Suicide among trans youth has become a silent pandemic, and it’s an outcome that’s often preventable with appropriate support and care. The trans community at large experiences rates of depression, anxiety, and other serious mental health issues at much higher rates than the rest of the population for a variety of reasons. Teens are an especially vulnerable group for these conditions as it is, and the challenges of being trans multiply the effects of preexisting risk factors.
One of the most heartbreaking aspects of teen suicide is that in most cases it’s entirely preventable. Suicide is almost never impulsive—it is the conclusion of a long process of negative thoughts and emotions that go unnoticed and unaddressed. One of the most important signs to watch out for is passive suicidal ideation, which is recurring suicidal thoughts that aren’t connected with a plan of action.
Healthcare providers, clinicians, and educators have more face time with our youth than their own families at times, placing them in the prime position to pick up on the signs of passive suicidal ideation among trans youth. Gaining insight into the struggles they face and how to provide support is key to empowering these frontline workers to make a difference.
Trans Youth in the United States Today
There are more than 1.3 million transgender youth in the U.S. today. The data tells us that a staggering 82% of those trans youth have considered killing themselves at least once, and 40% have made an attempt. These rates, as well as incidences of depression and anxiety, are much higher than for their cisgender and LGB counterparts.
Contrary to some mainstream commentary, people aren’t suicidal as a direct result of being trans. The fact is, life in many communities is extremely difficult for trans people, and various social, institutional, and cultural factors can make their gender expression a painful and dangerous proposition. Among other things, trans people routinely face:
- Inequalities stemming from institutional prejudice
- Verbal and physical discrimination and harassment
- A lack or absence of family and community support
- Gender dysphoria
- Stress and fear related to transitioning and gender expression
For trans youth, all of these challenges are amplified because of their emergent quality and are compounded by developing brain physiology and the emotional instability all teens face. Simple, everyday experiences for their peers can be sources of extreme stress. 80% of trans youth say they avoid bathrooms because they feel unsafe and 64% avoid gym class for the same reason. As a result, it’s hardly surprising that only 8% of trans youth view their community as accepting, and only 12% view their school system as being supportive.
What Is Passive Suicidal Ideation?
Passive suicidal ideation is the desire to end your own life without having a plan to commit the act. While a person with passive suicidal ideation may not be actively planning or working towards harming themselves, it is evidence that suicidal thoughts are escalating towards potentially harmful behavior.
Suicidal ideation doesn’t require expressing your thoughts in words or writing, either. Someone can be passively suicidal while simply thinking or dreaming about hurting themselves. Picking up on the signs of potentially harmful thoughts often requires attention to subtle interactions that may seem unimportant or overly dramatic in a typical teen.
Expressions of passive suicidal ideation may include saying things like:
“I wish someone would crash into me.”
“I hope I die in my sleep.”
“I wish I was never born.”
“They’d all be better without me.”
This kind of thinking is a gateway to more tangible ideas that can quickly become deadly. Teens are already a vulnerable population when it comes to suicide and passive suicidal ideation, but it’s particularly critical to be sensitive to potentially harmful thoughts from trans youth because of compounding risk factors.
Risk Factors for Trans Youth
Active and passive suicidal ideations in trans youth exist concurrently with risk factors that are particularly prominent in the trans experience. While many teenagers may have intermittent encounters with one of these challenges, trans youth often have an ongoing struggle with some or all of them.
Bullying
A national survey aimed at assessing the state of mental health for the queer community revealed that 36% of LGBTQIA+ youth have been physically threatened or harmed, and those same youth attempted suicide at almost triple the rate of their peers who were not bullied. Trans youth have the highest rate of bullying among all LGBTQIA+ populations at 61%, and it’s a major contributing factor to passive suicidal ideation.
Lack of Gender Affirming Care
Trans youth who receive gender-affirming care experience dramatically lowered rates of depression and anxiety (-52%) and a 46% decrease in suicide attempts. Long-term data reflects that trans people who were provided gender-affirming care such as puberty blockers during adolescence experienced a lesser incidence of suicidal ideations in adulthood.
Lack of Institutional Acceptance
Because a lack of acceptance in the home may be unavoidable for some trans youth, institutions like schools and healthcare facilities are often their first, best option for finding support. Unfortunately, there are many places in the country where both are either lacking in solid policy or are outright hostile to the trans community.
An inability to find support and a sense of isolation are both serious risk factors for passive suicidal ideation, and trans youth are particularly vulnerable to both.
Supporting Trans Youth
Because of the elevated and ongoing risks trans youth face in addition to being members of an already vulnerable teen population, engagement for suicide and passive suicidal ideation needs to come early and often. A multifaceted approach to supporting trans youth is critical, including interprofessional collaboration aimed at physical health and wellness that’s enhanced through resources like gender-affirming care and mental health support.
Training and continuing education for identifying warning signs and implementing evidence-based strategies for managing passive suicidal ideation is critical for healthcare providers, educators, counselors, parents, and other professionals as part of an overall suicide prevention strategy.
Be Prepared for Passive Suicidal Ideations
Healthcare professionals and educators need the essential knowledge and skills to effectively address the critical issue of active and passive suicidal ideations among transgender and gender-diverse youth. Embracing Identities - Suicide Prevention with Trans Youth and Not Alone - Techniques to Support Trans Youth, both created by Brian Masciadrelli Ph.D., LICS, LMSW, and Megan Arbour Ph.D., RN, CNM, CNE, will give you all the tools you need to make a difference.
These two courses highlight the significance of affirming and inclusive approaches and the impact of interprofessional collaboration in the context of suicide prevention among trans youth. All content by Premiere is created by leading industry professionals and provides the tools and training they need to make a difference in the lives of the people they serve.
