The press release in relation to the article highlights the important contribution this study makes: strong evidence that trans and non-binary children and young people are at higher risk of suicide and self-harm. 

The study is of high quality given the huge database available. The data strongly concludes that trans and non-binary youth are at risk of suicide and self-harm given their significant exposure to vulnerability and discrimination. This conclusion is reached by analysing the reason for admission of the child/youth population and comparing it between the trans and non-binary population and the cis population. In the case of the trans/non-binary population, there is a higher proportion of admissions in relation to events of self-harming or self-injurious intent.

This is the first study to show evidence on this issue, which we have strongly suspected for years.  

The article is in line with previous evidence, especially developed in North America, on the elevated risk of self-harm in trans and non-binary populations. Furthermore, it highlights, as in previous studies, that affirmative and respectful attention to gender identity are positive approaches to providing care in the health care setting to this population. 

The study makes explicit the limitations they have had. These limitations have not been a disadvantage in reaching the study's conclusion. It opens up new lines of study, especially in populations where, apparently, there is less registration of trans or non-binary identities: racialised and impoverished populations, among others. 

The study contributes to knowledge about the health of trans and non-binary children, showing that social discrimination and the lack of specific care expose them to a vulnerability that sometimes leads to suicidal or self-harming actions. It also shows that comprehensive, respectful and gender-affirmative care is a protective and health-generating factor for this population.