Psychosocial Functioning in Transgender Youth after Hormones

To the Editor: Chen et al. (Jan. 19 issue)(1) provide useful data on a cohort of youth who received treatment with cross-sex hormones for gender dysphoria. One finding deserves to be emphasized. Among the 315 participants, 2 died by suicide in 2 years. I calculate an annual suicide rate of 317 per 100,000 (95% confidence interval, 38 to 1142). This rate is significantly higher than that found among 15,000 adolescents who had been referred to the world's largest pediatric gender clinic in London, most of whom were not undergoing any endocrinologic intervention. The annual suicide rate in that cohort was . . .