If you are in distress, you can call or text 988 at any time. If it is an emergency, call 9-1-1 or go to your local emergency department.

Transgender people and suicide prevention

Trans people face unique stressors and experience higher rates of discrimination and harassment than cisgender people.

Published in collaboration with CMHA AB and CSP: July 2025

Key Terms

  • TRANSGENDER refers to people whose gender identity differs from
    assigned sex at birth (Veale et al., 2015).
  • GENDER IDENTITY refers to a personal conception of one’s place on the gender spectrum; as woman or man, man and woman, or neither man nor woman (Ontario Human Rights Commission, n.d.).
  • There are many other terms, such as genderqueer, non-binary, and genderfluid that people may use to describe their gender identity.

Transgender (trans) people face unique stressors and experience higher rates of discrimination and harassment than cisgender people. This can result in poorer mental health outcomes and a greater likelihood that they may consider suicide (Kingsbury et al., 2022).

Download the Fact Sheet

Trans people are 2x more likely to think about and
attempt suicide than lesbian,
gay, or bisexual people
(McNeil et al., 2017).

Why are trans people at risk?

Transgender people experience mental distress at significantly higher rates than the general population. This is not because of their gender identity but because of the unique stressors they face, including stress from being part of a minority group and stigma. All of these experiences and stressors can increase suicide risk (Valentine & Shipherd, 2018).

STIGMA

Trans people can be affected by many different forms of stigma. This stigma causes stress and can include external factors like discrimination, prejudice, and violence, and internal factors such as internalized identity concealment (Lick et al., 2013).

INDIVIDUAL STIGMA

People who belong to stigmatized and minority groups may conceal their true identities even to themselves; this is a form of internalized stigma against oneself as a result of exposure to stigma from the outside world (Puckett & Levitt, 2015).

FAMILIAL STIGMA

When family and friends do not accept a person’s gender identity it can be extremely distressing to the individual and can lead to isolation, depression, and hopelessness (Dickey et al., 2016).

STRUCTURAL STIGMA

Structural stigma manifests as laws and policies which create inequalities and/or fail to protect trans people from discrimination; for example, policies that make gender-affirming care more difficult to access. Trans people may also face discrimination in workplaces, academic institutions, and health and social services (Hatzenbueheler et al., 2024).

PUBLIC STIGMA

This kind of stigma affecting trans people is caused by the general public’s lack of knowledge and understanding about gender identity, gender fluidity, and transgender people (which can lead to isolation and discrimination).

INTERSECTIONAL STIGMA

Intersectionality refers to when people belong to or identify with more than one social group. People experiencing intersectionality will feel the effects of identifying with their different groups (Turan et al., 2019). For example, a white transgender person may be exposed to less discrimination than a Black transgender person, who may be experiencing racial discrimination as well as gender discrimination. These complexities need to be considered in any suicide prevention effort designed to support people experiencing intersectionality.

EXPERIENCE OF DISCRIMINATION (TRANSPHOBIA)

Transphobia refers to the rejection of trans identity and a refusal to acknowledge that it is real and valid (TransActual, 2024). It can manifest as physical or verbal harassment, or physical or sexual assault. Transphobia can be perpetrated by individuals or on an institutional or societal level (see above “Structural stigma”).

STRESS RELATED TO TRANSITIONING

A person who has chosen to medically transition to the gender with which they identify may experience stress related to the transition. These stressors include: life disruption,
potential backlash from friends, family, and employers, as well as the risks and sometimes lengthy time period involved in medical transitioning (Dickey et al., 2016).

LACK OF ACCESS TO GENDER AFFIRMING MENTAL HEALTH CARE AND HEALTH CARE

Trans people often face discrimination in healthcare settings, yet access to health care is vital for trans people as those who seek to medically transition require specialized care (Taylor et al., 2020).

HOMELESSNESS

2SLGBTQIA+ youth are greatly overrepresented in the youth population who are experiencing homelessness in North America (McCann & Brown, 2021). The shelter system needs to foster safe spaces for all youth and staf should be trained on “issues relating to [2SLGBTQIA+] youth culture, terminology, needs, homophobia and transphobia”(Abramovich et al., 2022).

2 in 3 surveyed transgender 14-18 year olds had seriously considered suicide in the previous year (Veale et al., 2017).

The lifetime prevalence of attempted suicide for trans people is estimated to be between 32 and 41% (Mak et al., 2020)

Warning Signs

A significant change in behaviour or mood can be a warning sign that someone may be thinking about suicide. Look out for signs such as:

  • Statements that indicate hopelessness or being a burden
  • Threatening suicide or talking about wanting to die*
  • Looking for ways to die*
  • Suicide attempt
  • Increased substance use
  • No sense of purpose in life or evident reason for living
  • Withdrawal from friends and family
  • Rage, anger, irritability
  • Recklessness
  • Dramatic mood changes (American Association of Suicidology, n.d.)


*These warning signs indicate immediate suicide risk. Stay with the person who is exhibiting these signs and connect them to help. In Canada, call or text the Suicide Crisis Helpline at 9-8-8.

What can we as individuals do to help reduce suicide among trans people? 

