF	None	26.5%
	FTM	None	31/2%
Nuttbrock et al. (2010)	All MTF N = 571	-	-	MTFs recruited in conjunction with the baseline component of the New York Transgender Project, a large ongoing study of this population in the New York Metropolitan Area. Ages = 19 to 59, mean age = 37.
	Younger: 19-39 Years	None	31.2%
	Older: 39-59 Years	None	28.0%
Maguen & Shipherd (2010)	All: 153	None	18% 27 / 153	American Transgender participants (N = 153), 18-75 years, recruited at First Event, a regional transgender conference sponsored by the Tiffany Club of New England on January16 and 17, 2004.
	Trans Men MTF	None	41% 9 / 22
	Trans Women FTM	None	20% 12 / 60
	Bigender	None	9% 3 of 32
	male crossdressers	None	7% 2 / 28
Grant et al. (2010)	All: 6,450 Transgender	None	41%	American: Internet Sample "Attempted Suicide" Results by Age Groups, Employment Status and Race/Ethnicity See Table Below. Discrimination Results by Herman et al (2014): Table Below. For suicidality results related to many demographic factors, see: Haas et al (2014)..
Scanlon et al. (2010) Bauer et al. (2013)	All: 433 Transgender	None	Attempted Suicide: Lifetime: 43% Past year: 10%	Ontario, Canada Sample: Trans PULSE Survey. See Additional Suicidality Results, Including :"Attempted Suicide" Incidences as related to age and having experienced verbal or physical assault: Table Below.
Bauer et al. (2015)	All: 380 Transgender	None	Attempted Suicide: Past year: 11,2%	Same non-random study sample as above: Scanlon et al (2010) & Bauer et al. 2013). Analysis to identify suicidality related factors that could be targeted in suicide prevention efforts.
Terada et al. (2011)	MTF N = 189	None	31.7%: See "Suicidality Variable"	Study Sample: 500 consecutive Japanese GID patients without any other psychiatric comorbidity at outpatient GID Clinic of Okayama University Hospital. GID: Gender Identity Disorder. "Suicidality Variable": Self-mutilation including suicide attempts. Risk Factors: Early onset and less education.
Terada et al. (2011)	FTM N = 311	None	31.8%: See "Suicidality Variable"
Effrig et al. (2011)	Transgender, Combined, 2 Study Samples: 32 Clinical, 65 Nonclinical. Total = 97	Attempted Suicide, Lifetime: 8.4%, men & Women, Clinical Sample. 4.9%, men & Women, Nonclinical Sample.	Transgender Attempted Suicide, Lifetime: 25.7% 27 / 97	Nonclinical Participants: random national sample of 21, 686 college students. Average age of participants: 22 years (SD = 9.52). Clinical Sample Participants: 27,616 college students who sought counseling services at one of 66 CCMH counseling centers.
Singh (2012)	48 GID Males (of 139 GID Males) who had related data.	None	Attempted Suicide Since the Age of 13 Years: 15 / 48 31.2%	The participants were biological males referred to and then assessed in the Gender Identity Service, Child, Youth, and Family Program at the Centre for Addiction and Mental Health (CAMH) in Toronto, Ontario during their childhood and were adolescents or adults at the time of follow-up. Data collection occurred over three decades, 1986-2011.
Jones & Hillier (2013)	91 Trans-spectrum Youth. 1,265 Cisgender SSAY: Same Sex Attracted Youth. Age Range: 14 to 21 Average: 17 Years	Cisgender 30.12%	Trans- Spectrum Lifetime Self-Harm 46.15% p < 0.01	“Writing Themselves In” 2010: an Australian online survey. 91 trans-spectrum youth: 43 elected their sex as “Gender Queer,” 21 as “Transgender f-m,” 18 as “Trans-gender m-f,” and 9 as “Other.” The 3,043 cisgender SSAY youth: 1,265 were males (vast majority described themselves as gay/homosexual), 1,766 females with identifications more evenly divided between bisexual and gay/homosexual).
Jones & Hillier (2013)		Cisgender 16.10%	Trans- Spectrum Lifetime Attempted Suicide 27.47% p < 0.01
Blosnich et al. (2013)	GID Diagnosed VHA Population.	General VHA Population. [USA Veteran Health Adminis-tration]	GID: Suicide- Related Events = Planning Suicide, Attempting Suicide.	"GID prevalence in the VHA is higher (22.9/100 000 persons) than are previous estimates of GID in the general US population (4.3/100 000 persons). The rate of suicide-related events among GID-diagnosed VHA veterans was more than 20 times higher than were rates for the general VHA population."
Moody & Smith (2013)	133 Transgender Adults	None	26.3% 35 / 133 Attempted Suicide, Lifetime	Internet Sampling: Recruitment e-mails sent to possible participants via LGBT and trans LISTSERVs and organizations: September 2010 to February 2011. 133 Volunteer Canadian Participants, self-identified as trans adults, ranging in age from 18 to 75 years (M=36.75, SD=13.01).
Boza & Perry (2014)	255 Transgender Adults	None	43.6% 106 / 243 Attempted Suicide, Lifetime	Internet Non-Random Sampling; Online Study Advertisements & Snowballing for Australian Transgender Residents. Sample: 87 Born Female. 168 Born Male. Mean Age: 38.15 years (SD = 13.56, range = 18–73). Participants were predominantly of Oceanic (60.9%) or European (33.3%) ethnicity.
Clark et al. (2014)	Transgender n = 83 to 95.	Non- Transgender: Attempted Suicide: 315 / 7,678 = 4.1%	Transgender: Attempted Suicide: 19 / 95 = 19.8% Odds Ratio: 5.0 (2.9-8.8)	Youth’12: a national, crosssectional, population-based survey: secondary school youth health, New Zealand. Self-Harm: 45.5% vs. 23.4%. OR: 2.7 (1.7-4.3). Depression: 41.3% vs. 11,8% OR: 5.7 (3.6-9.2)
de Bolger et al. (2014)	Trans Men n = 230 Female at birth.	None	Attempted Suicide: 79 / 222 = 35.1% Self-Harm 150 / 222 = 67.6%	Australian trans men aged 16 years and over. Recruited via gender centres, gender clinics, and government and non-government organisations. Survey completed online. Age range = 16 to 64 years. Mean = 30.5 years.
Reisner et al. (2014)	Transgender n =31	Cisgender n = 2,622 Attempted Suicide, Lifetime: 8.5%	Transgender Attempted Suicide, Lifetime: 29.0%	Results from the Core Data Project survey of patients engaged in medical care from 2001–2002 at Fenway Community Health Center (FCHC) in Boston, Massachusetts.
Reisner et al. (2015)	Transgender n =31	Cisgender n = 180 Attempted Suicide, Lifetime: 6.1%	Transgender Attempted Suicide, Lifetime: 17.2% RR, With Controls: 3.2 (1.5-6.7)	A retrospective cohort study of electronic health record data from 180 transgender patients aged 12-29 years seen between 2002 and 2011 at at the Fenway Community Health Center (FCHC) in Boston, Massachusetts. Transgender compared with matched cisgender (nontransgender) youth patients.
Veale et al. (2015)	923 Trans Youth: 14 to 25 Years Old	None	Suicidality, past 12 months, younger youth (14-18 years old): Attempted suicide: 37% Had seriously considered suicide: 65% Lifetime suicidality, older youth (19-25 years old): Attempted suicide: 37% Had seriously considered suicide: 65%	Youth could participate in the study if they were between 14 and 25 years old, lived in Canada, and identified as trans or genderqueer, or felt their gender didn’t match their body. The survey was open from October 1, 2013 to May 31, 2014.Volunteer study participant: 923 youth, average age = 20 years old, 70% white. Overall, 1 in 10 participants identified as Aboriginal, which included First Nations, Inuit, and Métis. This number was much higher in the Prairie Provinces. Same study sample as Veale et al. (2017).
