I think you need to pull back from how this narrative has been used in gender dysphoria and look at the history of "suicide awareness" for adolescents in schools and online. Whether by design or as an unintended consequence, adolescents are learning to understand and equate strong emotional distress with the language of suicidal ideation. We have all experienced deep distress and thought "I don't know how to live through this," "I can't see my way out of this," and "I don't want to live through this" but understood that does not mean we want to die or are suicidal. But now those thoughts are being understood and translated into the language of suicidal ideation, not just for gender dysphoria (where there's a well established script for it) but for ALL adolescent distress. I hear this language used all the time among adolescents and by the adults who think they are supporting them and engaging in suicide prevention. They don't recognize the iatrogenic harm, and this harm is 10x worse in the world of gender identity because of the scripts that have become so inextricably tied to the narrative.
We need to stop this talk of the suicide narrative.
When Dr. Miriam Grossman gave testimony at the Health Subcommittee Hearing on 6-14-23, she pointed out that suicide ideation is common in teens, it has become a common expression of distress, but it should not conflated with actual suicides.
Yes, exactly this. And, instead of the "multiple possible pathways" suggested in the Cass Report, our "mental health industrial complex" offers a very one-size-fits-all formula, where schools and police commit distressed kids to psych wards, from which they move on to facilities and programs which are (surprise!) very much captured by gender ideology.
Yes, this. Also, this was ramped up even more for the LGB young people during the same-sex rights campaigns, before we ever got mired (to our* detriment) in the T stuff. When the LGBs got equality there had to be something new to move on to for the "suicide risk is higher" orgs.
As a side note, the study of 315 adolescents is typical transmedical crap, not worthy of publication in any peer-reviewed journal, much less such prestigious as NEJM. (A study of such quality would NEVER get published in NEJM if it was any other topic). The infamous Diane Enhrensaft and Johanna Olson-Kennedy are two of the authors. Two suicides? No big deal, just look at the ground-breaking 0.5-2 point change in all psych measures over the period of two years! Yeah, there is no control group and it's teens so perhaps they change either way over two years but the study still proves that GAH is effective! We don't know what happened to six kids who dropped out and oh yeah, 11 other participants reported suicide ideation.
Sorry if this is a terrible question, but do we know about any possible links related to teens, antidepressants and suicide risk? Isn’t it true that a possible side effect of antidepressants, for some people, is increased risk of suicide ideation?
There are lots of warnings on SSRIs, given for depression (Prozac, Lexapro, etc) regarding a higher rate of suicidal feelings in the first few weeks on the drugs. There was also a study, I don't have the reference, which claimed these drugs don't help with depression in clinical trials.
It may not be the first time it appeared in print, but Donna Gephart quotes the "dead son or live daughter" threat and the bogus suicide data in her 2016 YA novel _Lily and Dunkin_. Apparently the book was widely read and favorably reviewed, so it probably had some influence on the discourse. (You could maybe contact the author and ask where she encountered it.) I suspect that the threat was borrowed from the similar narrative regarding gay kids from a generation earlier: Affirm this child's identity/sexuality or s/he will attempt suicide.
Thank you, Lisa. This is so important. It's infuriating to me that this myth persists - given all the things you cite - and also that it persists in a broader context of "distressed" teens, as Puzzle Therapy notes. In California, we're about to vote on gazillions for mental health services and there are no new thoughtful voices around this.
This is excellent, Lisa, and tremendously helpful to have at hand. Thank you for your hard and good work on this issue, and all else you are doing. It is much appreciated and sorely needed.
Lisa, thank-you once again for a smart and relevant piece of journalism. This week's publication by Ruuska, Tusk, Holttinen and Kaltiala in BMJ Mental Health, should end forever the presumption that medicalization of children with GD should proceed prior to treatment of other mental health challenges. There is no inherent suicidality associated with GD. There is suicidality associated with other conditions for which we have effective treatments. Heal the child first.
I am always struck by the early transition conundrum. On the one hand early transitioning allows for transfolk to blend in but in the process of early transitioning the child and their peers are completely aware of the change. In that process the trans identity subsumes male and female and allows for the status that difference allows. That status becomes a thing in itself, a way to separate oneself from others. Blending in is the concern of adults, not the concern of status-conscious teens.
