(Oyow/The New York Times)
Editor’s note • This article discusses suicide. If you or people you know are at risk of self-harm, call or text 988 to reach the Suicide & Crisis Lifeline for 24-hour support.
The Supreme Court’s decision to uphold Tennessee’s law banning gender-affirming care for transgender minors and the Trump administration’s decision to end funding for the specialized suicide hotline for L.G.B.T.Q.+ callers are not coincidental. They both speak to a fundamental failure to acknowledge the day-to-day reality of trans people in America.
As part of my research for a book about suicide prevention, I spent about a year working weekends on a hotline. I couldn’t acquire a serious understanding of what it meant to talk someone out of attempting suicide just by interviewing therapists or even sitting next to the people taking hotline calls. I wanted to feel the weight of caring for suicidal people and experience what it was like to help them through a crisis.
What the Trump administration fails to understand is that a common thread running through these calls is the desperate search for just one trusted adult. If the callers had one, there is a good chance they might not have had the need to reach us. One trusted adult could help them figure out how to open up to their families and friends. One trusted adult could get them through a tough night when they feel utterly hopeless.
The national 988 Suicide and Crisis Lifeline on which I worked is the nation’s main suicide prevention effort. In many areas of the country, it may be the only therapy the callers will ever get. On any given night, I was taking calls from all over America.
Most of my calls came from rural, isolated communities that lacked public transportation. After my standard greeting, calls could quickly get intimate. We had our share of regulars: quiet ladies in nursing home beds, college students alone in their dorms. People would call from their cars after their shifts stocking shelves and dressing window displays or from hallways of a noisy homeless shelter.
Some were unsure if they could trust me. I never could predict how a call would go. I would try at least to stay with the caller as long as they wanted, which could be when their cellphone ran out of juice. Next to my computer, I wrote on a scrap of paper, “Be humble.”
Crisis interventions had evolved a lot since the turn of the 20th century, when the Salvation Army put ads in newspapers for the emergency counseling services of its anti-suicide bureaus. The Maryland-based nonprofit I worked for covered more than just the main 988 line. We covered lines dedicated to Alaskan residents and a help line from New York City that was used mainly by severely mentally ill people seeking shelter. We referred cutters to a hotline addressing self-harm and rape victims to a line specializing in their trauma. Each line carried the promise of expertise on the other end.
Suicide is a leading cause of death in the United States, especially for teenagers and young adults. The risk of attempting suicide is even higher among L.G.B.T.Q. young people because of stigma and discrimination. When a call popped up on my screen from the Trevor Project line dedicated to L.G.B.T.Q.+ callers, I waited a beat and took a deep breath. I was all but guaranteed to find someone who sounded much younger than my average caller. The risk of suicide on this line was so great that our supervisors required us to ask callers whether they were having suicidal thoughts in that moment. We were not to assume the gender of the caller. It never stopped being a shock to answer the line and hear a prepubescent voice.
Some had already tried self-harm or made more than one suicide attempt. Many on a daily basis contemplated killing themselves. Gender dysphoria, one explained to me, was like “being tortured in my body.”
My experience runs counter to what the Trump administration has asserted in its decision to end this line. The Office of Management and Budget falsely argued that the phone line was a conduit of indoctrination “where children are encouraged to embrace radical gender ideology by ‘counselors’ without consent or knowledge of their parents.”
My callers wished their parents weren’t in denial and didn’t echo right-wing talking points. They wished they didn’t feel so alone late at night. They called from Utah and Arizona and Iowa. That more calls came from rural red states than from urban blue states was not a mere gut feeling on my part. Published data by the Trevor Project links the dozens of recent anti-trans laws with increases in the rates of suicide attempts by transgender and nonbinary youth.
One night, a suicidal trans girl said she had to cut the call short because it was getting to be past her bedtime. I am a cisgender male and a corny dad with a kid similar in age to these callers. Before they hung up, I whisper-yelled into the phone that they could call again anytime.
I also had trans adults calling, just as alone. A colleague got a call from a trans woman inside a psych ward — hospitals were no guarantee of safety. A caller from a rural state out west trying to transition told me, “Somebody has to give me a reason to live.” Telling them “it gets better” seemed not only hollow but false. I couldn’t pretend that the legislatures in the states where my callers lived were going to reverse course (they have not) or that the general anti-trans beliefs among policymakers in their state would change. I could only listen and validate that what they were going through was difficult — in other words, prove that they hadn’t made a mistake in reaching out.
The kids were telling us that to survive, they needed a kinder, safer world. We don’t have to take expensive, showy steps to get there. It can involve as basic a gesture as a middle school teacher wearing a rainbow necklace or a neighbor planting a trans flag in the yard. These are more than performative gestures to someone who feels abandoned.
A community college could open its library — and its L.G.B.T.Q. materials — to surrounding neighborhoods. The librarian could make a point of complimenting someone’s gender-nonconforming haircut or clothing. These kinds of safety signals let kids know where they can go in an emergency.
Surgeries for youth are rare. But hatred, spurred by the Trump administration, is not. Ultimately, the children whose stories of trauma and isolation I listened to had only one question. It was a simple one: Who can I turn to?
Jason Cherkis is a journalist based in Washington who covers mental health, among other subjects. He is working on a book about suicide. This article originally appeared in The New York Times.