What peer-reviewed studies from 2020–2025 report suicide attempt and suicide death rates among transgender adults in the U.S.?
Executive summary
Peer-reviewed U.S. studies and major peer-reviewed analyses from 2020–2025 consistently report very high prevalence of suicidal thoughts and attempts among transgender adults, with lifetime attempt estimates commonly cited in the 40% range (for example, 42–44% reported in large U.S. surveys) and past‑year attempts in some probability samples around 7% [1] [2] [3]. Population-level death-by‑suicide estimates for transgender adults are sparse and derived mainly from clinical cohorts or small samples; one large clinical cohort from the Netherlands (not U.S.) reports suicide mortality rates in gender‑referred people of roughly 0.7–2.7 per 1,000 person‑years in prior literature reviews [4] [5].
1. What peer‑reviewed U.S. studies report attempt prevalence among transgender adults?
Multiple peer‑reviewed publications and authoritative reports drawing on U.S. survey data show very high lifetime and recent suicide attempt prevalence among transgender adults. The Williams Institute’s peer‑reviewed analysis of U.S. data reported that 44% of transgender adults reported recent suicidal ideation and 7% a recent suicide attempt in their sample (U.S. TransPop analysis summarized by the Williams Institute) [1]. Other widely cited analyses of national survey data — for instance summaries and synthesis pieces from the Williams Institute in 2020 — document that transgender adults have past‑year suicidal ideation nearly twelve times and attempts about eighteen times higher than the general U.S. population [3]. Secondary sources and syntheses cite lifetime attempt rates around 40–42% from U.S. samples [2] [6].
2. What peer‑reviewed U.S. studies report suicide death rates among transgender adults?
Peer‑reviewed, population‑representative estimates of suicide deaths for U.S. transgender adults are largely missing from the recent literature provided. Available peer‑reviewed mortality evidence comes mainly from clinical cohorts or international samples; for example, literature reviews and clinical cohort studies report suicide mortality rates in gender‑referred samples ranging roughly 0.7–2.7 suicides per 1,000 person‑years (figures synthesized in a BMJ Mental Health review and cited cohort work) [5]. The Amsterdam cohort (Netherlands) reported trends in suicide deaths among gender‑referred people over decades but is not a U.S. study [4]. Available sources do not mention a large, peer‑reviewed U.S. national study that directly measures suicide death rates among transgender adults.
3. Methodological context and limits readers must know
Most higher‑prevalence figures for attempts come from survey-based, often convenience or community‑based samples and from the large national transgender surveys; these measure self‑reported lifetime or past‑year attempts and ideation rather than confirmed medical records or death certificates [1] [3] [2]. Clinical cohorts that can report deaths tend to be smaller, clinically ascertained, or non‑U.S., which limits national generalizability and complicates direct translation from attempt prevalence to mortality rates [4] [5]. News and fact‑checks emphasize that headline percentages (e.g., “42% attempted suicide”) require careful reading of sample frame, time window (lifetime vs past year), and question wording [6].
4. Variation by age, intersectionality, and social context
Recent peer‑reviewed work and major surveys show that younger transgender people report higher rates of ideation and attempts than older adults; intersectional factors (race, socioeconomic status, sex work, legal environment) change risk substantially [7] [1]. A 2025 intersectional analysis notes past‑year attempt rates near 4.2% in certain samples but highlights steep age gradients and subgroup differences [7]. Policy‑context studies show anti‑trans laws associate with large increases in past‑year suicide attempts among transgender and nonbinary youth — evidence that social and legislative context shifts suicidal behaviors [8] [9].
5. Competing interpretations and potential agendas in the literature
Researchers and advocacy groups interpret elevated suicidality as evidence of minority‑stress effects and the need for anti‑discrimination and gender‑affirming supports (Williams Institute; Trevor Project summaries) [1] [10]. Opposing commentaries and legal scholars sometimes use high adult suicidality figures to argue for caution in pediatric transition care; those arguments rely on the same prevalence data but apply them differently to policy debates [11]. Readers should note sources’ institutional perspectives: advocacy organizations use survey data to press for protective policies, while some legal analyses emphasize unresolved causal links between medical care and long‑term suicide outcomes [1] [11].
6. Bottom line and gaps for future research
Peer‑reviewed U.S. work from 2020–2025 documents very high self‑reported suicide attempt prevalence among transgender adults (commonly ~40% lifetime; recent attempts ~7% in some probability samples) but lacks a large, peer‑reviewed U.S. study that directly measures suicide death rates in a population‑representative way; mortality evidence remains concentrated in clinical cohorts and international samples [1] [3] [4] [5]. Future peer‑reviewed research needs representative linkage of identity data to administrative mortality records to produce robust U.S. suicide‑death rates for transgender adults — currently not found in the provided reporting (available sources do not mention a large U.S. national suicide‑death study of transgender adults).