In the world of social media, it seems I can’t go more than a few weeks (sometimes a few days) without hearing that another transgender person has committed suicide. As a healthcare professional, and the very concerned mom of a 10-year old, I want to discuss why and how you should be talking to your transgender child, loved one, patient, or student about suicide.
There tends to be a misconception that talking about suicide with someone who has suicidal thoughts may encourage the behavior. However, research suggests that talking about suicide may actually decrease suicidal behavior and improve the likelihood that someone will seek help (Dazzi, Gribble, Wessely, and Fear, 2014). [link]
Within the general population, the attempted suicide rate is 1.6%, but in the transgender and gender non-conforming population, the rate of attempted suicide is 41%. While the reasons behind suicidal ideation are many, Trans Lifeline, a crisis and suicide hotline run by transgender volunteers, has reported that calls have doubled since the passing of North Carolina’s bill, HB2.
In my own Facebook feed, I’ve increasingly seen transgender and gender-nonconforming friends comment about how hard it is to ignore the comments that go along with the news stories about bathroom bills. I am reading comments of friends feeling sad, feeling alone, and feeling hopeless. As the mother of a transgender child, I’ve done my best to shield her from the ugly comments of others, but I can’t make the news comments stop. I’ve been posting frequently about how to contact suicide hotlines and we’ve had conversations in our house about how to remain safe. Don’t be afraid to talk to your loved one, student, or patient about suicide even if they aren’t displaying any of these signs. It’s never a bad idea to check in, and let them know that you care for them and that they matter to you.
Signs of suicidal thoughts include:
(Adapted from National Suicide Prevention Lifeline)
- Talking about wanting to die
- Talking about feeling hopeless
- Talking about how the world would be better without them
- Talking about how they are a burden to others
- Looking for a way to complete suicide
- Increasing use of alcohol, drugs, or reckless behaviors
- Withdrawing from others
- Displaying extreme changes in mood
If you are the parent or partner of a transgender loved one:
- Talk to your loved one about suicide. Be direct, open, and non-judgmental. Be prepared to listen. Don’t make false assurances that everything will be okay.
- Make sure you have the phone number for The Trevor Project (1-866-488-7386) and Trans Lifeline (1-877-565-8860 in the US, 1-877-330-6366 in Canada) in a visible place in your home. Make sure your teen or loved one has the number in their phone.
- Ask your loved one if they have thoughts of harming themselves.
- Ask your loved one if they have a plan in place in case they develop thoughts of harming themselves.
- Help your loved one create a safety plan. The plan should include how to know the warning signs of when a crisis may be developing. Identify the thoughts and feelings that might come up when a crisis is developing. Identify potentially harmful situations (persons or places that may trigger suicidal thoughts) and the behaviors that may accompany them. The plan should include coping strategies to help if suicidal thoughts develop, and what to do if the coping strategies don’t work such as who they should call and where could they go for help. Make sure that phone numbers are written on the safety plan.
If you are a medical professional:
- Have your transgender/gender non-conforming patient complete a depression and suicide screening at every visit
- At every visit, ask if they have had suicidal thoughts or thoughts of self-harm since their last visit.
- Ask if they have attempted to harm themselves since their last visit.
- Ask if they have a safety plan in place in case they develop suicidal thoughts.
- Provide a safety plan template in the discharge instructions and make sure to include the phone numbers for the Trevor Project, Trans Lifeline, or a local resource for crisis intervention.
- If they are depressed, talk about coping mechanisms, review options for medication if appropriate, and refer them to a mental health specialist that is familiar with the transgender/gender non-conforming population. Do not assume that it can wait until the next visit.
If you are a school counselor or teacher:
- Have the phone number for the Trevor Project and Trans Lifeline easily available to give to your student. Make sure the student puts the number in their phone.
- If a student talks about having suicidal ideation, then walk the student to the school mental health professional. Don’t assume they will walk there on their own. If there isn’t one available, then follow your school policy on getting the student in contact with the proper person.
- Make sure the student is supervised until they are in a safe place.
If you are having suicidal thoughts, please reach out to the Trevor Project or Trans Lifeline. Please know that you matter and there are friends and allies fighting for you. We care about you and want to see you safe. I know that the visibility has been a double-edged sword and that many of you are feeling the negative effects of the sudden prominence in the news and media. Please know that people care for you and the world is a better place because you are in it. You are worthy and you matter.
I know I’m not YOUR mom, but your life still matters to me. If you are unsafe, please call and talk to someone who can help you.
Dazzi, T., Gribble, R., Wessely, S., & Fear, N.T. (2014). Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychological Medicine 44, 3361-3363doi:10.1017/S0033291714001299 [link]