Suicide prevention in the LGBTQ+ community requires addressing stigma, valuing everyone equally

The LGBTQI+ community is vulnerable to suicide; it is a reality that we all need to wake up to and respond to. General suicide prevention programs in the community will not work, because most of them are designed by imagining a cis-heterosexual person as a target. It won’t take into account the stress a person in the community experiences just because they are who they are. Or maybe who they’re not for.

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A response to suicides in the LGBTQI+ community requires a commitment to understanding the social factors that drive people to suicide. That doesn’t mean that strange people may not suffer from mental health issues like depression, anxiety etc This means that hatred, discrimination and isolation can lead to a sense of hopelessness and helplessness where death feels like a release from an impossible life. This lack of hope is due to social reasons. You can’t work with trauma and mental illness without looking at what’s causing it. For example, suicide prevention programs/initiatives for queer community should include an understanding of these structural and systemic factors.

Cases of queer/trans people dying by suicide are an issue of preventable and premature deaths. They are lives that end because individuals are denied the conditions necessary for human beings to create livable lives. These are not intrinsic human vulnerabilities; they are vulnerabilities produced by social and political inequalities. The absence of social structures that could provide conditions for habitability contributes to what researcher Lauren Berlant calls “slow death”. According to Berlant, some populations are marked for being depleted by structural and governmental factors, and queer/trans lives fit that description. Suicide then becomes something that only ends or escapes slow death.

When we understand the social context in which LGBTQI+ suicides occur, we begin to realize that it is society’s responsibility to provide living conditions. Social, political and legal infrastructure and support systems are essential conditions. While LGBTQI+ positive mental health services are needed, we also need to build this infrastructure in order to queer and trans people live a life, survive and thrive. Currently, the social, political, and legal infrastructure extends primarily to cisgender, heterosexual men or women who fit society’s ideas of what is “normal” gender and sexuality. Those who do not return are expelled. This often pushes them to commit suicide to escape the hostility and stigma of society. In our current social configuration, some lives are not considered worthy of mourning. Some bodies don’t matter. The way society conveys this is by not viewing these lives as distressing. This means there were lives that weren’t deemed important enough to even be mourned by death, let alone receive support to live on.

Therapeutic suicidality support will involve providing trauma and crisis care informed by an understanding of the context of stressors in LGBTQI+ lives. Hostility from families, medical and legal institutions, discrimination at work, difficulties in finding safe shelter are all challenges that have a negative impact on mental health. A context of deprivation and discrimination shapes the emotional experience of people in the community and impacts how difficult it is for them to imagine the possibilities of a safe and fulfilling life. Otherwise, suicide prevention working with the trans community should involve providing services that allow them to experience their true gender. This would include affordable quality medical services, support for changing documents, redress mechanisms for violence and discrimination, as well as housing and employment. Thus, suicide prevention is not just about mental health services, but about providing services that support individuals to experience their gender authentically.

With the LGBTQI+ community, it is important to understand that suicide prevention cannot take the form of a purely therapy-oriented mental health intervention, although it can be a tremendous form of support. If a trans woman cannot afford surgery to live her gender, therapy will not compensate for the absence of this affirmation procedure. The question to ask is this: “What will help this person to imagine a future in this heteronormative world?

Suicide prevention work with the community will need to take an approach that recognizes how some lives are forced to end with a complete lack of opportunities to build a life they can live without discrimination. Thus, suicides of LGBTQI+ people must be considered a social problem and reframed as preventable and premature deaths. This means that if society provided the necessary conditions, infrastructure and support, the number of suicide deaths would decrease. Thus, suicide prevention work must go beyond focusing on the individual alone and focus on systemic change. When societal stigma decreases, when all people are valued equally, when services, policies, laws and infrastructure are inclusive of everyone, then we can truly achieve suicide prevention in the LGBTQI+ community.

(The author is a professor in the Queer Affirmative Counseling Practice course and has co-authored ‘Queer Affirmative Counseling Practice (QACP): A Resource Book for Mental Health Practitioners in India’. She is also a consultant therapist for Mariwala Health Initiative.)

If you feel suicidal or are having suicidal thoughts, help is available – please contact Sneha Suicide Prevention Helpline – 044 -2464000 (24 hours)

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