‘Transitioning Teens’ and an irresponsible BBC

Suicide is a personal tragedy that leaves deep, life-long wounds upon families and friends. Journalists and public figures have been rightly condemned for treating the matter glibly or sensationally.1 And yet, even as experts warn that poor reporting on the issue could even contribute to ‘imitational suicides’,2 such advice appears to be lost on the BBC.

Transitioning Teens, a BBC3 documentary, throws caution to the wind and resurrects the recurring myth: that if children identifying as trans are denied life-altering hormone drugs, they are likely to commit suicide. This is a dangerous falsehood.

The programme follows trans activist Charlie Craggs as he interviews a number of young people. Each has spent years sitting on a swollen waiting list at the Gender Identity Development Service (GIDS). In their eagerness for treatment, some are accessing hormone drugs privately, including online. Craggs’ own experience sadly appears to have been one of hardship and bullying, yet this does not excuse the BBC from its serious mishandling of such a delicate subject.

At one point, Craggs interviews the outspoken activist lawyer Jolyon Maugham, who is helping a 14-year-old boy to sue GIDS over its long waiting list.

there is no persuasive evidence that gender transition reduces the likelihood of suicide

‘Why is access to hormone drugs so crucial for young people?’ Craggs asks leadingly. Maugham responds: “[If] you get those treatments, you’re much less likely to commit suicide. I mean that’s the basic fact of the matter”.

But Maugham is wrong. The “basic fact of the matter” is that there is no persuasive evidence that gender transition reduces the likelihood of suicide.

Check the data

One much-touted study, published in 2019, serves as a good example. This mammoth survey used the Swedish Total Population register to track mental health treatment in 9.7 million Swedes from 2005 to 2015 – around 95 percent of the country.3 The outcome? The study found no mental health benefits for hormonal interventions in transgender people. That’s right – none.

But reality does not deter Transitioning Teens from weighing in with various bald assertions. After interviewing disgraced GP Helen Webberley – whose overseas clinic bypasses legal safeguards to prescribe hormones to children online – Craggs expresses his own opinion on the controversial treatment:

We’re talking about like ‘oh, the long-term side-effects of being on hormones or hormone-blockers’. [But] why are we not talking about the long-term side-effects of not being on them? Because guess what, there is no long-term without them. Look at the attempted suicide rates amongst young trans people. Why aren’t we talking about that?”

reality does not deter Transitioning Teens from weighing in with various bald assertions

As if to back up Craggs’ unqualified claim that without puberty blockers “there is no long-term”, text then appears on the screen: “One small scale study suggested 48% of young trans people had attempted suicide at least once”. Even with the caveats, quoting this figure is totally misleading.

The study referenced here is the notorious 2015 RaRE research report.4 There are several problems with this report and its infamous 48% figure.

Firstly, recruits to RaRE report were not randomly selected, but voluntarily participated in a questionnaire. The questionnaire was advertised to “health and wellbeing organisations, LGB&T organisations, mental health related websites”. “Flyers and posters were sent to LGB&T and health promotion events across the country”. Inevitably, those whose mental health was worst were most likely to participate, thereby skewing the results.

Secondly, 2,078 people responded to the RaRE questionnaire, but only 120 identified as transgender. Of these, only 27 were under the age of 26, and of these, 13 reported to have attempted suicide at some point in their lives. This is where the 48% figure comes from: “48% of Trans young people had made at least one suicide attempt in their livesmeans 13 out of 27 people.

Thirdly, understanding the very meaning of these ‘suicide attempt’ claims requires careful scrutiny. For example, the binary options of ‘Yes/No’ to the question ‘have you ever attempted suicide?’ are known to inflate the number of Yeses. Those wanting to communicate emotional struggle, or self-harm behaviour will often express this as a ‘suicide attempt’ when answering the question. Other studies probing for intent to die in one-on-one interviews (instead of questionnaires) show the number of suicide attempt claims drop by almost half.

