Significantly higher suicide mortality (p=.05) without gender reassignment should not be dismissed. A commentary on Ruuska 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;27:1–6.

Ruuska et al.’s [1] analysis inappropriately concluded that medical gender reassignment (GR) did not reduce suicide mortality because they had assessed that “the suicide mortality of both those [presenting with gender dysphoria (GD)] who proceeded and did not proceed to GR did not statistically significantly differ from that of controls.” On the contrary, by conventional criteria, the suicide mortality of the non-GR group was significantly higher than controls while that of the GR group was not. This complicates, but does not negate, their observation that this comparison “does not support the claims that GR is necessary in order to prevent suicide.”