Prior research has been unable to tease out cause and effect between health outcomes and gender-affirming care like hormone therapy or gender-denying interventions like conversion therapy, largely because of a lack of broad data or an appropriate control group. “The Conversation” team, along with other researchers studied data from the 2015 U.S. Transgender Survey which includes responses from over 27,000 trans adults across the nation. They compared people who initiated an intervention with those who initiated the same intervention one year later. They found that over 40% of trans adolescents living in family environments that are unsupportive of their gender identity attempted suicide by the age of 18. The analysis also showed that hormone replacement therapy significantly improves the mental health of trans youths. In comparing differences in suicide attempts between trans youths who started HRT a year apart from each other, they found that both groups experienced similar increases in suicide attempts over the five years before initiating treatment but experienced a significant drop the year they started treatment. Overall, initiating hormone therapy led to a 14.4% reduction in attempting suicide for trans youths. There was a 13.8% increase in attempted suicide within the first year of conversation therapy and a 47.5% increase in running away from home.