From Recognition to Rights: Suicidal Risk and Protective Factors Among Trans and Gender Diverse Youth in Japan.

Background: Trans and gender diverse youth experience disproportionately high rates of suicidal ideation and suicide attempts globally. In Japan, which has one of the highest youth suicide rates among OECD countries, research on this population remains limited. Aims: This study aimed to identify demographic and psychosocial factors associated with suicidal ideation and suicide attempts in the past 12 months among trans and gender diverse youth in Japan. Methods: Data were drawn from a 2024 national cross-sectional online survey. Analyses focused on 1,693 trans and gender diverse participants aged 15-25 years. Multivariable logistic regressions were conducted to identify correlates of past-year suicidal ideation and suicide attempts. Results: In total, 45.2% of participants reported suicidal ideation and 14.7% reported a suicide attempt in the past year. Harassment, social exclusion based on gender identity, and recent homelessness were strongly associated with both suicidal ideation and attempt in the past 12 months. In contrast, disclosure of gender identity to friends was associated with reduced odds of suicidal ideation. Suicide attempts were less common among participants aged 21-25 and more common among those not currently in education. Conclusions: Findings underscore the urgent need for targeted suicide prevention strategies for trans and gender diverse youth in Japan. National policy must address systemic drivers such as harassment, exclusion, and homelessness, while expanding access to gender-affirming peer and community supports.