  • Respect trans people by affirming their gender identity:
    Normalize pronoun sharing by sharing your own when introducing yourself or as part of your identification (e.g., in an email signature, on video calls). Use their pronouns and chosen name, as well as inclusive language that is gender neutral.  If you’re not sure what terms to use, listen to how individuals refer to themselves or ask directly (Russell et al., 2018).
  • Educate yourself: Educate yourself about what it means to be trans, what challenges are faced by trans people, as well as learning more about the 2SLGBTQIA+ community. 
  • Keep information private:  If anyone discloses anything to you about their gender identity or sexual orientation, be supportive and keep that information private and confidential unless they’ve indicated otherwise.
    Thank them for telling you and let them know that you’re there to support them.
  • Have an open, non-judgmental conversation:  If someone you know is exhibiting warning signs for suicide, have an open, non-judgmental conversation with them. You can find a guide to having this
    conversation in the About suicide prevention toolkit.

A 2022 US survey found that 94%
of transgender individuals
feel satisfied with their lives
after transitioning
(James et al., 2024).

What strategies can trans people use to care for their mental health?

  • Consider transitioning:  Consider if and how to transition (socially, medically, or both) (Dickey et al., 2016). A social transition could include using a different name and pronouns, and/or altering your appearance through choice of clothing  and hairstyle. A medical transition could include altering your appearance by using hormones and/or through medical procedures. Choosing if and how to transition is unique to each individual and depends on personal preference as well as what is accessible.
  • Create a network of support: Surround yourself with supportive, affirming people and consider reaching out to other trans people or groups to expand your network of support (Lucassen et al., 2022).
  • Find an inclusive and affirming health-care provider (Bhatt et al., 2022): Trans people may consider seeking out support for navigating the health-care system and finding an inclusive and affirming health-care provider through peer navigation or other services. 211.ca has a listing of navigation services.
  • Reach out to community supports:  Reach out to community or non-profit groups that support trans people. Visit 211.ca to find a listing of 2SLGBTQIA+ groups in your area.
  • Ask for help when needed: When you need help, talk to a loved one or call or text 9-8-8, the Suicide Crisis Helpline, or the Trans Lifeline at 1-877-330-6366
  • Adopt positive coping strategies:  Positive coping strategies are important for everyone. For 2SLGBTQIA+ young people, strategies that incorporate elements of Cognitive Behavioural Therapy (CBT) are the most effective (Lucassen et al., 2022).

Resources

  • 211 is a nation-wide directory of local government and community-based, non-clinical health and social services. 211.ca
  • 988 is the Suicide Crisis Helpline, call or text 24/7. 988.ca
  • Trans Lifeline connects trans people to the community support and resources they need to survive and thrive. translifeline.org
  • Kids Help Phone provides 24/7 mental health support for youth, including 2SLGBTQIA+ youth, through phone, text, and live chat. Their Resources Around Me tool helps young people locate local well-being resources such as mental health, housing, and social services. kidshelpphone.ca
  • Camp FYrefly is a Canadian leadership retreat for queer and trans youth. ualberta.ca/en/camp-fyrefly
  • Egale Canada works to improve the lives of 2SLGBTQIA+ people in Canada by informing public policy, inspiring cultural change, and promoting
    human rights and inclusion through research, education, awareness, and legal advocacy. egale.ca
  • Native Youth Sexual Health Network is an organization by and for Indigenous youth that works across issues of sexual and reproductive health, rights, and justice throughout the United States and Canada. nativeyouthsexualhealth.com
    • Resource: You are made of medicine: A mental health peer support manual for Indigiqueer, two-spirit, LGBTQ+, and gender non-conforming
      Indigenous youth (bit.ly/4jDcbQe)
  • PFLAG Canada is an organization that helps 2SLGBTQIA+ people and loved ones connect with resources and find a supportive community. pflagcanada.ca
  • It Gets Better Canada uplifts and empowers 2SLGBTQIA+ youth through storytelling and building community. itgetsbettercanada.org
  • Rainbow Health Ontario offers evidence-based health resources across Canada for 2SLGBTQ+ community members, service providers, and the general public. bit.ly/42BiLkr