Finally of course, central to Craggs’ (and Maugham’s) statement is the question of when these suicide ‘attempts’ took place. Craggs is arguing that hormones lead to a decrease in suicidality. But, crucially, the RaRE report did not record when the ‘attempts’ took place; indeed they could well have taken place after the administration of hormones, not before. If this was so, it would not only fail to support Craggs’ case, but actually affirm the very reverse.

The weaknesses of the RaRE report are not unique. Indeed they are characteristic of the research into suicidality in trans-identifying youth more generally.

Irresponsible BBC

Any suicide is a tragedy. The few solid facts we do have though, offer a more reassuring picture.

In the last fifteen years, four suicides have been committed by young people referred to GIDS. One of those involved had been “referred with severe psychiatric difficulties”.5 Since 2018, one attempted suicide has been recorded and no actual suicides.6 This is despite the GIDS waiting list standing at 4,600 in January 2021. Responsibly, GIDS’s website says that percentages for self-harm among trans-identifying youth are in line “increasingly with the general population” and that “suicide is extremely rare.”7

suicide is extremely rare

Transitioning Teens has not followed this example. The result is an immensely irresponsible documentary, and a step backwards in the debate around healthcare for people identifying as transgender.

In the future, the BBC should be quicker to consult media guidelines like those drawn up by the Independent Press Standards Organisation (IPSO) and the Samaritans. IPSO warns against reporting “which might suggest that suicide is a way of responding to the difficulties that people might be experiencing”8, while Samaritans caution that “young people are more susceptible to media influence and are more likely to imitate suicidal behaviour”.9

The documentary contributes to a dangerous sense of urgency, with Craggs suggesting in his closing words that if you’re “very clearly trans” then you’ll probably become “very clearly suicidal” too. The results of this downright lie are seen in an increasing number of young people identifying as transgender, insistent to obtain experimental hormones for fear of their very lives.

Therapists Sasha Ayad and Stella O’Malley deserve the final word. Speaking in their podcast, Gender: A Wider Lens, Ayad explains why the suicide myth is “really not a helpful idea to put in the minds of children who are already struggling with a variety of issues.”10

She says: “I’ve worked with people who, especially when they’re quite young, don’t really understand what this suicide risk means. I’ve met some young people who really believe that they’re just going to be hit with this desire for suicide. [As if] they’re just going to be overtaken by this force, even though they’re not suicidal at all.”

O’Malley agrees, saying that she also has met children who think “this suicide thing is coming to get me, and so I have to transition quite quickly before it comes!”

The BBC should heed these warnings, and avoid contributing to the very problem it says it wishes to address.

[1] https://www.bbc.co.uk/news/world-asia-42644321

[2] https://www.psychologytoday.com/ie/blog/talking-about-men/201908/robin-williams-death-and-subsequent-suicide-contagion

[3] https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2019.19010080; New Data Show “Gender-Affirming” Surgery Doesn’t Really Improve Mental Health. So Why Are the Study’s Authors Saying It Does? – Public Discourse (thepublicdiscourse.com)

[4] http://www.queerfutures.co.uk/wp-content/uploads/2015/04/RARE_Research_Report_PACE_2015.pdf

[5] https://www.transgendertrend.com/suicide-by-trans-identified-children-in-england-and-wales/

[6] file:///C:/Users/michaelt/Downloads/FOI_19-20375_GIDS_suicide_rate_2018-19__2019-20.pdf

[7] https://gids.nhs.uk/evidence-base

[8] https://www.ipso.co.uk/member-publishers/guidance-for-journalists-and-editors/guidance-on-reporting-suicide/

[9] https://www.samaritans.org/about-samaritans/media-guidelines/guidance-covering-suicide-and-self-harm-documentaries/

[10] https://gender-a-wider-lens.captivate.fm/episode/34-gender-dysphoria-suicide