Guzmán- Parra (2015)	MTF n=101 FTM n = 96	None	Attempted Suicide, Lifetime: 21.8%, MTF Attempted Suicide, Lifetime: 24.0%, FTM	Study of the sociodemographic characteristics and the psychological adjustment of transsexuals in Andalusia (Spain), with an analysis of the differences between female-to-male (FtM) and male-to-female (MtF) transsexuals. The sample was selected from patients attending theTGIU [Transsexuality and Gender Identity Unit (TGIU) at the Carlos Haya Hospital in Malaga] who met the Transsexualism criteria for the ICD-10 (F64.0) standards and did not meet any of the exclusion criteria for sex reassignment set by the unit.
Marshall et al. (2015-16)	Transwomen n = 438 Transwomen n = 44 N = 482	None	Attempted Suicide, Lifetime: Transwomen 141 / 438 = 25,1% Transmen 18/ 44 = 40.9% All: 159 / 482 = 33.0%	Non-random - as representative as possible - nation-wide, cross-sectional 2013 survey of transgender individuals living in Argentina. Median Age = 30 Years
Perez-Brumer et`al. (2015)	MTF n = 697 FTM n = 532 All: N = 1,229	None	Attempted Suicide, Lifetime: 355 / 1,097 = 32.4% Attempted Suicide, Past Year 51 / 796 = 6.4%	2003 cross-sectional Internet-based health assessment of American transgender adults. Only 1,097 transgender individuals supplied lifetime suicidality information. Only 796 transgender individuals supplies past-year suicidality information.
Olsen et al. (2015)	MTF n = 50 FTM n = 51 All: N = 101	None	Attempted Suicide, Lifetime: Transfeminine 27% Transmasculine 33%	Baseline Characteristics, Trans-gender Youth Seeking Care for Gender Dysphoria in Los Angeles. Mean Ages: Transfeminine (19.8 Years), Transmasculine (18.6 Years).
Brown et al. (2015)	Transgender n = 5,135	Non- transgender n = 15,405 Suicide Ideation and/or Attempted Suicide, Lifetime: 4.5%	Suicide Ideation and/or Attempted Suicide, Lifetime: 19.4% ORs, Not Adjusted / Adjusted: 5.22 (4.7–5.8) 4.10 (3.7–4.6)	Study of a cohort of 5,135 TG veterans treated in the Veterans Health Administration (VHA) between 1996 and 2013. A matched 1:3 case–control design used to determine medical and/or mental health disparities existing in the TG veteran population. See Brown et al. (2014) for Transgender White / Black Veterans' Suicide Ideation and/or Attempted Suicide Incidences: 19.2% / 21.2%
Su et al. (2016)	Transgender n = 85	LGB Nontrans- gender n = 665 Attempted Suicide, Lifetime: 15.9%	Attempted Suicide, Lifetime: 37.6%	2010 online survey over the large geographical area of Nebraska, USA. Participants were self-identified lesbian, gay, bisexual, and/or transgender persons over the age of 19. A multipronged recruitment strategy was used. 770 LGBT Nebraskans in the study
Aitken et al. (2016)	Gender Dysphoric Children n = 572	Siblings n = 425 Lifetime. Self-Harm / Attempted Suicide: 2.2%	Lifetime. Self-Harm or Attempted Suicide: 6.6%	Gender Dysphoric Children n = 572, 463 Boys, 109 Girls, Age: 3 to 12 Years. Siblings, n = 425, 239 Boys, 186 Girls. Age: 3 to 12 Years. Other comparisons also given: Other clinic referred and non-referred children. Plus results from another somewhat similar study.
Barboza et al. (2016)	Transgender Men and Women n = 350	None	Attempted Suicide, Lifetime: 25%	Virginia Transgender Health Initiative Survey (THIS). Most identified their gender as man (19.4%), woman (25.4%) or transgender (41.7%), their sexual preference as heterosexual (20.9%), gay (15.4%), lesbian (13.4%) or bisexual (17.1%). 39% under the age of 30. A majority = low socioeconomic status
Grossman et al. (2016)	Transgender / Gender Non- conforming TGNC n =129	None	Attempted Suicide, Lifetime: TGNC: 24.4% 29 / 119 FTM: 18.4% 7 / 38 MTF: 15.4% 6 /39 FTDG: 46.4% 13 / 28 MTDG: 21.4% 3 / 14	Youth recruited in three U.S. cities from community organizations and college groups for LGBTQ youth, by invitations placed on websites frequented by LGBTQ youth in those cities and by inviting youth participating in LGBTQ Pride activities. 14 (11%) female to male (FTM), 44 (34%) male to female (MTF), 31 (24%) female to different gender (FTDG), and 14 (11%) male to different gender. Age Range = 15 to 21 Years, Mean = 18 Years.
Kaplan et al. (2016)	Trans Feminine Individuals n = 54	None	Attempted Suicide, Lifetime: 46.3% 25 / 54	Age Range = 18 to 58 Years Average Age = 27 Years Long chain referral sampling of volunteer transgender individuals assigned male sex at birth, currently identifying as a woman or trans, age 18 years or older, residing in greater Beirut, Lebanon.
Lehavot et al. (2016)	USA Transgender Veterans n = 212	None	Attempted Suicide, Lifetime: 32.1% 68 / 212 Did not want to die: n = 17 Really hoped to die: n = 51	Online, convenience sample of 212 U.S. transgender veterans surveyed from February to May, 2014.
Lytle et al. (2016-17)	White Non-Hispanic Transgender & Cisgender College Students n =77,775	Cisgender n = 77,685 Attempted Suicide, One Year: 0.9%	Transgender n = 90 Attempted Suicide, One Year: 10.0% OR = 12.2	Fall 2008 and Spring 2009 surveys of the American College Health Association (ACHA) National College Health Assessment-II. For Additional Information, including comparisons within the GLBQ & Heterosexual groups, and also for Self-Harm comparisons, see Table Below.
Lytle et al. (2016-17)	Non-White Transgender & Cisgender College Students n = 30,574	Cisgender n = 30,501 Attempted Suicide, One Year: 1.5%	Transgender n = 73 Attempted Suicide, One Year: 29.6% OR = 27.6
Peterson et al. (2016-17)	96 transgender adolescents and emerging adults (aged 12–22 years) presenting with gender dysphoria.	None	Attempted Suicide, Lifetime: 30.3% 27 / 89 Self-Harm, Lifetime: 41.8%	Data from a retrospective chart review of 96 patients at Cincinnati Children’s Hospital Medical Center Transgender Clinic. Mean age of 17.1 years (SD = 2.3). Study Sample = 54 FTM*, 31 MTF, and 15 nonbinary/gender fluid.
Veale et al. (2017)	839 transgender youth sampled online, non-random	2 other Canadian study results used as comparisons with study results	14-18 Years: Attempted Suicide, Past Year: 36.1% 19-25 Years: Attempted Suicide, Lifetime: 37.8% Attempted Suicide, Past Year: 11.3% For results on identity basis, see Table Below.	Canadian Trans Youth Health Survey (2014, Online, French, English): Recruited via transgender and queer community organizations, distributing a call for participants through social media, and the study’s research team, and network including pediatric endocrinology clinics across Canada. Age = 14 to 25 years. 14-18 years (n - 300): 32 transgender girls/women (11%), 140 transgender boys/men (47%), and 128 (42%) nonbinary youth. 19-25 years (n = 539): 107 transgender girls/women (20%), 216 transgender boys/men (40%), and 216 nonbinary youth (40%). 14-18 Years: Self-Harm, Past Year: 74.9%
* MTF: Male to Female - FTM: Female to Male The Nemoto (2001) Study Sample is Likely a Subset of Nemoto et al. (2002) Study Sample. * Mean Ages are from Nemoto et al. (2004). **** Face-to-Face Interviews.

