Review of suicides and gender dysphoria

The Hilary Cass review—an independent NHS England audit of the Gender Identity Development Service—found no evidence to support claims of a “surge” in suicides among young gender-dysphoric patients after 2020–21. 

Over six NHS financial years (2018–24), there were 12 confirmed suicides (five in the three years before 2020–21, seven after), a fluctuation too small to reach statistical significance. 

Cass emphasised multiple contributing factors—mental illness, trauma, family disruption—and cautioned against attributing suicide rates to any single element of care. The review called for higher-quality, transparent data collection and recommended that puberty blockers be prescribed only under research protocols. 

It also highlighted a robust Finnish registry study (Ruuska et al., BMJ Mental Health 2024) showing reduced suicide risk after gender-affirming surgery was actually explained by treatment of co-occurring mental health conditions.

Independent report
Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report
By Professor Louis Appleby, University of Manchester
Department of Health and Social Care adviser on suicide prevention

Aim of this review

I have reviewed data provided by NHS England (NHSE) on suicides by young patients of the gender services at the Tavistock and Portman NHS Foundation Trust, based on an audit at the trust. The specific aim is to examine evidence for a large rise in suicides claimed by campaigners.

Summary of conclusions

The data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock.

• 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.
• The claims that have been placed in the public domain do not meet basic standards for statistical evidence.
• There is a need to move away from the perception that puberty-blocking drugs are the main marker of non-judgemental acceptance in this area of health care.
• We need to ensure high quality data in which everyone has confidence, as the basis of improved safety for this at risk group of young people.

https://www.gov.uk/government/publications/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust-independent-report