References

  • Abramovich, A., Pang, N. & Moss, A. (2022). Experiences of family violence among 2SLGBTQ+ youth at risk of, and experiencing, homelessness before and during the COVID-19 pandemic. Journal of Gay and Lesbian Mental Health, 26(3), 265-288. bit.ly/4gBuPFx
  • American Association of Suicidology. (n.d.). Know the Warning Signs of Suicide. bit.ly/3PWU8aa
  • Bhatt, N., Cannella, J. & Gentile, J. (2022). Gender-affirming care for transgender patients. Innovations in Clinical Neuroscience, 19(4–6), 23–32. bit.ly/4hAomeU
  • Dickey, L., Karasic, D. & Sharon, N. (2016). Mental health considerations with transgender and gender nonconforming clients. UCSF Transgender Care. bit.ly/4hy6kKV
  • Government of Canada. (2022). Canada’s first federal 2SLGBTQI+ action plan: Building our future, with pride. bit.ly/4fdscJQ
  • Hatzenbuehler, M., Lattaner, M., McKetta, S. & Pachankis, J. (2024). Structural stigma and LGBTQ+ health: A narrative review of quantitative studies. The Lancet Public Health, 9(2), e109-e127. bit.ly/410jvNF
  • James, S., Herman, J., Durso, L. & Heng-Lehtinen, R. (2024). Early insights: A report of the 2022 U.S. Transgender Survey. bit.ly/40W67Lp
  • Kingsbury, M., Hammond, N., Johnstone, F. & Colman, I. (2022). Suicidality among sexual minority and transgender adolescents: a nationally representative population-based study of youth in Canada. CMAJ, 194(22), E767-74. bit.ly/42FocyF
  • Lick, D., Durso, L. & Johnson, K. (2013). Minority stress and physical health among sexual minorities. Perspectives on Psychological Science, 8(5), 521-548. bit.ly/3PZm9y1
  • Lucassen, M., Nunez-Garcia, A., Rimes, K., Wallace, L., Brown, K. & Samra, R. (2022). Coping strategies to enhance the mental wellbeing of sexual and gender minority youths: A scoping review. International Journal of Environmental Research and Public Health, 19(14), 8738. bit.ly/3WJtDc2
  • Mak, J., Shires, D., Zhang, Q., Prieto, L., Ahmedani, B., Kattari, L., Becarra-Culqui, T., Bradlyn, A. et al. (2020). Suicide attempts among a cohort of transgender and gender diverse people. American Journal of Preventive Medicine, 59(4), 570-577. bit.ly/3CN9JpI
  • McCann, E., & Brown, M. (2021). Homeless experiences and support needs of transgender people: A systematic review of the international evidence. Journal of Nursing Management, 29(1), 85-94. bit.ly/3Q1rzZ9
  • McNeil, J., Ellis, S. & Eccles, F. (2017). Suicide in trans populations: A systematic review of prevalence and correlates. Psychology of Sexual Orientation, 4(3), 341–353. bit.ly/4hWqrC0
  • Ontario Human Rights Commission. (n.d). Gender identity and gender expression. bit.ly/3CA9RJc
  • Peter, T., Campbell, C, & Taylor, C. (2021). Still in every class in every school: Final report on the second climate survey on homophobia, biphobia, and transphobia in Canadian schools. Egale Canada Human Rights Trust. bit.ly/3Ejm05Z
  • Puckett, J. & Levitt, H. (2015). Internalized stigma within sexual and gender minorities: Change strategies and clinical implications. Journal of LGBT Issues in Counseling, 9(4), 329-349. bit.ly/4jJzKqH
  • Russell, S., Pollitt, A., Li, G. & Grossman, A. (2018). Chosen name is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth. Journal of Adolescent Health, 63(4), 503-505. bit.ly/4hkf2p
  • Russell, S., Bishop, M., Saba, V., James, I. & Ioveno, S. (2021). Promoting school safety for LGBTQ and all students. Policy Insights from the Behavioral and Brain Sciences, 8(2), 160-166. bit.ly/4aHZO1c
  • Saewyc, E., Konishi, C., Rose, H., & Homma, Y.(2014). School-based strategies to reduce suicidal ideation, suicide attempts and
    discrimination among sexual minority and heterosexual adolescents in western Canada. International Journal of Child and Youth Family Studies, 5(1), 89-112. bit.ly/3Cy8ESO
  • Seelman, K. (2016). Transgender adults’ access to college bathrooms and housing and the relationship to suicidality. Journal of Homosexuality, 63(10), 1378-1399. bit.ly/3WK4jmu
  • Strauss, P., Cook, A., Winter, S., Watson, V., Wright Toussaint, D. & Lin, A. (2017). Trans Pathways: the mental health experiences and
    care pathways of trans young people. Summary of results. Telethon Kids Institute, Perth, Australia. bit.ly/4hC7NPC
  • Taylor, A., Chan, A., Hall, S, Saewyc, E., & the Canadian Trans & Non-binary Youth Health Survey Research Group. (2020). Being Safe, Being Me 2019: Results of the Canadian Trans and Non-binary Youth Health Survey. Vancouver, Canada: Stigma and Resilience Among Vulnerable Youth Centre, University
    of British Columbia. bit.ly/40WdMcK
  • TransActual. (2024). Transphobia. bit.ly/4hivZab
  • Turan, J., Elafros, M., Logie, C., Banik, S., Tuan, B., Crockett, K., Pescosolido, B. & Murray, S. (2019). Challenges and opportunities in examining and addressing intersectional stigma and health. BMC Medicine, 17(7). bit.ly/4aJb9y5
  • Valentine, S. & Shipherd, J. (2019). A systematic review of social stress and mental health among transgender and gender nonconforming people in the United States. Clinical Psychology Review, 66, 24-38. bit.ly/4gp41Iz
  • Veale, J., Watson, R., Peter, T. & Saewyc, E. (2017). The mental health of Canadian transgender youth compared with the Canadian population. Journal of Adolescent Health, 60(1), 44-49. bit.ly/3X9bUez