Tag Archive for Trans Women’s Suicidal tendencies

Suicidal tendencies of trans women : Links between loneliness and exclusion

Transgender- India

This is an edited version of the paper presented at the Seminar on Trans Inclusion: Implications and Challenges held on 21 and 22 January 2016 at the Periyar University, Tamil Nadu

By Prof. A Mani
It is well known that a large percentage of trans women experience social exclusion, isolation, loneliness and suicidal tendencies at various stages of their life. An alarmingly large percentage actually attempt suicide at some stage of their life. For details of the situation in the US and EU, one can refer to the surveys indicated in the references [1,2,3]. Since loneliness is a subjective internal experience, all of these surveys and much of activism has focused on social exclusion, isolation and discrimination. In this article the nature and existence of connections between loneliness, exclusion, sexualities and suicidal tendencies is explored in India and ‘developed societies’ through reference to surveys and also to personal blogs and accounts. At the end of the essay I present a research agenda as the amount of information available is inadequate to create a supportive political and social environment. However some suggestions for demands are also made at the end to address and bring down the high rate of suicide amongst trans women.

Social Isolation and Concepts of Loneliness
Loneliness (or ‘real loneliness’) is best seen as an interior, subjective experience that is influenced by external objective conditions in different ways [4,7,10]. Two different individuals do not in general generate identical degrees of response in similar loneliness inducing objective contexts. It is not the same thing as being alone and one may feel severe loneliness in the company of others.

Loneliness can have a number of negative consequences on humans that include: reduced lifespan, heath problems, lowered level of trust levels in others, feelings of social incompetence, victim mentality and self consciousness [4,5,6,9].

Stokes and Levin’1986 [8] in a couple of studies on social networks found that men may use more group oriented criteria in evaluating loneliness, whereas women focus more on the qualities of dyadic relationships. Other studies confirm similar phenomena [10], but the nature of loneliness in trans people and coping mechanisms that they may adopt is not well understood.

Research on connections between gender differences and loneliness needs to be reviewed with a feminist perspective for useful conclusions to be drawn, as the focus used in many studies seem to be unsuitable. There are many studies on loneliness in the literature ( [4--10] and some of the conclusions are used in this article.

On Suicidal Tendencies of Trans Women
People can, in general, plan their suicides in many different ways and they do kill themselves in many ways, but I will not be concerned with the suicide act as such. Here my concerns will be about the maturity level and nature of suicide plans of transsexual women during their pre-transition days or during transition. The exercise should be useful for formulating/defining concepts of reasonable social transition process and in accessing extent of damage due to social isolation and loneliness.
Of the various patterns in trans women suicides in their pre/post-transition state or transition the following are fairly prominent:

Those who have killed themselves at a relatively young age-under 25, have done so due to social oppression, persecution and inability to find the means to escape from them. The number of women in this category who actually commit suicide for reasons of wrong self-diagnosis is comparatively small. The number of people who kill themselves for their own inability to come to terms with their state may seem to be large – but blame should be put on social conditions for precipitating such a state of affairs through intersectional feminist perspectives.

All of the above also apply to the class of people who kill themselves at relatively older ages – above 30, but there are also important differences-studies of which are still insufficient. For this age-group the reasons also tend to center around problems of body transformations and insurmountable defensive adaptations of pre-transition period.

The insufficiency mentioned above is in choice of paradigms for empirical studies that pervade across age groups. It is known that problems like depression, social isolation and poor quality of life are common among “late bloomers”. These have been confirmed in recent duplication studies. It is also possible to collect large sets of data from people, but predicting failure or success is not easy because the coupling that matters may not be available for expression at all times and may also be consciously hidden by the subject of study in question. A relevant but limited study that attempts to answer some of questions is Moody and others in 2013 [17].

I am also working on the problem from a vagueness related mathematical perspective. Essentially it is about problem representation and finding multi-stage reducts (or removing the chaff). Simplified schematics have the following form:

So let us call our subject X.

X is a trans women of chronological age > 30

X wants feature sets F and maybe G as part of her transition process.

This F may be graded in various ways.

X has developed a set of adaptations S in response to loneliness (or ‘real loneliness’ if you like) connected with gender dysphoria. It should be mentioned that not all trans women feel that way.
Typically X is likely to commit suicide on realizing that critical parts of F would not be possible. In ideal situations, this and connections with S suffice to predict a “mature suicide”. But other social factors do matter and related prediction models are bound to get more complex.

