As I write this article, trans people worldwide are reeling from a barrage of intense and severe attacks on our legal rights: in the United States, the Trump administration has, in its first weeks of operations, released a series of executive orders that are an effective attempt to govern the trans population out of existence. Legal recognition of trans people’s gender identities, access to gender-affirming healthcare, protection from transphobic discrimination and many more essential rights have been thrown into jeopardy. Trans youth in particular are the subject of an outright ban on gender-affirming care and gender-affirming education.
Given the U.S.’s outsize influence on the world stage, these executive orders have global impact, as they not only set the tone for anti-trans politicians and agitators everywhere but may also directly affect any organization or institution that receives funding from the American federal government.
The situation is, in a word, devastating. The fight for trans liberation, an uphill battle to begin with, has just gotten significantly harder—and the worst is likely yet to come. As the simple act of existing while trans becomes increasingly criminalized, the collective mental health of our communities is set to pay a harsh price for the intolerance and hatred of the anti-trans moral panic.
Though I deeply wish that we did not live in a world where this thought was necessary to articulate, it is essential that trans people and our allies prepare for a heightened risk of suicide among our people. It is essential that we strengthen our ability to intervene to protect our loved ones’ lives—and to do that, we must as a community be able to think and talk about suicide with emotional depth and room for complexity.
I have been a support worker of various kinds in the queer and trans community since I was sixteen years old, and as a result, conversations about suicide are sadly second nature to me to now, as they are to many of us. According to a survey of over 18,000 LGBTQ2S+ youth conducted by The Trevor Project in 2024, 46 percent of trans and non-binary youth reported seriously considering suicide in the past year. A study published by the UCLA School of Law’s Williams Institute in 2023 found that a staggering 81 percent of trans adults had considered suicide in their lifetime, and 42 percent had attempted it.
I have done suicide interventions in formal, clinical settings, and I have done them informally for friends and chosen family and intimate partners. I have done suicide interventions in hospitals and living rooms, and on Zoom calls and crisis phone lines with strangers. Once, I did a suicide intervention in the middle of a forest in rural Ontario. I have done suicide interventions for children as young as six years old and for adults in their seventies; I have done them for countless trans teenagers, and I remember every single one.
In a world that wants so badly to kill us, every breath we take is a rebellion, and every time we walk another trans comrade or sibling back from the brink of despair is a victory beyond measure.
Something I have learned about suicide through these moments is that it is deeply human to think about ending your own life, particularly when the dominant culture is doing its level best to crush you and destroy everything you love. Something else I know is that suicide and suicide prevention are deeply political: our lives do in fact matter, in the grand scheme of things, and it is in the interest of fascism, imperialism, transphobia and every other kind of oppression to try and convince us otherwise. In a world that wants so badly to kill us, every breath we take is a rebellion, and every time we walk another trans comrade or sibling back from the brink of despair is a victory beyond measure.
The mainstream mental health industry, which has historically been homophobic and transphobic, not to mention sexist and racist, has come to dominate the field of suicide intervention, as it has come to dominate the societal conversation on mental and emotional health in general. As a result, professionalized supports for trans folks and other marginalized people who experience suicidal ideation are often profoundly unappealing, unhelpful or even dangerous.
People are often afraid that emergency services will force them into involuntary care if they admit that they are having suicidal thoughts. And for trans people, this fear can be compounded by the possibility that psychiatric hospitals will be transphobic toward them—a fear that is made more likely as legal pressure increases on healthcare facilities to explicitly disregard trans people’s human rights. Emergency services are also generally tied to and backed up by the police, who have a long history of deadly interactions with mentally ill and suicidal people, not to mention a long history of violence against queer and trans people.
This isn’t to say that emergency response teams and hospitals are all bad for trans people—in my time as a support provider, I’ve seen a wide spectrum of experiences in this regard, from terrible to excellent. However, I also firmly believe that the revolutionary and transformative power of suicide intervention for trans people lies within trans community itself, rather than in the mental health industry. Health and social care are always political, and marginalized communities have a long and beautiful history of taking care work into our own hands for the sake of liberation.
For example, feminist communities all over the world have worked for many decades to organize community-based reproductive care, including access to contraception and abortion medications, and were instrumental in the resurgence of midwives and doulas. Similarly, queer community organizations developed and practised HIV/AIDS care and sexual health education for queer and trans folks long before the state ever stepped in.
Trans people have been doing community-based suicide intervention (whether we call it that or not) throughout our history. In fact, I first learned suicide intervention skills from another trans woman. As a result of the unique forms of oppression and marginalization that we experience, trans communities have developed unique insights and ways of doing suicide intervention, particularly when it comes to working outside the purview of the state and the mental health industry.