My ex-husband, who has been claiming to be me, the mother of our children since 1995, even prior to his surgeries a year later, used the suicide narrative on me going back to 1992. This narrative goes way, way back, and the therapists promote it, even when the patient does not report being suicidal. In the 1990s I was gaslit to worry about a suicide he might commit. Now at the age of 69, fully owning an apartment worth 3 million and still holding an executive position in a database management company serving fine arts museums throughout the globe, I don't hear about this fragility. He might die from a pulmonary embolism or stroke from the decades of estrogen consumption. The Swedish study from 2011 (Cecilia Dhejne, et al, Karolinska Inst.) demonstrated that natal females who'd had "transition" surgeries dating from 1973 to 2003 were 40 TIMES more likely to have ended their lives by suicide, compared to age-matched, income-matched control females. This result was hidden by the researchers by folding it in with males, ("only" 19 times higher rate than male controls) because they knew they'd take heat from the lobbyists. Dr. Stephen B. Levine, formerly "affirming" psychiatrist, got the raw data and revealed this during the Florida Board of Health testimony.
Excellent post thank you, Lisa. In our experience, schools lean heavily on the suicide narrative and supporting research and data to defend social transition/unquestioning affirmation, and that is why it is so important to get the counter-narrative out there.
For example, in what became an email war between me and our trans identified daughter's dean, the dean sent my husband and me this on suicide/suicidality (I have pasted the links she included below as they didn't copy):
"We aim to ensure that all of our students feel belonging at [school name]. As experienced educators, we know that meeting our students where they are, promoting anti-discrimination, and affirming their identity and identity journey are best practices. Research shows that trans, non-binary, and LGBTQIA+ youth are at the highest risk of anxiety, depression, and suicide (see: NIH study, statistics from Trevor Project, U.S. National Survey, Guardian report). Protective factors include positive self-esteem, school belonging, family support, and peer support (see: U.S. Department of Education recommendations, APA recommendations, CDC study, mental health research study). As the statistics show, we are informed by research that using someone’s pronouns and honoring their identity is a form of suicide prevention. It’s worth reiterating that, as minors, students cannot pursue hormone treatment or medical transition without parental permission and oversight."
In other words, we're right and you're wrong.
I don't know what the best way to debunk all these "studies" that supposedly support the suicide narrative is but I suspect it's going to take a lot more than a few high quality studies showing the opposite is true.
When you see what the surgery/mutilation does to their bodies, they are basically disabled for life. How many of them go on to live a “normal “ life? Assuming that being a prostitute, a sex worker, model, or “activist” is not a normal life, is it worth it? They will have to work twice as hard to avoid being marginalized, drug addicted, and homeless. Not glamorous, which is what they are promised. Watching I am Jazz is eye opening. Not just what happened to him, but his friends who are obsessed with getting all kinds of surgery. The adult trans that he and his friends look up to are models and activists and they look clownish and foolish in all that makeup and bizarre clothing. One of his friends worked in a restaurant until someone misgendered him and he quit, because the coworker who misgendered him wasn’t fired. He is then isolated into the trans community, not earning a living or being in a loving relationship. And poor Jazz, who was a cute little child when all this started, expresses how much he just wants love.
If they push this in schools, the truth needs to be taught, too.
Just finished listening to the 6-part podcast (see https://www.memoryholepodcast.com/ ) about the whole "suppressed memories" scandal which delves into how a lot of that claptrap was based on much of the hooey dreamed up by that quack Freud over a hundred years before . . . talk about enduring myths! Dare we hope that it'll take less than a century to beat back all the snake oil poured into popular culture by this current batch of white-coated frauds and egomaniacs?
I don’t know when the “transition or death” thing came about, but I remember saying “rather have a live son than a dead daughter” to a skeptic at a 2017 Pride event in Colorado, as if I’d been hearing it my whole life.
In retrospect, especially given my radically changed thoughts on the whole topic, it seems bizarre that I can’t remember where or when I’d heard that first.
I think you need to pull back from how this narrative has been used in gender dysphoria and look at the history of "suicide awareness" for adolescents in schools and online. Whether by design or as an unintended consequence, adolescents are learning to understand and equate strong emotional distress with the language of suicidal ideation. We have all experienced deep distress and thought "I don't know how to live through this," "I can't see my way out of this," and "I don't want to live through this" but understood that does not mean we want to die or are suicidal. But now those thoughts are being understood and translated into the language of suicidal ideation, not just for gender dysphoria (where there's a well established script for it) but for ALL adolescent distress. I hear this language used all the time among adolescents and by the adults who think they are supporting them and engaging in suicide prevention. They don't recognize the iatrogenic harm, and this harm is 10x worse in the world of gender identity because of the scripts that have become so inextricably tied to the narrative.
