Transgender young people who want hormone therapy but cannot access it are nearly twice as likely to attempt suicide. That is the conclusion of new research by The Trevor Project, a leading US suicide prevention organisation for LGBTQ+ youth. The findings, published in spring 2026, add to a growing body of evidence linking access to gender-affirming care with mental health outcomes.

The study comes at a tense political moment. Several US states have restricted or banned hormone therapy for minors. In the Netherlands and other European countries, debate about waiting lists and treatment guidelines continues. For young people and their families, the question is concrete: what does the science actually show?

What the new research found

The Trevor Project surveyed more than 18,000 LGBTQ+ young people aged 13 to 24 across the United States. Among transgender and nonbinary respondents who wanted hormone therapy, those who could not access it reported a suicide attempt rate roughly twice as high as those who received treatment. The researchers controlled for other risk factors such as family rejection and bullying.

The study does not prove that hormones alone prevent suicide. But it does show a strong link between being denied wanted care and worse mental health. Earlier studies in JAMA Network Open (2022) and The Lancet Child & Adolescent Health (2020) reached similar conclusions.

Dr. Ronita Nath, vice president of research at The Trevor Project, told reporters that the data should inform policy. Denying care that a young person and their doctors have agreed on, she said, carries measurable risks.

How hormone therapy for minors actually works

There is a lot of confusion about what gender-affirming care for young people involves. The actual medical pathway is careful and stepped.

For pre-pubertal children, no medical treatment is given. Support is social and psychological. Once puberty begins, some young people may be prescribed puberty blockers. These medicines pause puberty and are reversible. They give the young person and their care team more time to decide on next steps.

Hormone therapy itself, with testosterone or oestrogen, is usually only started from around age 16. This is the standard set by the World Professional Association for Transgender Health (WPATH) and followed by Dutch clinics such as the gender team at Amsterdam UMC. Treatment requires a thorough mental health assessment, parental involvement and ongoing medical monitoring.

Surgery on minors is rare and, in most European countries, not offered before adulthood.

What the research debate looks like

The science is not without discussion. The English NHS commissioned the Cass Review, published in 2024, which called for more caution and better long-term studies on puberty blockers. Sweden and Finland have also tightened their guidelines in recent years.

At the same time, major medical bodies including the American Academy of Pediatrics, the Endocrine Society and the Dutch knowledge centre Kenniscentrum Sekse & Diversiteit continue to support gender-affirming care as evidence-based when delivered by trained teams.

The disagreement is mostly about how strong the evidence is and how to weigh risks, not about whether trans young people exist or need support. Most clinicians agree that mental health care, family support and time for reflection are essential parts of the process.

What this means for parents and young people

For families, the practical takeaways from the new research are clear.

• Mental health risks are real when wanted care is blocked. Watch for signs of depression and suicidal thoughts.
• Gender-affirming care is not a single decision but a long process with checkpoints.
• Family support is one of the strongest protective factors, regardless of which medical steps are taken.
• If you are worried about a young person, professional help from a GP or specialised gender team is the first step.

In the Netherlands, waiting lists for gender care remain long. The Transvisie patient organisation advises families to register early and to seek mental health support in the meantime, separate from the medical track.

The wider political context

The research lands as the Trump administration in the United States expands restrictions on trans health care. A Republican governor recently signed a law creating a database of transgender patients. The White House has labelled some pro-trans groups a security risk. Federal courts are now handling several lawsuits about medical records and care access.

European countries are not following the same path, but policy is shifting. The UK has restricted puberty blockers outside research settings. Hungary has rolled back legal recognition of trans people. In contrast, Germany passed a self-identification law in 2024.

For young people caught in these political shifts, the medical evidence is one anchor. Organisations such as The Trevor Project, the Aidsfonds-supported Soa Aids Nederland and the international ILGA network continue to publish data that helps cut through the noise.

Where to find help

If you or someone you know is struggling, support is available. In the Netherlands, 113 Zelfmoordpreventie offers free, confidential help by phone (113 or 0800-0113) and online chat. Switchboard, the LGBTQ+ helpline, can also help find specialised care.

For broader context on LGBTQ+ health topics, see our pieces on sober sex and gay health and on recent UK court rulings on trans inclusion policy.

The bottom line

The new Trevor Project data does not settle every question about gender-affirming care for young people. But it does add weight to a consistent finding: when young people who want hormone therapy cannot access it, mental health outcomes get worse. That is a fact policymakers, clinicians and families have to take seriously, whatever their starting position in the debate.