The Mathy (2002b) Study of Transgender Suicidality North America: Internet Survey
Categories	TG	Random Heterosexual		Matched		Homosexual
Gender *	TG	F	M	F	M	F	M
N's	73	1,083	1,077	73	73	256	356
Mean Age SD Age Range	36.9 (10.0) 19-58	30.1 (9.3) 18-76	33.7 (11.0) 18-80	36.0 (9.8) 19-53	37.0 (10.0) 19-56	33.7 (8.9) 18-69	33.0 (9.7) 18-70
Attempted Suicide / Self-Harm **	23.3%	11.4%	5.0%	11.0%	4.1%	16.0%	8.7%
*** Risk Ratio: TG vs. Specified Category		2.9	4.7	2.1	5.7	1.5	2.7
p		< .01	< .001	< .05	< .001	ns	< .001
* TG = Transgender - M = Males - F = Females -- * Not Given in Mathy (2002b) Suicide Question: "I have made a serious suicide attempt or gesture." Yes/No Sampling: News Web Site: MSNBC - Every 1000th visitor: USA, Canada - A Sexuality Survey Using mostly counts from random sample, but also from volunteer sample. TG (Transgender) Sample: N = 73, 61 Canadian, 12 American, with 12 / 73 from random sample.

The Clements-Nolle et al. (2006) Study of Suicidality* In The San Francisco Transgender Population
Categories	Attempted Suicide Lifetime: % (n / n)	Odds Ratio (95%CI) Unadjusted **	Odds Ratio (95%CI) Adjusted
All, N = 515	32.2% (166 / 515)
MTF, n = 391 Male-to-Female	32.5% (127 / 391)	1.04 (0.67, 1.6) ns	1.1 (0.59, 1.9) Controls: 9 Variables
FTM, n = 123 Female-to-Male	31.7% (39 / 123_	1.04 (0.67, 1.6) ns	1.1 (0.59, 1.9) Controls: 9 Variables
White	37.8% (71 / 188)	1.5 (1.02, 2.2) p = 0.036	1.5 (0.92, 2.4) Controls: 9 Variables
Non-White	28.8% (93 / 323)	1.5 (1.02, 2.2) p = 0.036	1.5 (0.92, 2.4) Controls: 9 Variables
< 25 Years-Old	47.0% (31 / 66)	2.1 (1.2, 3.5) p = 0.006	2.17 (1.17, 4.01) Controls: 9 Variables
25 + Years-Old	30.1% (135 / 449)	2.1 (1.2, 3.5) p = 0.006	2.17 (1.17, 4.01) Controls: 9 Variables
Volunteers Interviewed. 37% White, 23% Black, 23% Latino/a, 11% Asian/PI, 5% Native American Median Age: 34, Age Range: 18 to 67 Years The "Attempted Suicide" 32% Lifetime Incidence was First Reported by Clements-Nolle et al. (2001) ** Odds Ratios Not Given. Calculated From Given Counts