Knowledge of feminism with all its intersectionality is an important life saving skill that is sometimes omitted by some trans women with terrible consequences because for them ‘feminism’ is a bad word. For people in the scope of ‘mature suicide’, there may often be no further sources of suicide mitigation.

Loneliness of the Dead
Examples for these patterns are not difficult to find, but ones with volumes of additional records are less common as in case of late Jess Phipps. Jess Shipps produced many popular you tube videos, was a moderator of few trans related subreddits, had plenty of social connections, was often vocal, expressive, positive and rarely seemed to lack empathy – all that is from her online expression and views of her friends. Yet, she was experiencing real loneliness (without social isolation), unemployment (and mentioned these as the primary reasons for her suicide) and was not really passing by her own standards (the last part is deducible from her posts in reddit). She needed wigs and makeup to pass and also believed that the “idea of a woman is distorted by mainstream media and nobody is perfect”. Maybe her suicide note was influenced by her position in trans advocacy… maybe not, but her suicide was the result of coupling of multiple factors and not just one of them.

Eventually it was the lack of material and emotional support that killed her. But it is surprising that she was actually looking forward to getting emotional support – that amounts to a tactical mistake.

Loneliness in the Living
Prof. A ManiA: Personal Experience:
Though I realized that I am a woman in my pre-teen years, my transition was well after my 30th year. I had to manage extremely high degree of loneliness in my pre-transition times – that was despite being fairly active in many academic and geek groups. The methods of adaptation included workaholism (through multiple careers), extreme degree of involvement in studies and research in solitude, cutting off people and bigots for a variety of reasons and restricting all interaction to bare essentials.

The nature of my suicidal tendencies during my pre-transition period was so mature that I had a definite plan that can be summarized in “suicide is admissible if no transition option becomes available and body has been sufficiently poisoned by testosterone”.

Physical part of my transition was very easy for me as I was already good looking, femme, healthy, athletic, response to hormones was excellent (that stabilized at estrogen level of ~360+ pg/ml (very high female range), had no complications, a partial class advantage and an Asian advantage. Details of some aspects of my transition can be found in my blog [18]. Suicidal tendencies vanished completely on commencement of HRT itself, but am yet to fully come out of the grips of loneliness related adaptations of pretransition period. Apparently this relates to a lack of open lesbian culture, prevalent transphobia and lesbophobia (am in Kolkata, India) among substantial sections of the older generation and an inhumane society. Hitting it off with women interested in women is easy for me, but not all lesbians are bold enough to break free of the patriarchy. A related aspect is that a generation of more Internet savvy urban upper class lesbians tend to be more confident in deviating from patriarchal norms in comparison to the women with far too limited opportunities to even explore themselves.

The Wikipedia articles on sex, gender and sexuality would be rated as pornography by majority of the population stuck in religion and/or conservative hetero sexist norms. No wonder the default goal of most of the whole LBT spectrum is to “emigrate”.

B: Experiences of Other Indian Trans Women
Brenda is a scientist who completed her doctorate from IMSC, Chennai before moving to Germany. Some of the issues that she faced are documented in [15]. This is what she has to say on the matter:

“1. Growing up it’s easy to assume (for myself) a hetero-normative appearance but once puberty hits, randomness + self questioning begins.

2. No matter how much I tried to hit this part, it doesn’t stay buried, if I hang out with male friends all those random comments about women bother. (not exactly misogynistic just to be clear)

3. At some point you are unable to express and process your own feelings especially sexual. (pan sexuality in my case was more than fun, just for the record)

4. Also with lack of proper sex education + information on sexual `and` gender diversity, it was hard for me to process my sexuality from gender identity.

5. Plus most of the common example of trans identity (pertaining to India) comes from media and what I see on the streets, which incidentally was almost never positive.

6. There were only two positive instances of media portrayal of trans I remember in my childhood (pardon me if my memory is not right). One – I think the movie was Sadak and Sadashiv Amrapurkar played a trans person who is in charge of a brothel (not a positive trans character but not one which was made a caricature of just for fun, which is what usually happens in Indian media). The second one was, I think, where a female infant is abandoned but adopted by a trans woman and the story revolves for the first part about their daughter and her parental relationship. I enjoyed the above two movies but rarely spoke about it with friends or family for fear of being ridiculed.

