The rate of suicide in the transgender community is staggeringly high. This week, activists gathered in Asheville to find ways to change it.

By Rose Hoban

Close to half of the people in the transgender community in the U.S. has attempted suicide at some point in their lives, compared to the overall population, where only about 4 percent of people have attempted suicide.

But Jacob Tobia would rather transgendered people not focus just on that number, but on the context that contributes to the staggeringly high rate.

“We have to acknowledge the causes in the same breath we acknowledge the gravity and pervasiveness of the problem,” said Tobia, a transgender activist who was born and raised in Cary, went to Duke and has become a national advocate for the rights of transgender people.

Portrait. Transgender activist Jacob Tobia said to bring attention to the high rates of suicide in the transgender community, "we have to acknowledge the causes." Those causes include family and social rejection, discrimination and trauma.
Transgender activist Jacob Tobia said to bring attention to the high rates of suicide in the transgender community, “we have to acknowledge the causes.” Those causes include family and social rejection, discrimination and trauma. Photo credit: Rose Hoban

“Instead of simply saying 41 percent of trans people have attempted suicide, we should say something like widespread discrimination and family rejection leads 41 percent of trans people to attempt suicide in their lifetime,” Tobia said.

Speaking to about a hundred people gathered a conference of the American Foundation for Suicide Prevention this week in Asheville, Tobia challenged the audience to “glamorize healing, we must learn to glamorize recovery.”

New org on the block

The North Carolina chapter of AFSP, which only launched in the past year, is currently a one-person operation. But even before the March passage of House Bill 2, which, among other things, limited access to bathrooms for transgender people in North Carolina, the group placed the issue of suicide in the Lesbian, Gay, Bisexual and Transgender (LGBT) community on the agenda for their first statewide gathering.

The organization, which started in the 1980s as a research-only foundation, has been more aggressively scaling up, doing more education, outreach and advocacy in recent years. According to IRS filings, the organization raised $11.1 million in 2010, and national board member Richard Kirchhoff said AFSP raised close to $20 million last year, with more than $4 million earmarked for research, the rest for education, survivor counseling and support, and legislative outreach.

“When it comes to advocacy in Washington, DC for suicide, suicide prevention, we’re the go-to group,” Kirchhoff said. “I want to see the North Carolina chapter become the go-to group when it comes to legislation.”

Epidemic for trans community

Despite Tobia’s encouragement, the statistics for suicidality in the transgender community are sobering.

[pullquote_left]You or a friend need help? Call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255) or the Trans Lifeline 877-565-8860[/pullquote_left]“Suicide in the trans community is an epidemic, it’s like HIV in the gay community,” said Asheville social worker Stephen Wiseman. He said every three to six months, he hears about another friend or acquaintance who dies by suicide.

“Forty-one percent of trans-identified individuals have attempted suicide,” he said. “That’s one in two. The national average is 1.9 percent for everyone.”

Jody Herman, a public policy researcher from the Williams Institute at the UCLA School of Law, ran through some of the stressors for transgendered people: higher unemployment rates, harassment and job loss due to discrimination.

[pullquote_right]Herman was part of the study team that used data from the Centers for Disease Control and Prevention to calculate the number of transgender people in the U.S., estimated at about 1.4 million, nearly twice the previous estimate.[/pullquote_right]She quoted statistics that reveal 19 percent of transgender people reported experiencing homelessness, 57 percent experienced family rejection, and 19 percent reported being refused medical care, all contributing to the types of stressors experienced by other minorities that face discrimination.

But even though surveys have found suicide attempt rates in the transgender community are higher, Herman said it’s hard to determine the actual number of deaths by suicide. Most coroners and medical examiners do not examine the sexual orientation of a suicide victim.

Toxic stress

Eric Davis, a social worker with Willow Wellness and Recovery, an addiction treatment center in Asheville, said the research shows many members of the LGBT community deal with considerable stress, along with both physical and psychological trauma.

Volunteers Robert Rominger and Dana Cea discuss conference logistics with Betsy Rhodes, who heads the North Carolina chapter of the American Foundation for Suicide Prevention.
Volunteers Robert Rominger and Dana Cea discuss conference logistics with Betsy Rhodes, who heads the North Carolina chapter of the American Foundation for Suicide Prevention. Photo credit: Rose Hoban

Many LGBT people internalize negative messages, he said, along with intolerant reactions, bigotry and often family rejection.

“Ultimately this can lead to poor self-regard and internal conflict, especially when the LGBT person is younger and getting a lot of mixed messages, and their identity isn’t so set in stone,” he said. “They’re influenced by this negative culture.”

And despite an increased acceptance of people in the transgender community, “transphobia and homophobia continue to be a major boundary to wellness.”

Herman went through the literature on stigma, suicide attempts and public policy and told the gathering that research has shown pretty conclusively that there are links between public policy, mental health and suicide. In large part, that’s a function of the stresses people in a discriminated group are subject to when discriminating behavior is codified in public policy.

Quoting from a study by Columbia University researcher Mark Hatzenbuehler, Herman noted that, “Having positive state level policies in regard to sexual orientation discrimination were associated with fewer suicide attempts for transgender adults.

“So good policies means fewer lifetime suicide attempts,” she concluded.

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Warning Signs of Suicide
  • Talking about wanting to die
  • Looking for a way to kill oneself
  • Talking about feeling hopeless or having no purpose (“What’s the point?”)
  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of alcohol or drugs
  • Acting anxious, agitated or recklessly
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings

The more of these signs a person shows, the greater the risk. Warning signs are associated with suicide but may not be what causes a suicide.

Source: American Foundation for Suicide Prevention

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Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...

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