Transgender and Transsexual People in Sweden An Internet Sample, N = 374 *
Age Group	Attempted Suicide Incidence, Lifetime
16 - 29 Years	27%, n = ?
30 - 44 years	28%, n = ?
45 - 54 years	12%, n = ?
55 - 64 Years	21%, n = ?
* Web Survey Data: Reported in National Public Health Survey, 2005. Results also reported by Winzer & Boström (2007) For comparison of Transgender Suicidality results to GLB & Heterosexual Results, See Table.

Transgender and Transsexual People in France An Internet Sample, N = 90
Group 16 to 26 Years-Old	Attempted Suicide Incidence, Lifetime
All N = 90	34%
FTM n = 60 Approximately	34%
MTF n = 30 Approximately	32%
Data Source: L’équipe Trans du MAG / La Commission Trans d’HES (2009)

Irish Transgender Study An Internet Sample: N = 106
Frequency	Attempted Suicide, Lifetime n = 85
Once	12%
Two to Five Times	22%
More Than Five Times	6%
One or More Times	40%
Data Source: TENI: Transgender Equality Network Ireland (2012) Additional Suicidality & Self-Harm Data is Given

Transgender and Transsexual People in the United Kingdom An Internet Sample, N = 872**
Frequency	Attempted Suicide / Self-Harmed in Adulthood*
Once	14%
Twice	7%
Three or More Times	14%
One or More Times	34.4%
Resulting from being a crossdresser, transgender/transsexual person or because of other people’s reactions to them being trans. Note: Data was solicited on suicidality before the age of 21 years, but the results were not reported. In Whittle et al. (2008), the incidence in this category was reported to be also 34%. * Sample may include duplicates? Data Source: Whittle et al. (2007)

Transgender and Transsexual People in Europe An Internet Sample, N = 985 (UK = 322)**
Frequency	Attempted Suicide / Self-Harmed in Adulthood*
Once	?
Twice	?
Three or More Times	?
One or More Times	29.9%
Resulting from being a crossdresser, transgender/transsexual person or because of other people’s reactions to them being trans. Note: Data was solicited on suicidality before the age of 21 years, but the results were not reported. * Duplicates Removed. Data Source: Whittle et al. (2008)

National Transgender Discrimination Survey Report On Health and Health Care (USA, 2010): Attempted Suicide
Categories	Attempted Suicide, Lifetime	Categories (% of Sample)	Attempted Suicide, Lifetime
All: 6,450	41%	White (76%)	38%
Age: 18-44	45%	Asian (2%)	39%
Age: > 65	16%	Latino/Latina (5%)	44%
Employed	37%	African American (5%)	45%
Unemployed	51%	Multi-Racial (11%)	54%
Lost Job Due to Bias	55%	Native American (1%)	56%
Street Economy	60%
Data Source: Grant et al. (2010) See More Results Below: By Herman et al. (2014)