7. With dissonance in relating with real life friends, video games were easy to relate.

8. In fact this is my common observation, if I meet another younger trans person, I would say with 70% certainty that video games are a safe topic to discuss and bond with.

9. Sadly I have also seen a fraction of trans people take refugee in alcohol or weed. (I am grateful neither of them are on my list).

10.Luckily my transition to Germany was a boon since the LGBT group is a bit wide and I never felt loneliness.

11. In fact in the 4 years I made like 5 times the number of friends I have in all my 28 years in India (and bear in mind, Germans are known to be a conservative lot, in terms of personal space).”

Anamika, a student of IIT Kharagpur (as of this writing) experienced dysphoria since her early childhood. She suppressed all desired gender expression and behavior, and tried to act normal in the sense of the decadent patriarchy for much of her life. Not surprisingly she remained as lonely as ever at the institute. When she did try to explore herself, this was the result in her own words [15]:

“Amidst these feelings, changing my body to match my gender for the better seemed a far fetched reality at least in the near future and having dealt with the emotional pain and self-abuse for a decade, I didn’t see any further hope. So at the start of my 3rd semester, I cut off all my contacts and was about to attempt suicide, when a senior (who later became one of my closest friends) contacted me. I didn’t tell him anything about myself then, yet he suggested that I consider visiting the Counseling Center as an option before taking any such step (I could always go back if it didn’t help) and it seemed a reasonable bargain to me. That small decision turned out to be a life changing event. I always had very low self-esteem with almost negligible self-worth and self-love, so accepting myself as a transgender girl was a bitter experience. It took me almost 2 years of therapy to accept myself and become comfortable to open-up to others.”

C: Trans Women in Developed World
Sub-optimal conditions prevail for trans women in the so-called developed world and some quantification has been attempted through surveys. To really understand we need to look at personal writings and blogs.

Being openly trans matters a lot. Natalie Yeh agrees with this. She is an Asian American trans woman living in Los Angeles. She transitioned after 30 and her musings on her post transition loneliness suggest that she is tired of explaining herself to others to the point that she finds herself muttering, “Maybe I’ll just live out a simple, solitary life…it’s not so bad, many people do it.”

Naomi Ceder did not have suicidal tendencies despite being in the closet all through her long pre-transition years in a hostile environment. In one of her blog posts she says ,“For a trans kid in this environment self hatred was inevitable. There was literally no one I knew who was like me, no one I could dare talk to, for fear of exposure and humiliation and worse.”

Rebecca Williams has this to say on loneliness:
“I think one of the things that can trigger acute feelings of loneliness is being “different”. Being different could mean anything, in this world. …. I think people internalize this difference as sense of wrongness early on in their lives. They learn to be ashamed of their difference, of themselves. In a sense, they learn to hide that part of themselves away. It is that part, that sense of self that feels lonely. I think people are in the most part resilient, especially as children, and they learn to cope and adapt around this sense of difference. Sometimes these coping mechanisms work OK, other times they don’t…. But to foster a culture of tolerance and kindness can only be a positive thing for everyone, so everyone can learn to be more themselves, a little more different, a little bit more individual.”
Here “learn to be ashamed ” necessarily requires propaganda by bigots of various grades.

Generalities of Loneliness in Trans Women
Trans women are often excluded by way of social stigma and this has its effect on their socializing techniques and methodologies. While it is true that only a small fragment of people believe in excluding them and get actively involved in actually excluding them, much of the evil hype is sustained by lack of knowledge, misogyny and by the patriarchy. As a result of exposure to bigoted environments many trans women are likely to be predisposed to activate their self-defense mechanisms on even partial clues of bigotry. Such heightened sensitivity may not necessarily be justified in the context in question.

This means that people wanting to interact with trans women in society need to be way more sensitive to trans issues- that is for real interaction to be possible.

Based on key generalities that can be isolated/ abstracted from the nature of loneliness in trans women, loneliness in their pre-transition state may be seen as the result of the following factors:

Their own gender dysphoria inhibiting the feel of their positive interactions with people. This in turn can result in their learning of social interaction over time being less than optimal.

External anti-social actions and systemic discrimination generated by other patriarchal forces (mostly men) in response to preferred gender expression and interaction models of trans women, and Internalized social conditioning limiting their preferred gender expression and interaction models.

Trauma due to physical violence, if any, can be a factor in causing trans women to isolate themselves from situations even remotely related to the threatening situation of their experience.

