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Background  Transgender youth have been found to be at higher risk of experiencing common mental health problems than their cisgender peers, but there has been little research into the mechanisms of peer support among this group. Research into how young people communicate about self-harm and suicidality on social media has found patterns of behavior in which young people encourage each other's risky and self-injurious actions, but whether this holds true among minority groups such as trans youth has not been established.    Method  Twitter biographies were searched to find self-identifying trans people aged 14–18 years. The resulting accounts were searched for key words related to common mental health issues. The tweets caught by the search terms and their replies were coded into themes using a combination of inductive and deductive coding. The occurrence of themes were quantified and analyzed using SPSS 24.    Results  1,468 tweets were analyzed from 235 accounts; 133 (56.6%) of the accounts with relevant content received no public replies to tweets mentioning mental health issues. Of the 102 (43.4%) that did receive public replies, 64 (62.7%) received a maximum of two replies. Three themes were found in replies to tweets, Support, Feeling the Same Way, and Advice. Most replies were expressions of support, followed by expressions of feeling the same way; advice was rare. There were no incidents of replies that were dismissive of or encouraged self-injurious behavior.    Discussion  Findings differ from existing research on how youth interact with each other online with regard to mental health issues: the trans youth in this study were not found to encourage risky and self-injurious behavior in each other. This has implications for caring for trans youth in mental health settings, where social media use is normally discouraged, as its use may be a protective factor for trans youth specifically.

Peer Responses to Trans Youth Tweeting about Self-Harm and Suicidality