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Professor questions methodology of study
There is no evidence for the widespread claim that suicide rates increase with bans on gender-affirming care for children, a recent report from the medical watchdog group Do No Harm found.
The study, which used three different data analysis methods, sought to examine the effects of state bans on gender interventions for gender-dysphoric minors.
Do No Harm concluded that there is no evidence that “state prohibitions on surgeries, puberty blockers, or cross-sex hormones for minors” lead to higher suicide rates.
However, economics Professor Travis Campbell of Southern Oregon University told The College Fix that he believes the report does not provide enough evidence to support this claim.
“Its estimates are too imprecise to rule out substantial harm concentrated in the small group whose treatment access changed,” Campbell said.
He conducted his own research using the same methodology as Do No Harm.
Using replication data, he found “an average suicide mortality rate of approximately 13.76 deaths per 100,000 in states that subsequently adopted bans.”
“Before the policy change, around 0.014% of youth died by suicide each year,” he said.
The professor raised concerns that following policy changes, youth who identify as transgender could be at heightened risk for suicidal ideation.
He presented a hypothetical of 100,000 people between 15 and 19 years old, with a ban preventing 200 of them people from receiving gender-affirming care.
Campbell noted that if even one additional suicide occurred in that population, “that would be a substantial increase in suicide deaths within the affected group of trans youth.”
He told The Fix that even if these deaths have not occurred, the Do No Harm study cannot definitively rule them out.
“Those numbers could translate into risk among the much smaller group whose treatment access changed,” the professor said.
Campbell also referenced a study conducted in the state of Oregon, in which it was found that “approximately 0.2% of insured 8-17-year-olds observed during 2016-2023 had recorded receipt of hormones.”
The study addresses the limitations of current knowledge on “transgender and gender-diverse” populations, particularly among the youth.
“Among 868,740 insured adolescents, 8,480 (0.98%) had a TGD-related diagnosis,” the study claims.
That study concluded that even when states supported gender-affirming care, “access remained limited, with variation by age and insurance type.”
The study recommends continuous monitoring of this issue “to inform clinical practice, health system capacity, and policy planning.”
When asked what methods or processes he would recommend for further analysis, Campbell said that he would suggest linking death records and healthcare data. He said this would allow analysts to “identify and follow youth with a gender-identity-related diagnosis recorded before the policy change.”
“Researchers could then follow this population to measure changes in both suicide deaths and receipt of gender-affirming hormones in states that adopt bans,” Campbell said.
He also noted that comparing states that adopted bans with states that did not would be crucial.
“This would allow researchers to conduct a similar difference-in-differences analysis using a population more likely to be affected by the policy,” Campbell said.
The professor said that for Do No Harm, such an analysis could help establish “whether the bans meaningfully reduced receipt of gender-affirming hormones.”
Do No Harm uses a difference-in-differences analysis, which is defined as “a statistical method comparing trends across states before and after policy changes.”
“Do No Harm found a 0.3-percent reduction in suicides among 15–19-year-olds, a statistically insignificant change,” its report states.
The report also states that it reviewed and responded to “flawed research cited by activists, media, and lawmakers.”
“These studies have profound methodological limitations and depend on unreliable evidence,” Do No Harm alleges.
