In recent years, social scientists have alarmed and traumatized us with descriptive statistics indicating transgender people feel ostracized for their identity; their high suicide rates reflect rejection, discrimination, violence, harassment, and the negative life circumstances that result from such treatment. Until recently, no study had actually assessed the factors that can reduce high rates of suicide, because until recently, access to legal and medical transition was difficult, if not impossible, and acceptance of transgender people and their identities was relatively nonexistent.

A recent study out of Ontario, Canada has reignited hope and has also confirmed what we have all known and been fighting for all along. The study identified specific factors that greatly reduce suicide attempt rates. For example, when transgender people had affirming parents, the rate dropped by 57 percent. Access to legal documentation consistent with a person’s gender identity reduced rates by 44 percent. Trans people who experienced low levels of anti-trans hate were 66 percent less likely to attempt suicide. And perhaps most importantly, the further along individuals were in their transitions — i.e. the closer they were to having a body and outward identity that matched their internal gender identity — the less likely they were to attempt suicide.

The current reality in the U.S. is that the barriers to these life-saving factors are still far too high.  Only 21 percent of transgender people in the U.S. have been able to update all of their identification documents and records with their accurate gender. Laws vary from state to state, but all of them require some form of medical approval. Medical access is also a huge barrier in the U.S. due to explicit insurance exclusions for transition-related care in most state and private insurance plans. Other countries, such as Malta, Argentina, Colombia, Denmark, and, hopefully soon, Ireland, have begun to remove these barriers by dropping the requirements that force transgender people to first seek medical or court approval to change their gender. Instead transgender people can self-declare their gender on legal documents solely based on their self-determination. Given this recent research, these steps should reduce the suicide rates of transgender people in those countries significantly.

There are a number of factors that contribute to suicide, and they include the trauma of being rejected and prevented from being one’s authentic self through socially constructed barriers. Suicide rates are not evidence of transgender pathology as some earlier theorists proclaimed, but unfortunately, their misguided theories have contributed to the harsh realities transgender people face today. Now that we know that increased acceptance, freedom from hate, and access to legal and medical interventions are critical to reducing these tragic losses to suicide, we, as a society, have the power and responsibility to take action. We can break down the legal and medical barriers to transition, as well as the prejudice that prevents acceptance and understanding of transgender people.

Keep fighting! Our tools are increasing and we must maintain the resilience to survive.