Podcast Summary: Facts Matter

Host: Roman, The Epoch Times
Episode: Studies on Transgender Individuals Find Elevated Suicide Rate—Especially After Surgery
Date: October 31, 2025

Episode Overview

This episode delves into recent scientific studies examining suicide rates among transgender individuals, particularly focusing on whether undergoing gender-affirming surgery affects mental health and suicide risk. Roman, the host, reviews major research from Canada, Denmark, the US, and Finland, challenging common narratives about affirming care lowering suicide risk. The discussion critically assesses the evidence, addresses prevailing clinical approaches, and encourages viewers to evaluate information for themselves.

Key Discussion Points & Insights

1. Elevated Suicide Rates Among Transgender Individuals

• Canadian Study (Transpulse Canada 2019) [00:00-02:50]
  • Uses nationwide survey data of trans and non-binary people (ages 14+).
  • Findings:
    • 30.2% reported suicidal ideation in the past year.
    • 4.2% reported a suicide attempt.
    • Higher suicidality found among:
      • Youth aged 16-24 (49.4% reported ideation).
      • College-educated, disabled participants (38.3%).
      • Ages 16-19, and those 20+ with sex work history.
• Roman notes this elevated risk is a persistent finding and not new ("this group as a whole has been known to have elevated levels of both [suicidal] ideation as well as attempts.").

2. International Data on Transgender Suicide

• Danish Study (1980-2021) [02:51-03:40]
  • Massive population-based analysis (6.6 million people).
  • Findings:
    • Suicide attempt rate for transgender people: 7.7x that of general population.
    • Suicide death rate: 3.5x higher among trans individuals.
    • Researchers acknowledge possible undercounting due to data limitations.
    • Quote:
      "The authors note that they only had data on gender identity for those who sought gender affirming care at a hospital or applied for a legal change of gender..." [03:10]
• US Survey—The Trevor Project (2023) [03:41-04:10]
  • Among LGBTQ youth (13-24):
    • 50% of transgender and nonbinary youth seriously considered suicide in the past year.
    • Nearly 20% attempted suicide.
  • Puts US rates at 2x to 4x the general youth population.

3. The Clinical Binary & Parental Dilemma

• [04:11-04:50]
  • Roman discusses a "binary choice" often presented to parents:
    • “Would you rather have a living daughter or a dead son?”
    • Speaker Attribution:
      "That question is asked over and over again, and therapists are trained to say..." (B, 04:35)
    • Roman critiques this framing as "sort of like a hostage situation" and suggests it may not reflect scientific data.

4. Does Gender-Affirming Surgery Lower Suicide Risk?

• California Study (Journal of Urology) [04:51-07:20]

  • Investigated psychiatric emergency and suicide rates before and after gender-affirming surgeries (2012-2018, n=1,226).
    • Vaginoplasty patients (male-to-female): 869
    • Phalloplasty patients (female-to-male): 357
  • Findings:
    • Suicide Rate (Vaginoplasty/MTF):
      • Before surgery: 1.5%
      • After surgery: 3.3% (more than doubled)
    • Female-to-male (Phalloplasty):
      • No significant increase observed for suicide, but psychiatric encounters did rise.
    • Quote:
      "More than twice as many men who identify as transgender women had attempted suicide after receiving the surgery when compared to those who had not undergone the procedure." [06:25]
    • Psychiatric emergency rates increased post-surgery for both groups:
      • Vaginoplasty: 22% before, 33% after
      • Phalloplasty: 20% before, 26% after
    • Conclusion from Study:
      "Rates of psychiatric emergencies are high both before and after surgery. Although both the phalloplasty and vaginoplasty patients have similar overall rates of psychiatric encounters, suicide attempts are more common in the latter." [07:00]
    • Roman summarizes:
      “Getting a gender-affirming surgery actually wound up increasing a person’s chance of having a psychiatric encounter.” [07:07]

• Finnish Study [07:21-08:45]

  • Cohort: 2,083 individuals referred to gender clinics by age 22 (average age 18, as young as 8).
  • Control group: Almost 17,000 matched Finns.
  • Findings:
    • Total 55 deaths, 20 (36%) by suicide among the gender-referred group.
    • All-cause mortality difference not statistically significant (0.5% vs 0.3%), but suicide proportion was 3x higher in the gender-referred group (0.3% vs 0.1%).
    • Quote:
      "All cause mortality did not statistically significantly differ... but the proportion of people who die by suicide increased by roughly three times." [08:40]

5. Critique of Prevailing Narrative

• Roman challenges the standard clinical claim that withholding affirmation or medical transition sharply increases suicide risk.
  "If you ever hear a trained psychiatrist or a school counselor give you this binary choice... the data suggests otherwise, that actually allowing your kid to go down this road might actually increase the risk of suicide, at least according to that study." [08:47]

Notable Quotes & Memorable Moments

• On the dramatic “binary choice” parents face:
  “It’s sort of like a hostage situation that many parents find themselves in... being told that if they don’t accept their children’s new gender identity, it’s tantamount to actually killing them.” (A, 04:40)
• On the outcomes post-surgery:
  “Men who cut off their penises were twice as likely to try and take their own lives after the fact compared to before.” (A, 06:10)
• Summary finding:
  “Patients undergoing vaginoplasty with a history of prior psychiatric emergencies or feminizing transition are at a higher risk and should be counseled appropriately.” (A, 07:09)
• On challenging medical establishment narratives:
  “The data suggests otherwise, that actually allowing your kid to go down this road might actually increase the risk of suicide, at least according to that study.” (A, 08:47)

Timestamps for Critical Segments

• Introduction & Canadian Study: 00:00–02:50
• Danish Study Overview: 02:51–03:40
• US Trevor Project Data: 03:41–04:10
• Parental Binary & Therapy Critique: 04:11–04:50
• California Surgery Study: 04:51–07:20
• Finnish Cohort Study: 07:21–08:45
• Challenging Established Narrative: 08:46–end

Tone and Language

The host speaks in a measured, fact-oriented, and at times critical tone, emphasizing skepticism toward mainstream narratives and a commitment to presenting data directly to the audience. The language is blunt when describing surgical procedures but remains anchored in reporting research outcomes.

Further Reading

All studies and data discussed in the episode are noted to be listed in the episode’s description box for those who wish to review the primary sources.