Yes, suicide ideation is contagious.
We need to stop this talk of the suicide narrative.
When Dr. Miriam Grossman gave testimony at the Health Subcommittee Hearing on 6-14-23, she pointed out that suicide ideation is common in teens, it has become a common expression of distress, but it should not conflated with actual suicides.
Yes, exactly this. And, instead of the "multiple possible pathways" suggested in the Cass Report, our "mental health industrial complex" offers a very one-size-fits-all formula, where schools and police commit distressed kids to psych wards, from which they move on to facilities and programs which are (surprise!) very much captured by gender ideology.
Iatrogenic harm is so rampant in all of this.
Yes, this. Also, this was ramped up even more for the LGB young people during the same-sex rights campaigns, before we ever got mired (to our* detriment) in the T stuff. When the LGBs got equality there had to be something new to move on to for the "suicide risk is higher" orgs.
(*proud L and OG "TERF" here, lol)
As a side note, the study of 315 adolescents is typical transmedical crap, not worthy of publication in any peer-reviewed journal, much less such prestigious as NEJM. (A study of such quality would NEVER get published in NEJM if it was any other topic). The infamous Diane Enhrensaft and Johanna Olson-Kennedy are two of the authors. Two suicides? No big deal, just look at the ground-breaking 0.5-2 point change in all psych measures over the period of two years! Yeah, there is no control group and it's teens so perhaps they change either way over two years but the study still proves that GAH is effective! We don't know what happened to six kids who dropped out and oh yeah, 11 other participants reported suicide ideation.
Sorry if this is a terrible question, but do we know about any possible links related to teens, antidepressants and suicide risk? Isn’t it true that a possible side effect of antidepressants, for some people, is increased risk of suicide ideation?
A necessary question, no apologies needed.
There are lots of warnings on SSRIs, given for depression (Prozac, Lexapro, etc) regarding a higher rate of suicidal feelings in the first few weeks on the drugs. There was also a study, I don't have the reference, which claimed these drugs don't help with depression in clinical trials.
If you're on X/Twitter, Dr. Roger McFillin talks about the black label boxes on SSRIs and studies surrounding them.
It may not be the first time it appeared in print, but Donna Gephart quotes the "dead son or live daughter" threat and the bogus suicide data in her 2016 YA novel _Lily and Dunkin_. Apparently the book was widely read and favorably reviewed, so it probably had some influence on the discourse. (You could maybe contact the author and ask where she encountered it.) I suspect that the threat was borrowed from the similar narrative regarding gay kids from a generation earlier: Affirm this child's identity/sexuality or s/he will attempt suicide.
Thank you, Lisa. This is so important. It's infuriating to me that this myth persists - given all the things you cite - and also that it persists in a broader context of "distressed" teens, as Puzzle Therapy notes. In California, we're about to vote on gazillions for mental health services and there are no new thoughtful voices around this.
This is excellent, Lisa, and tremendously helpful to have at hand. Thank you for your hard and good work on this issue, and all else you are doing. It is much appreciated and sorely needed.
Lisa, thank-you once again for a smart and relevant piece of journalism. This week's publication by Ruuska, Tusk, Holttinen and Kaltiala in BMJ Mental Health, should end forever the presumption that medicalization of children with GD should proceed prior to treatment of other mental health challenges. There is no inherent suicidality associated with GD. There is suicidality associated with other conditions for which we have effective treatments. Heal the child first.
I am always struck by the early transition conundrum. On the one hand early transitioning allows for transfolk to blend in but in the process of early transitioning the child and their peers are completely aware of the change. In that process the trans identity subsumes male and female and allows for the status that difference allows. That status becomes a thing in itself, a way to separate oneself from others. Blending in is the concern of adults, not the concern of status-conscious teens.
Thank you!
I'd add...
"A new paper from Finland **again** questions the narrative that such interventions are life-saving. The study looked at deaths of adolescents ..."
