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Following Up on Suicidality

Gender Ideology / Counseling / Science / Culture

Debra Baty

This truth in Proverbs is important enough that Solomon repeats the exact verbiage in chapter 14 & 16. Clearly, this is a truth worth driving home… there are countless ways men, women and young people make foolish and destructive decisions based upon what seems right in the moment.
 

This faulty thinking can be traced all the way back to Adam and Eve’s original disobedience to God in the Garden of Eden. Even there, before sin saturated nearly every aspect of humanity, a decision was made. A decision based not on what God clearly stated, but on what “seemed right” regardless of what God said.
 

Naturally, the world doesn’t care about God’s laws. Many don’t even believe in the reality of a personal God who created all things, let alone a God who gave His life to redeem hopelessly fallen humanity. The real issue isn’t the perspective of the unchurched and non-believers. Rather, the far greater concern is so many are living according to “a way that seems right” to them, even as professed Christ-followers.
 

The examples are endless, but certainly compromise made in the inordinate pursuit of: pleasure, comfort, money, careers, retirement planning, following feelings, personal happiness, sex, and identity are a few of the many ways we set ourselves on a path leading toward death because we reject God’s way for what feels right to us.
 

As our understanding of and value for God’s laws diminish, we functionally consider ourselves to be more enlightened and “nicer” than God. So we make compromises for ourselves and others that often seem small at the time, frequently giving way to cumulative or major sudden life-choices that are a total departure from God’s intention and outside of His protective boundaries.
 

When this happens, we engage in the same distorted thinking and reasoning as Eve. We observe the “fruit” before us (whatever that might be). Satan, the world, and our own flesh reason that “it” seems good (Genesis 3:6) and we depart the narrow path of life for the wide path of destruction and death. Sadly, in our deluded condition we often influence others to join us on this path that promises wisdom, fun, and freedom, but actually leads to bondage.
 

Setting aside the many areas we as purported Christ-followers and regular church-attendeee ignore the lordship of Christ in our lives and abandon The Narrow Way, this particular blog post is addressing one primary area: cohabitation.
 

In 2019 Pew Research reported that 58% of white evangelicals approved of cohabitation if the couple intended to get married.
 

According an article at www.probe.org/cohabitation “Cohabitation, as a lifestyle, is on the rise. Consider the significant growth in cohabitation rates in the last few decades. In 1960 and 1970, about a half million were living together. But by 1980 that number was 1.5 million. By 1990 the number was nearly three million. And by 2000 the number was almost five million.

Researchers estimate that today as many as 50% of Americans cohabit at one time or another prior to marriage. The stereotype of two young, childless people living together is not completely accurate; currently, some 40% of cohabiting relationships involve children.”
 

I have a friend who regularly attends church, participates in Bible-studies, and highly values connecting with other Christians for support and mutual encouragement. She gave her all to an abusive first marriage, doing everything she knew to walk out her commitment and vows. When she discovered that her husband was committing adultery repeatedly she separated from him for a significant amount of time. With his apparent repentance and commitment to work on their marriage, supported by positive actions on his part over time, she returned home in hopes of participating in the much needed growth and development of a far better marriage.
 

Unfortunately, he did not have the same level of commitment, and as bad as the first 10 years of their marriage was, the years that followed were far worse, including more adultery. Eventually, she left the marriage and divorced her husband. She was devastated, to say the least, and needed time and counseling.
 

Eventually, without any intention of pursuing a relationship she became friends with a Christian guy, which led to a romantic connection. This brought about a dilemma. My friend had been so emotionally and mentally abused and violated, she was totally afraid of the prospect of ever marrying again. She also didn’t want to put her kids or herself through another failed marriage. She and her boyfriend wound up crossing sexual boundary lines. After that behavior continued for months, it didn’t seem like a big deal for him to move in, with the idea that it wouldn’t be long before they would “tie the knot”.
 

It’s been 4 or 5 years. They attend church together and seemingly have a life and family together, but with no actual commitment. Her boyfriend wants to get married, but there are still so many areas of unprocessed pain and fear it’s just been easier for my friend to stay where she’s at – living a life of cohabitation, disconnecting from God and her own conscience in this area and ignoring the impact her behavior is having on her now adult children, who are great young men and women, but care nothing for Christianity. Her witness for Christ and her inner peace have been compromised.
 

In most cases though, cohabitation isn’t about unresolved or avoided trauma from a previous marriage. It’s simply convenient; a way to save money, a way to “test drive” the guy or girl before saying “I do”. But this is a complete disregard for the institution of covenant marriage originated by God.
 

At www.crosswalk.com an article entitled, “Cohabitation and divorce - - is there a correlation?” stated the following: A 2010 "meta-analysis" looked at 26 peer-reviewed, published studies that followed various couples over time. This analysis found that marrieds who had cohabiting pasts were more likely to face divorce, and that "noncohabitors seem to have more confidence in the future of their relationship, and have less accepting attitudes toward divorce.
 