National Transgender Discrimination Survey: Some Discrimination Related Attempted Suicide Results
Categories	Attempted Suicide, Lifetime Incidence
All: 6,456	41%
Family chose not to speak/spend time with them.	57%
Harassed or bullied at school: any level.	50-54%
Experienced discrimination or harassment at work.	50-59%
Doctor or health care provider refused to treat them.	60%
Suffered physical or sexual violence at work.	64-65%
Suffered physical or sexual violence at school (any level).	63-78%
Disrespected or harassed by law enforcement officers.	57-61%
Suffered physical or sexual violence by law enforcement officers.	60-70%
Experienced homelessness.	69%
Data Source: Herman et al. (2014)

Ontario’s Trans Communities and Suicide (Canada, 2010): Seriously Considered Suicide & Attempted Suicide
Categories	Age: 16-24 Years	Age: 25 + Years	Experienced Physical or Sexual Assault	Experienced Verbal Harassment or Threats	No Assaults or Verbal Harassment or Threats	All N = 433
Attempted Suicide, Lifetime	-	-	-	-	-	43%
Seriously Considered Suicide, Lifetime	-	-	-	-	-	77%
Seriously Considered Suicide, Lifetime, Because of Being trans	-	-	-	-	-	50%
Attempted Suicide, Past Year	19%	7%	29%	8%	4%	10%
Seriously Considered Suicide, Past Year	47%	27%	47%	33%	26%	32%
Data Source: Scanlon et al. (2010), Bauer et al. (2013): 'Data collected via respondent-driven sampling (RDS) in 2009–2010 as part of the Trans PULSE Project, a community-based research study in Ontario, Canada.' 'The information was collected using a unique research method that allowed us to take the most statistically accurate picture of trans people possible.'

Transgender Self-Harm & Attempted Suicide USA National College Health Assessment: 2008-09
Groups Compared	Self-Harm % ¹	Odds Ratio ²	Attempted Suicide % ¹	Odds Ratio ²
Racial / Ethnic Minorities (Non-White)
Transgender n = 73	38.0%	10.9	29.6%	27.6
Cisgender n = 30,501	5.3%		1.5%
Non-Hispanic White
Transgender n = 90	27.8%	7.3	10.0%	12.2
Cisgender n = 77,685	5.0%		0.9%
LGBQ (Lesbian / Gay / Bisexual / Questioning)
Transgender n = 123	41.3%	4.2	25.6%	9.8
Cisgender n = 7,388	14.4%		3.4%
Heterosexual
Transgender n = 45	13.3%	3.3	4.4%	5.1
Cisgender n = 103,025	4.5%		0.9%
Data Source: Lytle et al. (2016) 1. Incidences (percent), if occurring in the past year, given by study authors. Similar incidences for depression, suicide ideation, and having sought suicide prevention information were also produced. Note: Average age for study sample = 21.15 years, for cisgender students = 21.14 years, and for transgender students = 28.24 years. 2. Transgender vs. Cisgender (Non-Transgender) within specified groups. Basic ORs calculated by webpage author using this calculator: http://statpages.info/ctab2x2.html . n = 100 assumed for both groups with percentages becoming the Present / Absent numbers. Example: 38.0 Present / 62.0 Absent vs. 5.3 Present / 94.7 Absent. This quickly produces accurate ORs (10.9 for this example), but the 95% confidence intervals are not accurate. However, given the n sizes and large ORs, it is expected that all ORs produced would be statistically significant.

Suicidality, Transgender / Transsexual Internet Sample, United Kingdom
Demography
Living Location / Race / Age (n = 518) England: 84% Scotland: 11% Wales: 4% Northern Ireland, Ireland; < 1% White: 86% Age: 18 to 78 Years	Gender Identity (N = 794) Constant and clear gender identity as a woman (40%), man (25%). Variable or fluid non-binary (15%). Constant and clear non-binary (85). Unsure (6%), Other (3%), and No gender identity (3%)	Sexual Orientation (N = 530) Bisexual (27%), Queer (24%), Straight or heterosexual (20%), Pansexual (15%), BDSM/Kink (14%), Lesbian (13%), Not sure or questioning (12%), Other (11%), Don’t define (10%), Gay (10%), Polyamorous (9%), Asexual (8%).

Suicidality
"The majority of participants, 84%, had thought about ending their lives at some point (N=581). These participants were then asked for more information about their experiences. 27% of those who had thought about ending their lives at some point, had thought about attempting suicide within the last week (N=471) with 4% thinking about it every day. In the last year 63% had thought about attempting suicide (N=472) with 3% thinking about it daily. Prevalence of actual suicide attempts, among those who had thought about ending their lives at some point, was 11% within the last year (N=427), however lifetime prevalence was substantially higher, at 48% (N=436). 33% had attempted to take their life more than once in their lifetime, 3% attempting suicide more than 10 times. More significantly, 11% of the respondents were unsure as to whether they were planning to attempt suicide in the near future, and 3.2% were planning to (N=473). When the participants who had never thought about suicide (and therefore were not asked further questions about suicidal ideation and attempts) are factored back in, this results in overall suicide attempt rates (N=581) of 35% attempting suicide at least once and 25% attempting suicide more than once. Suicidal ideation and actual attempts reduced after transition, with 63% thinking about or attempting suicide more before they transitioned and only 3% thinking about or attempting suicide more post-transition. 7% found that this increased during transition, which has implications for the support provided to those undergoing these processes (N=316)." P. 59
Data Source: McNeil (2012)