My ex-husband, who has been claiming to be me, the mother of our children since 1995, even prior to his surgeries a year later, used the suicide narrative on me going back to 1992. This narrative goes way, way back, and the therapists promote it, even when the patient does not report being suicidal. In the 1990s I was gaslit to worry about a suicide he might commit. Now at the age of 69, fully owning an apartment worth 3 million and still holding an executive position in a database management company serving fine arts museums throughout the globe, I don't hear about this fragility. He might die from a pulmonary embolism or stroke from the decades of estrogen consumption. The Swedish study from 2011 (Cecilia Dhejne, et al, Karolinska Inst.) demonstrated that natal females who'd had "transition" surgeries dating from 1973 to 2003 were 40 TIMES more likely to have ended their lives by suicide, compared to age-matched, income-matched control females. This result was hidden by the researchers by folding it in with males, ("only" 19 times higher rate than male controls) because they knew they'd take heat from the lobbyists. Dr. Stephen B. Levine, formerly "affirming" psychiatrist, got the raw data and revealed this during the Florida Board of Health testimony.
Excellent post thank you, Lisa. In our experience, schools lean heavily on the suicide narrative and supporting research and data to defend social transition/unquestioning affirmation, and that is why it is so important to get the counter-narrative out there.
For example, in what became an email war between me and our trans identified daughter's dean, the dean sent my husband and me this on suicide/suicidality (I have pasted the links she included below as they didn't copy):
"We aim to ensure that all of our students feel belonging at [school name]. As experienced educators, we know that meeting our students where they are, promoting anti-discrimination, and affirming their identity and identity journey are best practices. Research shows that trans, non-binary, and LGBTQIA+ youth are at the highest risk of anxiety, depression, and suicide (see: NIH study, statistics from Trevor Project, U.S. National Survey, Guardian report). Protective factors include positive self-esteem, school belonging, family support, and peer support (see: U.S. Department of Education recommendations, APA recommendations, CDC study, mental health research study). As the statistics show, we are informed by research that using someone’s pronouns and honoring their identity is a form of suicide prevention. It’s worth reiterating that, as minors, students cannot pursue hormone treatment or medical transition without parental permission and oversight."
In other words, we're right and you're wrong.
I don't know what the best way to debunk all these "studies" that supposedly support the suicide narrative is but I suspect it's going to take a lot more than a few high quality studies showing the opposite is true.
Links from dean's email:
NIH study: https://pubmed.ncbi.nlm.nih.gov/32345113/
Trevor project statistics: https://www.thetrevorproject.org/resources/article/facts-about-lgbtq-youth-suicide/
U.S. National Survey: https://www.thetrevorproject.org/research-briefs/2022-u-s-national-survey-on-lgbtq-youth-mental-health-by-state-dec-2022/
Guardian report: https://www.theguardian.com/us-news/2022/dec/16/us-trans-non-binary-youth-suicide-mental-health
U.S. Department of Education recommendations: https://www2.ed.gov/about/offices/list/ocr/docs/ed-factsheet-transgender-202106.pdf
APA recommendations: https://www.apa.org/pi/lgbt/programs/safe-supportive/lgbt/risk-factors.pdf
CDC study: https://www.cdc.gov/healthyyouth/disparities/protective-factors-for-lgbtq-youth.htm
mental health research study: https://www.nature.com/articles/s44184-023-00029-8.epdf
When you see what the surgery/mutilation does to their bodies, they are basically disabled for life. How many of them go on to live a “normal “ life? Assuming that being a prostitute, a sex worker, model, or “activist” is not a normal life, is it worth it? They will have to work twice as hard to avoid being marginalized, drug addicted, and homeless. Not glamorous, which is what they are promised. Watching I am Jazz is eye opening. Not just what happened to him, but his friends who are obsessed with getting all kinds of surgery. The adult trans that he and his friends look up to are models and activists and they look clownish and foolish in all that makeup and bizarre clothing. One of his friends worked in a restaurant until someone misgendered him and he quit, because the coworker who misgendered him wasn’t fired. He is then isolated into the trans community, not earning a living or being in a loving relationship. And poor Jazz, who was a cute little child when all this started, expresses how much he just wants love.
If they push this in schools, the truth needs to be taught, too.
Just finished listening to the 6-part podcast (see https://www.memoryholepodcast.com/ ) about the whole "suppressed memories" scandal which delves into how a lot of that claptrap was based on much of the hooey dreamed up by that quack Freud over a hundred years before . . . talk about enduring myths! Dare we hope that it'll take less than a century to beat back all the snake oil poured into popular culture by this current batch of white-coated frauds and egomaniacs?
I don’t know when the “transition or death” thing came about, but I remember saying “rather have a live son than a dead daughter” to a skeptic at a 2017 Pride event in Colorado, as if I’d been hearing it my whole life.
In retrospect, especially given my radically changed thoughts on the whole topic, it seems bizarre that I can’t remember where or when I’d heard that first.