u/Ravatu

The problem is that you're both looking at "how many people died by suicide" versus "how many people attempted suicide". This is an entirely different statistic that, in my clinical viewpoint, vastly dismisses the very real effects of minority stress and anti-LGBTQ legislation on the mental health of LGBTQ people. It also dismisses incomplete or attempted suicides as less serious. More on that momentarily.

I want to link to a variety of studies and articles that talk about the disproportionate suicidality among LGBTQ individuals before diving in further.

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https://www.thetrevorproject.org/resources/article/facts-about-lgbtq-youth-suicide/ Youth suicidality, general overview. Easy to read snapshot.

https://williamsinstitute.law.ucla.edu/visualization/lgbt-toplines/ *** Starred because these are findings are very recent and many efforts were made to make this generalizable to the USA's LGBTQ population. The full report can be found here: https://williamsinstitute.law.ucla.edu/publications/generations-transpop-toplines/

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423 tl;dr "This study found that gender-affirming medical interventions were associated with lower odds of depression and suicidality over 12 months. These data add to existing evidence suggesting that gender-affirming care may be associated with improved well-being among TNB youths over a short period, which is important given mental health disparities experienced by this population, particularly the high levels of self-harm and suicide." US - Youth

https://www.nature.com/articles/s44159-022-00109-0#Sec4 Well rounded explanation of disparities with links to additional research on suicidality disparities between transgender and cisgender individuals.

If you want more, here's Google Scholar: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C27&as_vis=1&q=suicidality+disparity+transgender&btnG=

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The reason why I stress suicidality and suicide *attempts* is because, frankly, viewing only completed suicides as life-threatening is callous and inhumane. I'm not sure how else to explain that suicidal ideation is complex, serious, and worth of concern even if an individual only contemplates suicide or attempts suicide. Whether or not transgender people are *completing* suicide, they experience suicidality at much higher rates than their cisgender and heterosexual peers.

Speaking to u/Ravatu first, I can't see the suicide heat map because your link goes to the article. I'd also like to point out that Netherland's model of healthcare, culture, and general social supports are markedly different than the US-- especially Arizona. I wouldn't use studies with a Dutch population to try and generalize to the US. That being said, this study directly states:

"A recent literature review clearly demonstrates the specific risk factors for suicide in sexual minority youth,which includes negative social environments, inadequate support within the closest social network, and an absence of lesbian, gay, bisexual, and transgender (LGBT) movements in commu-ities (29). In our cohort, both trans women andtrans men show a three- to four-fold elevated risk of suicide compared with the population rate in the Netherlands and can therefore be considered a high-risk group."

I don't doubt there are counties in the US where the suicide rate is over 40 per 100k. However, again, you're looking at completed suicides rather than suicidality as a whole. If you looked at these same suicide hot spots and could look at data for cis/het vs LGBTQ people, I would expect to see LGBTQ people have higher suicide rates than cis/het peers.

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u/Theguywhosme Please take a look at the third and fourth links above for an overview of the affects of affirming treatment on mental health outcomes! Affirmative treatment *is* effective in reducing suicidality in LGBTQ individuals. However, the overall suicidality rate remains high due to other factors such as cultural stigma, disproportionate violence against LGBTQ people, inability to meet basic needs (LGBTQ people are more likely to be homeless or have experienced homelessness), etc. This is often called minority stress.

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edit// formatting problems

Disproportionately higher. It's an easily googled statistic.