Suicidality & Self-Harm Canadian Trans Youth Health Survey (2014)
Categories	Transgender Boys/Men n, %	Transgender Girls/Women n, %	Nonbinary ¹ n, %
Ages: 14 to18 Years
Seriously Considered Suicide, Past Year	90, 68.9%	20, 55.0%	93, 64.5%
Attempted Suicide, Past Year	90, 44.2%	20, 21.1%	94, 34.4%
Self-Harm, Past Year	106, 79.2%	24, 50.0%	100, 77.0%
Ages: 19 to 25 Years
Seriously Considered Suicide, Lifetime	138, 76.8%	65, 66.2%	129, 76.7%
Attempted Suicide, Lifetime	51, 43.1%	33, 21.2%	69, 42.0%
Seriously Considered Suicide, Past Year	141, 36.9%	68, 46.2%	97, 41.7%
Attempted Suicide, Past Year	53, 11.3%	34, 8.8%	70, 11.4%
Self-Harm, Past Year	150, 48.0%	77, 40.3%	150, 60.7%
Data Source: Veale et al. (2017) 1. Participants who responded as “transgender and identify in some other way,” rather than as boys/men or girls/women.

The 2015 National Canadian Homeless Youth Survey ¹
Categories	n, % of Sample	Lifetime Attempted Suicide
Cisgender Males	620, 56%	39%
Cisgender Females	390, 35%	59%
Cisgender & Heterosexual	752, 68%	39%
Sexual & Gender Identities	319, 28%	70% ³
Aboriginal / First Nations ²	314, 29%	54%
Black	142, 13%	Black, Latin American + Other Racial Minorities 41%
Latin American	38, 3.5%	Black, Latin American + Other Racial Minorities 41%
Indigenous / White		51%
White	676, 61%	?
Data Source: Kidd et al. (2017-18) 1. "A total of 1161 youth completed the survey, and after cleaning, 1,103 were retained (cases with key demographic data and measures omitted were excluded). Data were collected from the Nunavut territory and all provinces except for Prince Edward Island... The largest amounts of data were collected from Ontario (n = 482; 44%), British Columbia (n = 238; 22%), and Alberta (n = 154; 14%) and the least from Nunavut (n = 2; 0.2%) and Manitoba (n = 16; 1.4%). Data were primarily gathered in large urban centres such as Toronto (n = 193; 18%), Vancouver (n = 167; 15%), Edmonton (n = 82; 7.4%), Ottawa (n = 67; 6.1%), and St. John’s (n = 67; 6.1%)." 2. The attempted suicide incidence for aboriginal LGBTQ2S (lesbian, gay, bisexual, transgender, queer, and 2 spirit) individuals is not reported. Aboriginal youth are overrepresented in the Canadian homeless youth population as is also the case for the general LGBTQ2S population that is overrepresented in the suicide attempter population 3. The "attempted suicide" Risk Ratio & Odds Ratio relationship between sexual & gender identity minorities and cisgender & heterosexual homeless youth (70% vs.39%) is RR = 1.8, OR = 3.6. RR / OR generated at http://statpages.info/ctab2x2.html

Suicide/Suicidality Risk: Psychiatric Patients Homosexuality & Bisexuality
Study	Homosexuality As Suicide/Suicidality Risk Factor	Study Information
Motto et al. (1985)	High Risk For Suicide: Being bisexual and sexually active, or homosexual and inactive (celibate)	Follow-up USA study of 2,753 adults "hospitalized due to a depressive or suicidal state" USA
Marten et al. (1985)	Homosexuals accounted for one-third of the suicide deaths	A prospective USA study of 500 randomly selected psychiatric outpatients during a mean follow-up period of seven years.
Pretorius (1992) Thesis	For males, subsequent suicide attempts were associated with: Being Single, Homosexuality, and Other Factors	All cases of attempted suicide referred to the Department of Psychiatry at the University of Pretoria were studied over a period of a year. A total of 307 patients, 86 males and 221 females, were evaluated. After 5 years, as many as possible were traced: 59 males and 205 females.
Note: After 1985, homosexuality issues have generally been ignored in studies of the suicide & suicidality of psychiatric patients.

Review & Meta-Analysis Papers
Sexual Minority Suicidality & Mental Disorders

Review Papers

Saunders JM, Valente SM (1987). Suicide risk among gay men and lesbians: A review. Death Studies, 11(1): 1-23. Abstract.

Remafedi G (1999). Suicide and sexual orientation: nearing the end of controversy? Archives of General Psychiatry, 56(10): 885-6. PDF Download.

Bagley C, Tremblay P (2000). Elevated rates of suicidal behavior in gay, lesbian and bisexual youth. Crisis, 21(3): 111-17. (Review) Internet draft of the paper: Full Text. PubMed Abstract.

Tremblay P, Ramsay R (2000). Orientations homosexuelles ou bisexuelles chez les jeunes présentant des problème suicidaires: recherche, problématique et propositions. Le Vis-À-Vie, 10(2): 5-8. (Review) Internet English version of the paper: Full Text. Full Text (French). Translation.

