I am writing this as a way to exercise my writing skills and the writing voice I developed over many years, which has atrophied somewhat since starting a job that requires a lot of writing in a specific health promotion style.
A part of my social work studies and placements was to regularly write critical reflections. This is a reflection of the past couple of years of working in both the LGBTQ+ health and suicide prevention sectors. I have learned so much and have had ideas form and morph and crystallise and lines of logic reinforced that I keep coming back to.
This is also a reflection on my ongoing education around LGBTQ+ lived experiences, not just in regards to suicide, but all the interesting facets of navigating this world as a queer person different to my own. It is essential work to understand the breadth of community experiences and to have nuanced, but succinct, scripts in my head for presentations to stakeholders in the broader health care community.
So far, I have had two opportunities to represent the organisation I work for and the work I do presenting to mainstream health organisations: one to Lifeline Macarthur and Western Sydney and one to the Mental Health Commission of NSW. I really enjoy public speaking and I get to use the skills I developed in over a decade of teaching. Both presentations were received well and I’m excited to do more in the future.
Through these presentations I have reflected on what it means to represent a marginalised and minority community and what our experiences and perspectives add to mainstream society. During my presentation to Lifeline, it struck me how demeaning it can be to serve as a curio or token - an afterthought in the fabric of society at large. Sexuality and gender diversity actually affects everyone, whether a person’s sexuality and/or gender is marginalised or not. So, I made a point that a pluralistic understanding of sexuality and gender benefited cisgender, heterosexual people, too.
There is no one way to be a man, a woman, or non-binary person. There is no one way to experience one’s sexuality, and one’s sexuality doesn’t have to predetermine life stages and romantic relationships. I forget how many people still have these implicit biases about gender and sexuality, even though in my experiences as a queer person in cisheteronormative environments it shouldn’t be so easily forgotten. I guess I underestimate the power of “normativity” and how it dictates assumptions and internalised expectations of oneself. Normativity is dangerous for everyone. If one buys into it, failure to stay the course of normativity can add to thoughts and feelings of suicide. Our current understanding of suicidality is predicated on isolation, burdensomeness, and hopelessness: social ostracisation that normativity reinforces.
Unfortunately, assumptions about gender and sexuality norms, innocent or not, keep many LGBTQ+ people away from accessing vital mental healthcare. Hospitalisation and interactions with police can be traumatic. Often, a person’s deviation from gender and sexuality norms is blamed for poor mental health, without looking at how the stigma and discrimination around LGBTQ+ lives is the real culprit.
It’s too common an occurrence that people dehumanise others’ lived experience and identities simply because they don’t understand or have exposure to them. During the presentation to the Mental Health Commission a cisgender man asked whether trans people had higher suicidality rates simply because they were trans, like it was innate to their biology. I wanted to ask him whether he thought calling into question a person’s agency and integrity was a part of the problem, but instead I explained that there are plenty of research papers that state that trans people who start socially transitioning in a supportive environment as early as possible are much less likely to experience suicidal ideation than trans people who transition under society’s scrutiny later on in life. The man sheepishly conceded that maybe trans people’s experiences of discrimination may have something to do with feelings of isolation and hopelessness.
I have been thinking a lot about this dehumanisation and “othering” and how pervasive it is in political discourse. It is the function of the state, of white supremacy, of capitalism and the patriarchy to divide people and retain power over them. Controlling people and their bodies is evident in anti-abortion laws, neglect of asylum seekers at sea and detention, keeping people reliant on welfare in poverty, barriers to gender affirming care, and upholding rigid norms around gender presentation and heterosexuality. It’s also evident in how people with disability and mental illness are treated in policy and healthcare settings.
In suicide prevention literature, the harm caused by these external life pressures is called “situational distress”. The term is relatively new and replaces “social determinants of health” to encompass not only experiences of systemic oppression, but of any life stress, like bereavement, mental ill health, or housing and employment status that could impact feelings of isolation, burdensomeness, and hopelessness - and therefore, suicidality.
Unfortunately, most of the suicide prevention sector works towards ongoing government funding more than advocating to the government to address “upstream” preventative factors, like better social housing, universal healthcare, and welfare and wage increases. (In fact, myths about high suicide rates in socialist-leaning countries are largely fabricated, bleakly enough.) The sector in Australia is focussed, instead, on mental health and the individual’s responsibility to “get better”. Mainstream organisations are chipping away at the tip of the iceberg by repeating the line that “it’s okay for men to cry”, whereas we, working with vastly higher LGBTQ+ suicide statistics, are crying out for systemic and cultural change. In the meantime, the best approach to suicide prevention for LGBTQ+ communities is strengths-based - using our existing deep reservoirs of resilience to organise communities of care and mutual aid.
Currently, my work is focussed on organising and facilitating workshops and webinars on suicide in LGBTQ+ communities. The major themes are sharing information on how to build communities of care and tools for self-advocacy for times when we need to assert our rights in clinical spaces and when we are communicating our care needs. While there’s no such thing as one big, unified LGBTQ+ community (it’s made up of many smaller ones), the benefit of being minority groups under an umbrella label is that messaging about ways to help each other disseminate faster when there is targeted funding and resources. (For example, the Monkeypox virus was stopped in its tracks because of the informative campaigns of LGBTQ+ orgs around the country and the health-literate men who have sex with men who lined up for the vaccine as soon as it was available.)
It’s all interesting, exciting, satisfying work, even though the word ‘suicide’ isn’t generally a positive one. As my team and I say, suicide prevention is not so much about an intervention at the lowest, darkest point, but really about looking at a person’s life in all its colours and states of repair and working out what can be made better. It’s not an exact science, and there are multiple factors that are extremely difficult to change for some, but the stories of people who have found themselves again despite it all are encouraging.
I don’t know how to end this ramble, so I will stop there.
Have some music: