Suicidal Ideation Among Transgender and Nonbinary Persons and Country-Level Support for Transgender Rights in the European Union: A Cross-National Study.
Objectives. To describe cross-national variation in suicidal ideation in the past year across transgender women, transgender men, and nonbinary persons and trace the association between ideation and gender along the continuum of country-level public support for transgender rights. Methods. We applied ordered random-intercept logistic regression models to cross-sectional data from the 2023 European Union Fundamental Rights Agency LGBTIQ Survey III fielded in 27 EU member states. These individual-level data were combined with the 2023 "Special Eurobarometer 535" survey used to construct the 4-item country-level composite measure of public support for transgender rights. Results. Higher levels of public support for transgender rights were associated with lower levels of suicidality but unequally across groups. Transgender men were the most and transgender women the least responsive to changes in public opinion. Differences between groups converged at high levels of support. Conclusions. Mental health among transgender men may be especially sensitive to public opinion, suggesting a need for suicide prevention that addresses public opinion as a social determinant of health-and the need to do so in contexts antagonistic to gender minority populations. (Am J Public Health. 2026;116(8):1189-1197. https://doi.org/10.2105/AJPH.2026.308572).