Morbidity & Mortality

The "50% Rule," Is it True?

If you go to Jennifer Diane Rietz's web site, www.transsexual.org , you will see she refers to the "50% Rule" and I have seen this repeated in many transsexual information resources - but have not found anyone who has cited a specific study from which it comes. Some people regard it as an "Urban Legend" of the Transgender Community. Nobody can, nor WANTS to believe that the death rate by suicide could be THAT high among transsexuals. In my attempts to verify this "rule" this is what I've found out:

"The number of deaths in male-to-female transsexuals was five times the number expected, due to increased numbers of suicide and death of unknown cause." - "Mortality and Morbidity in Transsexual Patients with Cross-Gender Hormone Treatment" -H. Asscheman, L.J.G. Gooren, and P.L.E. Eklund

I had originally misread a statistic on suicide being just over 10% and I'm certain others - like those who've started the "50% Rule" story - probably did the same. I am a bit surprised nobody called it to my attention in the years (yes YEARS) I've had this posted, but a couple of astute readers finally did (thankyou!). Anyway, the corrected information on the suicide rate from American Association of Suicidology places the annual suicide rate at about 11 per 100,000, or 0.011%. So it was not 11%, which is 11 out of every 100, it's .0011%, or 11 out of every 100,000.

So if suicide is 5 times more likely for transsexuals, that is .0055%, or 55 out of every 100,000. The AAS also says there are approximately 25 attempted suicides for each successful one. I'll let those better with math than I am compare that with the following study's findings concerning suicide ATTEMPTS among preo-operative transsexuals:

"Most studies reported a pre- transition suicide attempt rate of 20% or more, with MFs relatively more suicide-prone than FMs." - Dixen J, Maddever H, van Maasdam J, Edwards P (1984) Psychosocial characteristics of applicants evaluated for surgical gender reassignment. Arch Sex Behav 13: 269-276.

Even if the suicide rate isn't that high, one still has to take into account the murder rate:

"Tansgender historian Candice "Kay" Brown recently calculated that a murder rate of one male-to-female transsexual person each month comes to ....16 times greater than the national average." - "Another transgender murder Local TG group declares 'state of emergency and national crisis' " by Vicky Kolakowski ,Bay Area Reporter, April 8, 1999 (Vol. 29, No, 14) p. 19 (c) 1999 Bay Area Reporter

It is also believed that many transsexuals will endure tense, life threatening situations rather than call the police because of a not unfounded fear of mistreatment by law enforcement:

"In over 50 percent of the total transgender hate violence cases, the offender was a law enforcement officer. . . .This completely mirrors the national trend. There is increased police brutality against the transgender community." - Shawna Virago, Community United Against Violence (CUAV) San Franscisco.

And that was in SAN FRANCISCO - a city well known for its "queer" population and often considered more "used to" or "tolerant" of transsexual people. I'd imagine the situation is even worse in communities known to be hostile toward GLBT people.

On a positive note concerning transition and suicide:

"Post-reassignment, Pfafflin and Junge found reports of only 16 possible suicide deaths among over 2000 cases: 14 in MFs, one in an FM, and one with gender not specified. Five of the 16 may have been accidental medication or drug overdoses rather than genuine suicides. In the remaining 11 cases, suicide was usually not thought to be related to gender problems per se. These results suggest that post- transition, suicidal tendencies probably get no worse, and may actually improve." - "Transsexual Surgery: Its Pros and Cons" By Anne Lawrence, M.D.

So, in short, (and thanks to the mathematical skills of other people), I'm pleased to say the the "50% Rule" is NOT TRUE!

Yes, it's apparantly tragically true that transsexual people are more likely than the general population to kill themselves. But the good news is that nowhere even CLOSE to half of all transsexual people are destined to take thier own lives!

DEATH & DISEASES

If you want more detailed data concerning deaths and incidence of diseases in a transsexual population by other causes (including suicide), there is at least one good study which has been done which is cited above. There is a copy of that complete study on this web site:

Mortality and Morbidity in Transsexual Patients With Cross-Gender Hormone Treatment by H. Asscheman, L.J.G. Gooren, and P.L.E. Eklund [ HTML version ] [ PDF version ]