Prevalence of Suicidality among Transgender Youth: A Meta-Analysis

Abstract

Objective: Suicide is the second leading cause of death among youth, with transgender and gender-diverse (TGD) youth at heightened risk. This meta-analysis examined the prevalence of suicidal ideation, suicide attempts, and nonsuicidal self-injury (NSSI) among TGD youth, and investigated moderators (e.g., country, measurement type, age, and sex) to clarify variability across studies.

Method: A systematic search was conducted in May 2023 across nine databases, including APA PsycINFO, PubMed, Ovid MEDLINE(R), Scopus, Web of Science, and ProQuest Dissertations and Theses Global. Studies were included if they sampled TGD youth (mean age < 25), reported prevalence data on suicidality or NSSI using validated measures, and used a quantitative design and were published in English. Meta-analytic procedures were performed in Comprehensive Meta-Analysis Software using a random-effects model.

Results: A total of 138 studies were included. Pooled prevalence estimates revealed high rates among TGD youth: suicidal ideation (49%; 95% CI [46%, 52%]), suicide attempts (26%; 95% CI [24%, 29%]), and NSSI (47%; 95% CI [41%, 54%]). All outcomes showed high heterogeneity (I² ≥ 98%). Moderator analyses revealed that country and measurement type were significant moderators across outcomes. Age and publication date were significant for suicidal ideation and attempts, while sex moderated NSSI. Other factors were not significant moderators.

Conclusion: Findings provide robust estimates of suicidality and self-injury among TGD youth. Identifying key moderators can inform targeted, evidence-based prevention and intervention strategies for this vulnerable population.