Trans+ suicides in the UK: why are reporting guidelines part of the debate?

“Trans healthcare saves lives” is a rallying cry of the movement for trans+ rights in the UK. Here, trans+ people face significant challenges accessing gender-related and mental healthcare. And these obstacles, experts and campaigners have said, can lead to a higher risk of suicide for some trans+ people.

However, like many conversations about the lives and deaths of trans+ people, the debate is polarised.

On the one hand, coroners and some charities have drawn a link between lack of access to healthcare and subsequent suicides. Scientific papers in the US have also suggested that being able to get proper healthcare made trans young people less likely to take their own lives.

On the other hand, gender critical campaigners and commentators have long disputed the evidence linking suicides of trans+ people to problems getting healthcare, claiming the risk is overstated or untrue. Now, some have claimed that a new report has definitively disproved any link – and that therefore, any reporting that mentions or suggests a link is breaching media rules on reporting suicides.

Samaritans media reporting guidelines, which are followed by most of the UK press, caution against suggesting a person may have a single reason for taking their own life. But the charity also says that some experiences that young trans+ people are more likely to have, such as discrimination, can lead to higher suicide risk for those groups.

What is the Appleby report and what did it find?

In July, the director of Good Law Project Jolyon Maugham claimed on X that deaths of young trans people on the NHS gender clinic waiting list – including suicides – had risen in the wake of a significant court case. Bell v Tavistock, a court case in 2020, led to limits for trans+ children in accessing puberty blockers. This year, puberty blockers for trans+ children were banned, a Conservative policy that Labour has chosen to continue. Puberty blockers could previously be prescribed to delay puberty in gender questioning young people, but have been subject to significant controversy and political opposition.

The government then took the highly unusual step of commissioning a report in direct response to Maugham’s posts.

Professor Louis Appleby, the government’s advisor on suicides, wrote the report and disputed Maugham’s data. He didn’t accept that there was enough evidence to show a rise in suicides since Bell v Tavistock.

However, his report did share data on 12 suicides of patients and former patients at the Tavistock gender clinic between 2018 and 2024, six of whom were children.

Appleby’s report was greeted by several gender-critical columnists as proof there was no link between access to healthcare and suicides among trans+ youth. He also wrote: “The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide.”

This point has since been taken up by several gender-critical commentators to argue that any suggestion of a link between suicide and restricted access to gender healthcare, such as puberty blockers, must therefore breach guidelines on reporting suicides.

This culminated in a letter sent to The Scotsman after the paper reported concerns about the puberty blocker ban and the implications in Scotland. The article quoted a campaigner who drew direct links between the ban and risk of increased suicides.

After it was published, the director of a group that actively campaigns against trans+ rights posted a letter on X demanding the article be removed. The Scotsman later took the article down.

What do Samaritans say about reporting suicides?

Samaritans is the most prominent suicide prevention charity in the UK. Its media guidelines and online safety advice urge caution when discussing suicide because research shows some forms of media coverage can lead to increases in suicide risk, particularly among young people.

According to the charity, in most cases there is no single event or factor that leads someone to take their own life. When it comes to trans+ people specifically, their experiences relating to gender or other identities will only ever be one part of the broader picture.

A spokesperson for Samaritans told TBIJ: “The important thing is to avoid suggesting that suicide is inevitable if you belong to a particular community and it should not be implied that the sole risk is simply being part of this group.

“Speculating about the reasons why someone took their own life can often oversimplify the issues behind someone’s death and increase the risk that other vulnerable people might over-identify with them and engage in suicidal behaviour themselves.”

However, Samaritans added that it was important to acknowledge that inequality and discrimination mean people within certain communities are more at risk. A spokesperson told TBIJ: “We can and should recognise that some people are at higher risk of suicide than others, as it helps target preventative action.”

The charity has published research and resources on LGBTQ+ communities and suicide, highlighting the specific experiences of trans+ people. And it said clearly that its guidelines should not prevent discussion of any issues that may contribute to suicides.

In fact, Samaritans has itself called for improved access to healthcare for trans+ people. It reported that some trans+ people are hesitant to seek mental health support because they fear it could stop them getting gender-related care. Samaritans emphasises that suicide is preventable and wants waiting lists for mental health services and gender identity care to be shorter for everyone.

What do trans campaigners say about reporting suicides?

There is clear anger and frustration from within the trans+ community, from allies and from some bereaved families about political decisions to limit or prevent access to gender-related healthcare and the risk of harm they believe this poses, particularly to children and young people.

But some are concerned that frequently invoking suicide could be putting young trans+ people at risk, and the focus on puberty blockers is overshadowing the broader issues.

In campaigning, the link between restricted access to care and suicides is often expressed starkly: “If I die on a GIC [gender identity clinic] waitlist forget burial just drop my body on the steps of NHS England” read one of many signs referencing deaths and suicides at the London Trans+ Pride march this summer.

Since late August, tiny paper coffins have been appearing on the doorstep of the health secretary Wes Streeting’s constituency office. They contain messages in coloured felt tip pens, such as “RIP – I want to live” and “You are killing us!”

But it is important to draw a distinction between this sort of community discourse and the media and digital space, said Cleo Madeleine from Gendered Intelligence, a trans-led charity whose work includes providing support for trans, non-binary, and gender questioning young people.

“We have a prominent concern about the way suicide and self-harm are reported on in the media and discussed in online spaces and the kind of harms that poses to our young people,” Madeleine told TBIJ.

“Some of the language about the links between a puberty blocker ban and suicide and suicidality can contribute to a toxic environment for young trans people at a time when they are highly unlikely to get that access.

“There is a disproportionate focus on puberty blockers in digital spaces, media and political narratives. There is a bigger health crisis precipitating that also needs to be on the agenda.

“The breakdown of trust between trans young people, parents, and the NHS is not being addressed. Trans children are afraid to seek mental health support because they’re worried it will lead to a discharge from gender services.”

All public discussion of suicides should be done with care. There may be different interpretations of what the evidence on suicides tells us. What cannot be disputed is that the issue of suicide is a real and significant one for trans+ people – and Samaritans guidelines aren’t a reason to stop discussing it.