Suicide prevention in LGBTQ+ community requires fighting stigma, valuing everyone as equals
The LGBTQI+ community is vulnerable to suicidality; this is a reality we all need to wake up and respond to. Broad-based programmes for suicide prevention in the community will not work, because most of them are designed imagining a cis-heterosexual person as the target. It will not account for the stresses that a person from the community experiences just for being who they are. Or perhaps for who they are not.
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A response to suicides in the LGBTQI+ community requires a commitment to understanding social factors that drive people to suicide. This does not mean that queer people may not be suffering from mental health challenges like depression, anxiety etc. It means that hate, discrimination and isolation can lead to a sense of hopelessness and helplessness where death appears like a release from a impossible life. This lack of hope is due to social reasons. One cannot work with trauma and mental illness without engaging with what causes it. Thus, suicide prevention programs/initiatives for the queer community should include an understanding of these structural and systemic factors.
Instances of queer/trans persons dying suicide is an issue of preventable and premature deaths. These are lives that end because individuals are denied the conditions necessary for human beings to create livable lives. This is not about intrinsic human vulnerabilities; it is about vulnerabilities that are produced social and political inequality. The absence of social structures that could provide conditions of livability contributes to what the scholar Lauren Berlant calls “slow death”. According to Berlant, certain populations are marked for being worn out structural and governmental factors, and queer/trans lives fit this description. Suicide then becomes something that merely puts an end to the slow death or provides an escape from it.
When we understand the social context in which LGBTQI+ suicides happen, we begin to realise it is society’s responsibility to provide conditions for liveability. Social, political and legal infrastructure, and support systems, are essential conditions. While LGBTQI+ affirmative mental health services are necessary, we also need to build this infrastructure in order for queer and trans persons to live a life, survive and thrive. Currently, social, political and legal infrastructure is extended mainly to cis-gender, heterosexual man or woman who fit society’s ideas of what is ‘normal’ gender and sexuality. Those who don’t fit are pushed out. This often drives them to suicide to escape society’s hostility and stigma. In our current social setup, some lives are not seen as worthy of being grieved. Some bodies do not matter. The way in which society conveys this is not considering these lives grievable. This means there were lives that were not deemed important enough to even be grieved in death, let alone be provided with support to live.
Therapeutic support for suicidality will involve providing trauma and crisis care that is informed an understanding of the context of stressors in LGBTQI+ lives. Hostility from families, medical and legal institutions, workplace discrimination, difficulties in finding safe shelter are all challenges that impact mental health adversely. A context of deprivation and discrimination shapes the emotional experience of persons from the community and impacts how it is difficult for them to imagine possibilities for a safe and fulfilling life. Furthermore, suicide prevention work with the trans community should involve providing services that allow for them to live their real gender. This would include quality medical services that are affordable, support for change of documents, redressal mechanisms for violence and discrimination, and shelter and employment. Thus, suicide prevention is not only about mental health services, but about providing services that support individuals to live their gender in authentic ways.
With the LGBTQI+ community, it is important to understand that suicide prevention cannot take the shape of mental health intervention that is only focused on therapy, although it can be a huge form of support. If a trans woman is unable to afford surgery to live their gender, therapy is not going to compensate for the lack of that affirming procedure. The question to ask ourselves is this, ‘What will help this person imagine a future for themselves in this heteronormative world?’
Suicide prevention work with the community will have to adopt an approach that takes into account how some lives are forced to end a total lack of possibilities to build a life that they can live which is free from discrimination. Thus, suicides LGBTQI+ persons must be seen as a social issue and reframed as preventable and premature deaths. This means that if society were to provide the necessary conditions, infrastructure and support, deaths suicide will reduce. Thus, suicide prevention work must go beyond focusing on the individual alone and focus on systemic change. When society’s stigma goes down, when all persons are equally valued, when services, policies, laws, infrastructure is inclusive of all people, then we can truly achieve suicide prevention in the LGBTQI+ community.
(The writer is faculty at the Queer Affirmative Counselling Practice course and has co-authored ‘Queer Affirmative Counselling Practice (QACP): A Resource Book for Mental Health Practitioners in India’. She is also a consultant therap with Mariwala Health Initiative.)
If you are feeling suicidal or have suicidal thoughts help is at hand- please contact Sneha Suicide Prevention helpline – 044 -2464000 (24 hours)
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