Hebrews 13:4 is frank and clear, “Marriage is to be held in honor among all, and the marriage bed is to be undefiled; for fornicators [those who have sex before marriage] and adulterers [those who have sex with someone other than their spouse after marriage] God will judge.”
 

A few years ago a friend confided in me that he was completely baffled by his 12-step program leader. He had been part of a popular Christian recovery program in a local church for more than a year, working out his own substance abuse issues. He had recently learned that his leader was living with his girlfriend, but according to the leader they weren’t having sex.
 

While it is possible (though highly unlikely) they were not having sex, is that all that matters in whether or not couples are cohabitating? Aside from the fact that sexual sin is far more likely when we are living and sleeping under the same roof, how does this impact those who look to us as a shepherd or mentor? Either this will generate mistrust (as it should), undermine the leader’s character, or it may embolden others to live out the same practice, usually without any effective boundaries to guard against sexual sin.
 

1 Thessalonians 5:21-22 says “But examine everything carefully; hold fast to that which is good; abstain from every appearance of evil”. Avoiding or delaying marriage and cohabitating instead may seem like wisdom, but it’s definitely not godly wisdom.
 

Staying on the narrow path with God and trusting His many commands to avoid sexual immorality are both good and for our flourishing, leads toward fulfillment, joy, and life. Let’s choose life, rather than momentary pleasure accompanied by severe long-term consequences.

A study entitled “All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study”1 was posted online on February 17, 2024.  It revealed, thankfully, that suicide rates among those who report gender dysphoria are low, and, according to the Society for Evidence Based Gender Medicine (SEGM), there was “no evidence of benefits of gender reassignment” among this population.2
 
The study covered a 25 year span, focusing on those under the age of 23:

Photo by Pixabay
The study found that suicide among young people <23 ("youth") seeking gender services in Finland is an unusual event (0.3%, or 0.51 per 1,000 person-years). Further, in comparing gender-referred youth to a cohort of matched controls (n=16,643), the study found no convincing evidence that gender-referred youth have statistically significantly higher suicide rates as compared to the general population, after controlling for psychiatric needs. The study also did not detect a statistically significant association between gender reassignment and the risk of suicide. The study did, however, find a statistically significant relationship between a high rate of co-occurring mental health difficulties and increased suicide. The authors concluded that "it is of utmost importance to identify and appropriately treat mental disorders in adolescents experiencing GD [gender dysphoria] to prevent suicide, while also noting that "the risk of suicide-related to transgender identity and/or GD per se may have been overestimated."

SEGM does a good job of outlining the strengths and weaknesses of this particular study, and shared the following in their summary:3

The results of the study should be interpreted in the context of the unique characteristics of Finland's transgender-identifying population (e.g., the reportedly low rates of substance use in Finland, in contrast to the high reported rate in the US), Finland's recent strides in having significantly reduced suicide rates in the country overall, and Finland's unique, high-quality healthcare system, which contributes to superior health outcomes for the Finnish population. At the same time, several important aspects of the Finnish results are nonetheless likely generalizable to other Western countries, as the trend of high numbers of young people presenting to specialty services with a wish to medicalize their recent-onset transgender identity appears to be ubiquitous in the West.
 
The recent Finnish study confirms the earlier finding from the UK that suicides remain uncommon events in gender-dysphoric youth, regardless of gender transition status. It also confirms the finding from an earlier international study on suicidality (a related concept) that while the frequency of such events is elevated in gender-dysphoric young people compared with the general population of youth, it is comparable to youth referred for other mental health problems but not gender dysphoria. The Finnish study's results suggest that the clinical management of gender-dysphoric young people should focus on the management of comorbid psychiatric conditions, which are a well-known risk factor for suicides. This conclusion is consistent with prior research, which consistently shows that psychiatric comorbidities are highly prevalent in gender-dysphoric youth, typically predating the diagnosis of gender dysphoria.

The UK study linked to above revealed that even those whose care was delayed by lengthy wait times were not at higher risk of suicide.  Once again, the co-morbidities of depression, anxiety, etc. which commonly are noted before being diagnosed (or self-assessed) with gender dysphoria, should be addressed.
Professor Louis Appleby is a psychiatrist who leads the National Suicide Prevention Strategy for England.  In March of this year he posted on X:

Children with gender distress may face bullying, isolation & family conflict, reasons to be alert to suicide risk. Empathic support is vital but evidence that puberty blockers reduce risk is weak & unreliable. Invoking suicide in this debate is mistaken & potentially harmful.  (March 12)
We need to see an end to that line about choosing a living daughter or dead son. It is not based on evidence. May add to distress in young people & mislead worried parents. Deeply insensitive to 200 families/yr to whom the suicide of a teenager is more than a slogan.  (March 13)4

This is good news, and hopefully will help those in need find the right care, addressing their core needs without being pressured into introducing medications, cross-sex hormones, or undergoing surgery that results in permanent changes to their bodies. 
[1] Ruuska S, Tuisku K, Holttinen T, et al, All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study BMJ Ment Health 2024;27:e300940. https://mentalhealth.bmj.com/content/27/1/e300940
[3] Ibid.
[4] louis Appleby @ProfLAppleby

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