Childhood trauma and transgender identity associated with increased risk of suicidal ideation and behavior in college students

An international study by Hospital del Mar Research Institute and Pompeu Fabra University researchers, done within the World Mental Health International College Student Initiative (WMH-ICS) led by Harvard University, analyzed data from nearly 73,000 first-year students from 71 universities in 18 countries spread across all continents, between 2017 and 2023.

The results show that the prevalence of suicidal thoughts (“ideation”) and suicide attempts in this university group is higher than in the general population: 47% of students had thought about suicide at some point in their lives, 26% had planned it and 10% had attempted it. In the last year before answering the survey, 30% had had ideation, 14% had planned it and 2.3% had made an attempt.

Still, the authors clarify that the study consisted of mental health surveys conducted via email, and that there may be an overestimation of people with suicidal ideation among those who had participated in the survey.

The analysis identifies as particularly relevant risk factors: having suffered traumatic events during childhood (such as emotional or sexual abuse or abandonment), having parents with a mental disorder and self-identification as a transgender person.

“All traumatic events, all mental disorders, without exception, carry a risk”
Philippe Mortier, first author of the study (Hospital del Mar Research Institute)

Philippe Mortier, first author of the study, says: “Women, non-heterosexual people and especially transgender people are at a clearly higher risk of suicidal ideation and behaviour. The risk in transgender students of both ideation and transition from ideation to attempt is 1.5 times higher, even after adjusting for adverse experiences and mental disorders. This indicates that there are additional specific factors, such as gender dysphoria or exposure to discrimination.”

The researchers emphasize that university – and more specifically the beginning of the academic year – is a period of high vulnerability. “It is a period of very intense life and emotional transition: increased autonomy, new social and academic environments, and often separation from the family context. These changes can aggravate previous vulnerabilities or make it difficult to adapt,” explains Mortier. For this reason, they emphasize the importance of prevention strategies, which must take into account the conjunction of factors such as gender, sexual orientation, previous mental disorders and adverse experiences to childhood.

In addition, another recent study by the same group has shown, through surveys over 14 consecutive days, that greater sensitivity to stress – experiencing more discomfort, and adverse feelings such as fear, anxiety, guilt or hostility in the face of a stressful situation – causes university students to have suicidal thoughts more often, more intensely and more variable.

These studies highlight the urgent need to implement an integrated approach in universities, with specific resources to detect and treat suicidal ideation and behaviour early, with an approach that combines early detection and psychological care with social and educational prevention actions.

There are already some inspiring initiatives, says Mortier, such as “digital screening and teleintervention programs, for example, the World Mental Health International College Student (WMH-ICS) Initiative or the Australian UniWellbeing program, which offer remote and personalized psychological support to reduce suicide risk in university students.”