For example, genderqueer therapist and facilitator Carly Boyce has developed a popular workshop on abolitionist suicide intervention titled Suicide Intervention (For Weirdos, Freaks, and Queers) along with an accompanying zine titled helping your friends who sometimes wanna die maybe not die. In the latter, Boyce challenges mainstream myths and assumptions about suicide and frames suicide as explicitly political, writing that “keeping our people alive isn’t just about having them continue to breathe, we have to think about the circumstances that led to the kind of pain and hopelessness they experience.”
In other words, our battle against the forces that want trans people to kill ourselves and those who simply don’t care if we die requires us to think beyond intervention as more than stopping suicide by calling 911: it requires a deep and purposeful commitment to transforming the conditions that make trans people want to die in the first place. It is about deeply hearing their pain and despair and offering them allyship in the war for a better world.
It is often this commitment to the future of trans people around me—the future of my loved ones, my trans sisters, brothers and siblings, the future of my trans mentees and daughters—that keeps me going and gives me strength in the midst of hopelessness and horror. This commitment requires me to receive care from my loved ones too, even though receiving care is something I struggle with immensely. In this way, suicide intervention becomes a life-giving loop rather than a service or an act of rescue from a hero on high. Community-based suicide intervention is about creating a web of life between our bodies where we can take turns resting and being held when we are overwhelmed.
Suicide intervention can take many different forms, and there are several models and frameworks that are commonly taught today. However, most do not include a trans-specific or anti-oppressive framework. For trans people and our allies, a basic framework might look like this:
1. Ask about suicide
If you suspect that a trans person in your life is suicidal, ask them if they are thinking about ending their life. A common fear is that asking about suicide might “plant the idea of suicide” in the mind of a person who is emotionally struggling. Something that all suicide intervention models agree upon is that this is not true. Generally speaking, there are far more benefits of asking someone if they are suicidal and far more potential risks in not asking.
When asking someone if they are suicidal, it’s best to do so in as non-stigmatizing and non-anxious a way as possible. You want the person that you’re asking to know that you care about them, that you are not judging them and that you’re someone they can trust to listen to their story. Remember that it’s not your job to control them or the outcome of the situation, and it’s okay to feel scared or overwhelmed. The key is to not make the person who’s already feeling suicidal take care of your feelings of fear or overwhelm. You want to hold space for them, not the other way around
2. Seek to understand
Let them know that you want to listen. Invite them to tell you more about what’s going on for them and whatever else they’d like you to know. Try not to give advice or “fix” things, but rather listen curiously. See if you can deeply understand on an emotional level what’s going on. What are they feeling and thinking about? It’s important to remember that this doesn’t need to be an interview, and you don’t need to come up with any magical questions or solutions. It’s a conversation about the person in front of you. It’s a truism in the field of suicide intervention that suicidal ideation is often about longing to live a different life. The more you know about what your person is going through, the more you’ll know about what kind of life they are longing to live.
3. Invitations and offers
Understanding more about what your person is going through and what has led them to suicidal ideation will usually also tell you more about what they might need to help them feel a little less suffering. With understanding, you can decide if you feel confident making an offer or invitation, such as inviting your person to crash at your place for a night, offering to take them to the hospital ER and sit with them in the waiting room, having a daily phone check-in for 15 minutes for the next five days. Offers and invitations should be about making life feel more bearable and moving toward hope. Try to only make offers and invitations that you feel confident you can follow through on. However, if you make a mistake about your capacity, it’s okay to admit this and renegotiate—that’s normal and a part of being human.
4. Bring in more supports
Always try to bring in more supports, for both you and the person who is suicidal. Remember that community suicide intervention is a web, not a thread: you will need folks who can hold you too, and people who can take over the support work when you need to tap out. Supports can look like friends, a 12-step meeting group, case managers or therapists, a spiritual or religious community that you trust or any other helpful person or group of people. Sometimes you or the trans person who is suicidal will feel that calling 911 or seeking another emergency service is the best/only way to go forward. In that case, make some plans about how the potential risks or scary aspects of those options could be reduced—for trans people in the vulnerable position of receiving suicide care, just having someone come along to advocate for them is often a deeply helpful strategy.
Every trans life is sacred and worth protecting. Trans people have been keeping each other alive for as long as we have existed—so let’s keep doing it. Let’s get better and better at holding and loving one another. The ones who hate us have never succeeded in destroying us, and they will not succeed now. We’ll survive until another world is born.
If you or someone you care for is experiencing suicidal ideation, these resources may be helpful:
Trans Lifeline: https://translifeline.org/
LGBT Youthline: https://www.youthline.ca/
Canadian Mental Health Association Crisis links: https://cmha.ca/find-help/if-you-are-in-crisis/
Carly Boyce’s website: https://www.tinylantern.net/suicide-intervention-resources
The opinions expressed in this column are not intended or implied to be a substitute for professional medical or mental health advice, diagnosis or treatment.
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