How to Stay With Us Using Science
In times of crisis, there are research backed methods to help you get through it.
by Veronica Esposito
Times of crisis are dangerous times when it comes to the potential for ending one’s life. Electing a sex offender and felon who has explicitly stated his plans to target trans people to the highest political office in the country definitely qualifies as a time of crisis for the trans community. At this time, our community is experiencing extreme amounts of overwhelm, anxiety, fatigue, and hopelessness—all danger signs for suicide.
But there are ways to prevent suicide and make yourself safer, even right now. I am a mental health therapist who specializes in helping individuals who have experienced significant amounts of trauma, as well as those facing high levels of systemic oppression, overcome suicidal periods and thrive. I am here to share some thoughts on how you can help both yourself and those you love and care about through crisis periods—we will surely be facing more of them in the coming four years and likely beyond.
While there is nothing that we can do to make the world completely safe for oppressed groups, there are many key steps that we can take to create safer environments during crisis times. Here are a few empirically backed steps that I recommend you take, or implement with those you believe to be in danger:
Avoid substance use if at all possible. There is a much higher chance that suicidal ideation will turn into suicidal behaviors when someone is intoxicated with drugs or alcohol. During crisis periods, it’s best to avoid substances, or to use them in very light amounts. This step may be challenging to take, because crises are often times when people turn to these substances to cope. If you feel that it is absolutely necessary to continue using substances in the face of suicidal ideation, try to at least use less of the substance, or do so in environments where you have al ower risk for ending your life (e.g. among groups of friends, or when you do not have access to lethal means).
Remove lethal means from your living space. In order to end our lives it’s necessary to have implements that allow us to carry out this act. Usually individuals who frequently think about ending their lives have some idea of how they would do it. It is imperative to remove any items that would help you end your life; it’s especially important to remove items such as guns that could be used impulsively in moments of extreme dysregulation, even if you have not thought specifically about using them for suicidal purposes.
Resist the urge to isolate. During crisis periods it is extremely common for individuals to attempt to cope by isolating from the outside world. While this is tempting and may be a tool that you have used in the past to cope with tough times, it greatly increases the chances that suicidal ideation will cross over into suicidal acts. During crises it’s imperative to connect with your support community—be that biological or chosen family, your friends, a local LGBTQ+ center, a trans-friendly gathering, or a therapist or hotline. Even small acts like taking a walk around your block, getting out to a local cafe, calling the national suicide hotline for a daily check in, or texting a few words to a friend can make an enormous difference.
Take some time to map out all of the reasons to continue living. The extreme levels of hopelessness and anxiety that can lead to suicide can be combated by having reasons to live. These can be big (I want to help build a better future for trans people) or they can be small (if I die there won’t be anyone around to care for my pet fish). It is a great idea to write down all of these reasons for living and to have it somewhere where you can regularly look at it. Every day, try to find some time to check in with your list and think about your reasons to continue living.
Build up positive experiences in your life. Similar to the last point, suicide risk can be greatly reduced by taking action to build a life that’s worth living. This is especially important during crisis times, when bad news mounts up and it seems like there is no future for us. This can be as simple as having a fun weekend plan to look forward to, a daily food treat that you reward yourself with, or even just stepping outside to watch a beautiful sunset. It can be helpful to make a weekly checklist of such positive experiences and check them off one by one as you complete them. You can think of building up positive experiences one by one as building up a counterweight to the heaviness of depression and anxiety.
Lastly, it’s important to remember that most people who survive an attempt to end their life say that they regretted attempting to kill themselves. Survivors generally say that once they passed the point of no return, they wanted to live, not die. Suicide may seem like an appealing way to relieve your pain, but the reality of survivors demonstrates the opposite.
If you are a friend of or family member of a trans person who you believe to be in crisis, or if you have a trans coworker or teach a class and have a trans student,, there are important ways that you can help to reduce the risk of suicide for that person.
Always ask if you suspect danger. It is a widely believed misconception that asking about suicide can inadvertently plant a seed of suicidal behavior—this is absolutely not true. If you perceive extreme levels of hopelessness, sadness, anhedonia, or anxiety in someone, always check in about suicidal ideation and/or plans. Indications that a suicide attempt is imminent include saying final goodbyes, giving away important possessions, arranging final affairs, or undertaking increasingly risky behaviors. Always ask, and if you suspect that a person is in danger, do not leave them alone—take steps to get them support via friends or family, a mental health therapist, a support hotline, or even emergency hospitalization in extreme circumstances.
Be a support. One fact that comes up again and again in the research is that, for a trans child, the single most protective factor against suicidal behavior is having one caring, accepting adult in their life—be it a teacher, a therapist, a family member, or someone else. Be that person. Just take a moment to check in with that kid, affirm them, tell them that you see them, and let them know that you value their presence here on earth. It is no exaggeration at all to say that it can be life-saving.
Help someone be their true self. Feeling seen and accepted as your true self, taking material steps to be that person, and feeling that you belong are among the most protective factors against suicide for trans people. Please help make this happen for the trans people in your life. This can include supporting someone in pursuing gender-affirming medical care, using correct names and pronouns, helping procure gender-affirming items, and making someone feel seen and accepted within a social group.
Make sure people know they’re not a burden. One of the key risk factors for ending one’s life is the sense of being a burden on others—often trans people can trick ourselves into believing that family and loved ones would be better off if we were dead. Make sure to make it absolutely clear to a trans person in your life that they are not a burden at all, and in fact are a cherished member of your world who makes your life so much richer and happier.
It can be helpful to understand suicidal crises in a larger context of minority stress that marginalized groups such as trans people face. To help get a better sense of that, Here is a model to help visualize how stressors related to politics and systemic oppression can create intense mental health struggles for trans people (it comes from this research):
What this model indicates is that oppressive factors outside of our control (e.g. enactment of a hate law or election of a transphobic sex offender to the White House) activate oppressive factors within us (e.g. internalized transphobia or an outlook of hopelessness) that sharply reduce our mental health. We can disrupt this chain of events by being connected with our communities and feeling good about who we are—this is why it’s important to take the steps outlined at the beginning of this article if you’re at risk for ending your life.
Over a longer span of time we can increase our self-protection against suicide by dismantling internalized forms of oppression, building a more hopeful attitude, living authentically, and building up robust support communities. When you feel that you are ready, you can undertake this long-term work by joining a support group, working with a therapist, taking time to engage with trans-created media and books, and using other tasks to build up your resilience.
During these difficult months, please remember that the trans community has survived much worse than Donald Trump—historically, we did not even have widespread access to the basics of medical care, or the rudimentary civil rights that we do currently have, and we have overcome immeasurable odds to find liberation, pride, and happiness in this world. Even if we lose our access to civil rights and the medical care we need to thrive, we will continue to find ways to support one another and be our authentic selves—we have done all this in past decades, and we would not be here if we were not capable of doing this again. We will continue to live and thrive by whatever means we need to, and we will see a better day for ourselves and future generations.
Veronica Esposito (she/her) is a writer and therapist based in the Bay Area. She writes regularly for The Guardian, Xtra Magazine, and KQED, the NPR member station for Northern California, on the arts, mental health, and LGBTQ+ issues.