Kulkin HS, Chauvin EA, Percle GA (2000). Suicide among gay and lesbian adolescents and young adults: a review of the literature. Journal of Homosexuality, 40(1): 1-29. (Review) PubMed Abstract.

Morrison LL, L'Heureux J (2001). Suicide and gay / lesbian / bisexual youth: implications for clinicians. Journal of Adolescence, 24(1): 39-49. PubMed Abstract. Full Text: PDF Download. PDF Download.

McDaniel JS, Purcell DW, D'Augelli AR (2001). The relationship between sexual orientation and risk for suicide: research findings and future directions for research and prevention.. Suicide and Life-Threatening Behavior, 31(Suppl.): 84-105. (Review) In: DHHS / CDC (2001). Suicide Prevention Now: Linking Research to Practice, pp. 190-218. PDF Download. PubMed Reference.

Lebson M (2002). Suicide among homosexual youth. Journal of Homosexuality, 42(4): 107-17. Abstract.

Meyer, IH (2003). Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychological Bulletin, 129(5): 674–697. Summary. Abstract. Full Text.

Russell ST (2003). Sexual minority youth and suicide risk. American Behavioral Scientist, 46(9): 1241-1257. Abstract. PDF Download.

McAndrew S, Warne T (2004). Ignoring the evidence dictating the practice: sexual orientation, suicidality and the dichotomy of the mental health nurse. Journal of Psychiatric and Mental Health Nursing, 11(4): 428-34. PubMed Abstract.

Julien D, Chartrand E (2005). Recension des études utilisant un échantillon probabiliste sur la santé des personnes gaies, lesbiennes et bisexuelles. Canadian Psychology/Psychologie canadienne, 46(4): 235-250. Abstract. Summary / Extract (French). Translation.

Schlatter J, Irala J, Escamilla I (2005). Psicopatología asociada a la homosexualidad [Psychopathology related to homosexuality.]. Revista de Medicina de la Universidad de Navarra, 49(3): 69-79. PDF Download. Translation.

Suicide Prevention Resource Center (2008). Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth. Newton, MA: Education Development Center, Inc. Prepared by the Suicide Prevention Resource Center for the Center for Mental Health Services Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services. Download: http://www.sprc.org/library/SPRC_LGBT_Youth.pdf. Download Page.

King M, Semlyen J, Tai SS, Killaspy H, Osborn D, Popelyuk D, Nazareth I (2008). A Systematic Review of Mental Disorder, Suicide, and Deliberate Self Harm in Lesbian, Gay and Bisexual People. BMC Psychiatry. Full Text. Full Text. Abstract.

Leu, Christian (2008). Orientation sexuelle et comportements suicidaires: Une enquête sur les résultats de la recherche internationale et nationale sur les facteurs de risque et de protection pour les adolescents homosexuels et bisexuels. Berne, La Suisse / Switzerland: Le collectif Formation de PINK CROSS, LOS et fels. Full Text N/A. Download Page N/A. Word Download. Translation N/A. Download Page N/A. Full Text. Download Page. Translation.

Leu, Christian (2008). Sexuelle Orientierung und Suizidalität: Eine Untersuchung der internationalen und nationalen Forschungs-ergebnisse der Risiko- und Schutzfaktoren für adoleszente Homo- und Bisexuelle. bern, Switzrland: PINK CROSS, LOS und fels. Full Text N/A. Download Page N/A. Word Download. Download Page N/A. Translation N/A. PDF Download N/A. Translation N/A. Full Text. Download Page. Translation.

Lhomond B, Saurel-Cubizolles MJ (2009). Orientation sexuelle et santé mentale: une revue de la littérature [Sexual orientation and mental health: a review]. Revue d'épidémiologie et de santé publique, 57(6): 437-50. Abstract. Download Page: In two Documents: Text & Tables. Download Page. Word Download.

Haas AP, Eliason M, Mays VM, Mathy RM, Cochran SD, D'Augelli AR, Silverman MM, Fisher PW, Hughes T, Rosario M, Russell ST, Malley E, Reed J, Litts DA, Haller E, Sell RL, Remafedi G, Bradford J, Beautrais AL, Brown GK, Diamond GM, Friedman MS, Garofalo R, Turner MS, Hollibaugh A, Clayton PJ (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. Journal of Homosexuality, 58(1): 10-51. Abstract. Full Text: Open Access. Full Text.

Meta-Analyses

Plŏderl M, Wagenmakers EJ, Tremblay P, Ramsay R, Kralovec K, Fartacek C, Fartacek R (2013). Suicide Risk and Sexual Orientation: A Critical Review. Archives of Sexual Behavior, 42(5): 715-727. Includes a meta-analysis. Download Page for Paper Draft PDF @ Dr. Martin Plöderl's Website. ResearchGate Full Text.

Online Additions to the Paper: "A Critical Examination of the Shaffer et al. (1995) & Renaud et al. (2010) Psychological Autopsy Studies of Adolescent Suicides" & "An Expanded Homosexuality Factor in Adolescent Suicide."

