A Primer on Suicide: Myths & Fact

By Brannen Clark & André Pérez

Suicide is no stranger to us, and a lot of people within the transgender community are much more closely affected by suicide than those in the general population. It is estimated that while the general rate of suicide in the US is 1.6%, a staggering 41% of transgender people have attempted suicide (Grant et al., 2011).

Within the transgender community there is disparity regarding who has attempted suicide. As an example, 70% of transgender individuals who have been sexually assaulted by a law enforcement officer or experience harassment at work have attempted suicide at least once. For those who’ve experienced familial violence, the attempt rate is around 73% (Haas, A. P., Rodgers, P. L., & Herman, J. L., 2014). The lowest statistics I was able to find came from the National Transgender Discrimination Survey, which was reported by Haas and colleagues. This study found that 16% of elderly transgender people (65 and older) attempted suicide and 21% of assigned male at birth (AMAB) cross-dressers have attempted suicide.

Given the extreme prevalence of suicide within the trans community, we should all know everything there is to know about suicide, right? Not so much. Let’s start with some terms we can use to talk about the issue at hand. Suicidal Ideation is suicidal thoughts, concerns thoughts about or an unusual preoccupation with suicide. We use the phrase complete suicide interchangeably with die by suicide, but we avoid the stigma and moral or criminal connotations that come with the phrase commit suicide.

You’d be amazed at the myths still flying around about who’s more likely to attempt suicide, why they’re attempting suicide, and how to best help someone who’s experiencing suicidal ideation. I hope this article can set the record straight.

Not all trans folks calling into Trans Lifeline (TLL) are actively suicidal, but many are. Calls with suicidal people are the hardest calls to take as a volunteer. I’m here to debunk some myths and present some facts about suicide for other volunteers, for trans people affected by suicide, and for others who want to be better informed about this serious and life-threatening aspect of mental health. Here they are, in no particular order:

1. Who’s at risk?

If I were to ask you who among us were more likely to attempt or complete suicide, I’m betting 9 out of 10 people would suggest that teens and young adults are most likely to either attempt or complete suicide. This is the first myth of suicide. Older individuals have the highest risk of suicide in the general population (Klein, S., 2011), which is often attributed to chronic health concerns or other factors related to aging, and elderly individuals made up 16% of all suicides in 2004 (Peeples, 2011).

Very little research exists that specifically speaks to the trans community’s experience. Dr. Ry Testa is the leading researcher who is tackling these questions head on by developing the Gender Minority Stress and Resiliency model. Testa draws from Minority Stress Models, which demonstrate how belonging to socially marginalized groups (ie. black people in the US) negatively impacts health outcomes even after controlling for factors such as economics. His research finds that the leading factors, which contribute to a transgender or gender nonconforming person’s likelihood of attempting suicide are external and include: non-affirmation of identity (ie. misgendering), discrimination, victimization, and rejection (Testa, 2015). A study of the Virginia Transgender Health Initiative Survey indicated that those who had endured physical and/or sexual violence were significantly more likely than those who had not had such experiences to report a history of suicide attempt and multiple suicide attempts (Testa, 2012). We know from Injustice at Every Turn that trans people who are black and latino are more likely to experience violence, familial rejection, homelessness, and extreme poverty than their white counterparts. We can extrapolate that black and latino transgender people are at an even higher risk for attempting suicide than their white counter parts due to the prevalence of these associated risk factors. American Indian and Alaskan Natives have the highest rate of suicide of an ethnic group — a combined 14% (Peeples, 2011).

2. When are people at risk?

Many people believe that suicides happen on the weekends or during holidays such as Christmas, and even more so when the two coincide so that Christmas happens over the weekend. However, these are actually both myths. There’s actually a “spring seasonality pattern” to suicides which indicates that there are more suicides occurring during spring and in the earlier months of summer (Pappas, 2014). May is the most difficult month for people struggling with suicidal ideation. Furthermore, the weekends aren’t actually the most common days on which suicides are attempted or completed. Of all the days of the week, Monday holds that dubious honor (Peeples, 2011).

3. Why are people at risk?

We know this for sure: it isn’t because someone approached a person with suicidal plans or ideations and started chatting with them about suicide. While many mistakenly believe that suicide can be initiated through conversation with a suicidal individual, this is very rarely the case. Someone who’s suicidal is typically feeling very isolated and unable to communicate their concerns or plans to anyone. By opening the channels of communication this allows someone to openly discuss their thoughts and plans, according to the Nevada Division of Public and Behavioral Health (Office of Suicide Prevention, 2014).

Creating space to talk about suicidal ideation is actually considered best practice among mental health professionals. If a client were to tell me in a therapy session that they’re suicidal, or had previously endorsed suicidal ideation, I would be required to assess them for current risk of suicide. One scale that’s commonly used is the Columbia-Suicide Severity Rating Scale, and I’ve had to use this at least once so far in my 3+ years of work and training.

People often conflate suicidality with mental illness, and while the two aren’t the same it’s important to know that certain diagnoses indicate a higher risk of suicide. Depressive disorders are most commonly associated with elevated suicide rates, but it’s important to keep in mind that everyone has the potential to become suicidal, for any number of reasons. However, those who might be more predisposed to suicidality (e.g. those with depressive or anxiety-related disorders, people who have experienced trauma, or those who have attempted suicide before) might be more likely to complete suicide (Office of Suicide Prevention, 2014).

There has also been considerable debate that a contagion effect is associated with suicide; i.e. that if one person completes suicide, others will shortly follow suite. From what I’ve been able to find, this currently considered to be more factual than not (Peeples, 2011). That’s why we Trans Lifeline is constantly updating our volunteers if we hear about a suicide happening in the United States, but we do not generally make public announcements when people die by suicide. News spreads like wildfire in the trans community without our help, and our call volume often increases in the wake of a recently completed suicide.

Guest Blogger: Brannen Clark

Editor & co-author: André Pérez is the Director of Marketing and Communications at the Trans Lifeline. He founded the Trans Oral History Project in 2007, and is currently creating America in Transition, a web series and community engagement campaign taking a look at social change from the perspective of trans people in marginalized communities.