Rosino, CC BY-SA 2.0 <https://creativecommons.org/licenses/by-sa/2.0>, via Wikimedia Commons
Crossposted (and lightly edited) from the LGBT Courage Coalition blog…
When I was scrolling through my social media feed in the past two weeks, a post popped up from the Mental Health Commission of Canada linking to a 2019 article they had posted about transgender suicide facts. The post was in honour of November 20th or Transgender Day of Remembrance,“an annual observance that honors the memory of the transgender people whose lives were lost in acts of anti-transgender violence”. TDoR was started in 1999 following the death of a black trans woman, Rita Hester, who was brutally stabbed to death in her Boston apartment in 1998. Her murder remains unsolved.
The MHCC chose to commemorate this somber occasion by highlighting the elevated suicide rate in the transgender community, framing social discrimination as its main cause. The MHCC is a national not-for-profit corporation and a registered Canadian charity that has partnerships with federal, provincial and territorial governments, foundations, as well as private sector organizations. It also receives donations from the public. The MHCC calls itself “a catalyst for change, an organization designed to recommend improvements to the mental health system on a national level.”
The MHCC’s fact sheet includes a reference to a study that found 1 in 3 Canadian transgender youth had contemplated suicide in the past year - a shocking number at face value. However, as others have pointed out, the suicide question is a complicated one, especially since youth mental health is in something of a crisis. Suicide rarely has only one causal factor, and gender dysphoria often exists alongside a wide array of co-occurring psychiatric conditions such as depression, anxiety, autism spectrum disorder, personality disorders, eating disorders and substance use disorders. These conditions by themselves have higher rates of completed suicides than gender dysphoria does.
More worrisome, however, are the conclusions that the MHCC draws about what reduces suicidality among trans people. The MHCC claims the following (bolding my own):
“What can reduce risk?
Supportive and strong relationships with family and friends
Completed medical transition (if medical transition is desired)
Self-awareness and acceptance
Access to gender affirming health care
Not having access to lethal means such as guns or potentially deadly medications
Having one’s name and pronouns accepted (Bailey et al., 2014; Bauer et al., 2015a; Haas et al., 2011; SPRC, 2008).
[…]
“What can trans people do to stay mentally healthy?
CONSIDER HOW TO TRANSITION
Decide whether to transition in appearance and by name, and if a medical transition is desired, too.PRIORITIZE POSITIVE RELATIONSHIPS
Call, text, and hang out with supportive and affirming friends and family members and consider reaching out to other trans people, especially peers.FIND AN INCLUSIVE AND AFFIRMING HEALTHCARE PROVIDER
This is vital to ensure safety and comfort when accessing healthcare services.ASK FOR HELP WHEN IT IS NEEDED!
When struggling to cope with life, tell a loved one or call the local crisis line, or the Trans Lifeline at 877-330-6366.”
The MHCC boldly claims that medical transition and gender affirming care reduces suicide risk. On what evidence is this claim made? Recently, a careful review of gender affirming care research found little evidence that gender affirming care actually improved mental health, and in some cases may even cause harm. Multiple systematic reviews in Finland, Sweden, and England “have found the risk/benefit ratio of youth gender transition ranges from unknown to unfavourable”.
Debate about the safety and efficacy of gender-affirming care in North America is only recently starting to get the attention it needs. By posting this article on TDoR, the MHCC is feeding into a harmful narrative that continues to suggest that medical transition is a cure for mental health issues. The data is in, and it simply is not true.
Action alert
Contact the Mental Health Commission of Canada (MHCC)
Help the MHCC live up to its mandate of being a catalyst for change and a leading voice for improving the mental health system in Canada. Write to the MHCC and let your voice be heard.
Contact info
Media Relations
Mental Health Commission of Canada
613-683-3748 / media@mentalhealthcommission.ca
Your letter can be simple and touch upon some of the following points:
I am writing as a concerned (parent, therapist, doctor, etc.)
I am concerned with the fact sheet posted about Transgender People and Suicide.
Explain why you are concerned (this could include mentioning recent reviews of evidence, the increase in lawsuits from detransitioners for whom medical transition was not the answer for mental health issues, or something from your own personal story or observations)
End with a statement showing that your concerns are because you care about trans-identified adults and young people. For example, “Like you, I want to support the mental health of transgender individuals. We need to allow for open and honest debate to make sure our best intentions are not actually causing more harm than good.”
If you are struggling with suicidal thoughts, help is available:
Call you local distress line, or
USA - dial 988 or visit https://988lifeline.org/
Canada - dial 1.833.456.4566 or visit https://talksuicide.ca/