Stone DM, Luo F, Ouyang L, Lippy C, Hertz MF, Crosby AE (2014). Sexual orientation and suicide ideation, plans, attempts, and medically serious attempts: evidence from local youth risk behavior surveys, 2001-2009. American Journal of Public Health, 104(2): 262-71. Abstract. Suicidality results for 2001 to 2009 Youth Risk Behavior Surveys used in large American cities generally with large Hispanic and African American populations: Boston, Chicago, New York, San Diego, San Francisco. The "more at risk for the more serious suicidal behaviors" often does not apply, also depending on the sexual minority group being described and the sex of individuals.
For more on this issue see related webpage.

Marshal MP, Dietz LJ, Friedman MS, Stall R, Smith HA, McGinley J, Thoma BC, Murray PJ, D'Augelli AR, Brent DA (2011). Suicidality and depression disparities between sexual minority and heterosexual youth: a meta-analytic review. Journal of Adolescent Health, 49(2): 115-123. Abstract. PDF Download. "SMY [Sexual Minority Youth] reported significantly higher rates of suicidality (odds ratio [OR] = 2.92) and depression symptoms (standardized mean difference, d = .33) as compared with the heterosexual youth. Disparities increased with the increase in the severity of suicidality (ideation [OR = 1.96], intent/plans [OR = 2.20], suicide attempts [OR = 3.18], suicide attempts requiring medical attention [OR = 4.17]). Effects did not vary across gender, recruitment source, and sexual orientation definition.'

Kann L, Olsen EO, McManus T, Kinchen S, Chyen D, Harris WA, Wechsler H; Centers for Disease Control and Prevention (CDC) (2011). Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9-12: Youth Risk Behavior Surveillance, Selected Sites, United States, 2001- 2009. MMWR Early Release 2011; 60. June 6: 1-113. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s_cid=ss60e0606a1_w. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6007a1.htm. Results, problem and related issues are presented in another webpage. A major problem seems to exist when combining sexual minority Youth Risk Behavior Survey suicidality results from large cities and states.

Plöderl M, Kralovec K, Fartacek C, Fartacek R (2009). Homosexualität als Risikofaktor für Depression und Suizidalität bei Männern. Blickpunkt DER MANN: 7(4): 28-37. PDF Download. Translation. Download Page for Paper PDF @ Dr. Martin Plöderl's Website.

Plöderl M, Sauer J, Reinhold FR (2006). Suizidalität und psychische Gesundheit von homo- und bisexuellen Männern und Frauen – Eine Metaanalyse internationaler Zufallsstichproben. Verhaltenstherapie & psychosoziale Praxis, 38(2): 283-302. Abstract. Related Conference Presentation PDF. Translation. Download Page for Paper PDF @ Dr. Martin Plöderl's Website.

Dennert G (2006). Die psychische Gesundheit von Lesben und Schwulen - eine Übersicht europäischer Studien. Verhaltenstherapie & psychosoziale Praxis, 38(3): 559-576.

Note 1

Study (France): Homosexual males are 13 times more likely to have attempted suicide, compared to heterosexual males. Result for the sample of 993 men - sampled in 3 locations - were generated by controlling for age, living area, education level, professional status, parental status, marital/partner status.

Homosexual/Heterosexual Male Study Results Reported by Chemin (2005) in Le Monde: "Les résultats préliminaires du travail de Marc Shelly, médecin de santé publique et responsable du centre de dépistage anonyme et gratuit de l'hôpital parisien Fernand-Widal, font apparaître que, "toutes choses égales par ailleurs" - âge, lieu de résidence, niveau d'études, catégorie socioprofessionnelle, structure familiale parentale, modes de vie (couple ou célibat) -, les jeunes homosexuels ont treize fois plus de risque de faire une tentative de suicide que les jeunes hétérosexuels. Ces résultats confirment les chiffres issus des études américaines, canadiennes et australiennes : elles aboutissent, chez les homosexuels, à des chiffres de "sursuicidalité" variant de six à treize.

Les chiffres français ont été obtenus à partir d'un échantillon de 993 hommes âgés de 16 à 39 ans. Tous ont raconté leur trajectoire "socio-biographique" en remplissant un long questionnaire informatisé installé, de 2000 à 2004, sur trois sites : le festival de lutte contre le sida Solidays, qui a lieu tous les ans en région parisienne, le Centre d'information et de documentation pour la jeunesse (CIDJ), à Paris, et le centre de sélection des appelés du contingent de Blois, dans le Loir-et-Cher."

Preliminary Results for a subsample of the above study (Shelly et al. 2002): Homosexual males are 6 times more that risk for having attempted suicide than are heterosexual males. Suicide Attempt incidence for homosexual males: 30%.

The Same Study: Homosexual males more at risk for having been sexually abused as children. Internet Reference: http://www.thewarning.info/IMG/doc/aremedia_abus.pdf .

Summary of Study Status: "Menée entre 1998 et 2003 auprès de 933 hommes, âgés de 16 à 39 ans, l'étude réalisée par Marc Shelly (médecin en santé publique à l'hôpital parisien Fernand-Widal ) et David Moreau (ingénieur de recherche à l'association de prévention Aremedia) a été préparée et validée par Pascale Tubert-Bitter, directrice de recherche à l'Institut national de la santé et de la recherche médicale (Inserm) à l'unité biostatistique et épidémiologie. Les résultats de cette enquête menée en dehors des associations et chercheurs LGBT sont encore en cours d’étude, seuls les résultats sur les homos et les bisexuels masculins étant actuellement totalement traités. " Internet Reference: http://v2.e-llico.com/article-retro.htm?articleID=4003&rubrique=actu&oldRubrique=actu .

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