PTSD (Post Traumatic Stress Disorder) due to physical and sexual violence, if any experienced by a trans women, can also be a reason for social withdrawal and impaired social function. It can be safely said that they would feel the bad effects in more severe ways than what cis women would have felt in similar situation. This is because PTSD in socially isolated people is harder to cure than in relatively less isolated people.

In an ideal tolerant environment, gender dysphoria would still kill and loneliness in pre-transition maybe the natural result of socially interacting in the wrong body. But this does not reduce the criminal responsibility of intolerant people who seek to exclude at every turn.

During physical transition, passing can affect socialization and this can happen even within LGBT groups. Further some trans women may actually believe that psychological changes from HRT is the cause of loneliness or that it intensifies the feeling of loneliness.

A related description that some trans women identify with is that whereas over time HRT improves their dysphoria and their physical appearance, they find the loneliness crushing them inside out. But this happens almost always due to their social anxiety and ideas of ‘passing’ to the point that they find the very idea of meeting people a terrifying one. Here loneliness is due to external factors, but is the feeling of loneliness actually being made deeper due to HRT? Though it is known that HRT tends to intensify emotions and improve levels of empathy in trans women, it cannot be immediately concluded that the same happens for feelings of loneliness.

Whatever the various causes, loneliness in trans women is never due to themselves alone.

Research Problems
It is clear that when we read ‘gender’ as a plural concept, then loneliness is related to it. But the concept of ‘gender identity’ is unrelated or ‘less related’. Two problems that seem to be of some interest are:
* How can we define usable concepts of ‘gendered loneliness’?
* What is the relationship of gender dysphoria to such possible concepts of ‘gendered loneliness’?

Sexuality and Related Intersections

Human beings exhibit a wide range of sexual orientation. Trans women may also have different sexual orientation and yes, it relates to their well being [2]. The largest EU survey in particular estimated that majority of the trans women were exclusively/predominantly sexually attracted to women. Survey data about preferences of trans women from countries like India are not available as most are closeted. Any talk about inclusion of trans people should also consider their sexualities in proper perspective. In this research paper, I will focus on trans lesbians from a lesbian perspective, how persecution of women who love women affects them adversely and what is required of society and socio-political economy to include them in the Indian context.

Trans women may belong to the very poor, poor, lower middle class, middle class, upper classes or super rich classes of society. They are discriminated and objectified at every turn and social progress is always an uphill task for them – this discrimination does not happen in a uniform way because of a number of reasons. In general, it can be said that objectification, discrimination and persecution applicable to women in general applies to trans women as well as they are women. Trans-ness carries its own load of objectification, discrimination and persecution, in addition, due to the patriarchy. But there are differences between the classes of trans women. Most trans women who belong to middle class and above are closeted and their lives are undocumented and less well known. While, those who are poor and part of stigmatized cultural groups are more severely persecuted and their persecution is more visible in the media.

A typical upper class trans woman in India can be expected to escape to a foreign country or a different part of the country after or before medical and legal procedures for her gender affirmation. So she would be living a new life as a cis woman and maybe a lesbian. The number of sex reassignment surgeries conducted by doctors in the country confirms the invisibility aspect. But all this requires resources and comes at substantial personal cost.

Middle and upper class societies (even in cosmopolitan Indian cities) differ a lot on their tolerance levels of human homosexuality. While religious people are predominantly bigoted, indulge in myth making to further their bigotry, irreligious people are tolerant and at least willing to learn. The bigger problem is that sex and egalitarian gender education is not compulsory and people may not be maintaining minimum standards in their relationships. This affects quality of lesbian relationships too.

An important concept in relationship to same-sex sexual relationships is that of ‘being closeted’. There are many levels of the concept ranging from ‘fully closeted’ (only the people involved in the relationship know about it), ‘open to friends’ (meaning a few friends know about it), ‘open to friends and relatives’ to ‘out and proud’. Such states are often dictated by the nature of discrimination or may be a conscious display of will to change society for the better.

If a Post-Op trans woman and a cis lesbian are in sexual relationship in India, then they are likely to be affected by the following:

Bigotry and hetero-sexist harassment from parents and relatives

Job discrimination

Absence of Community

General alienation from society

Hate and Sexual Harassment from bigots, micro aggressions from so-called friends/relatives, and
Poor medical support.

All that is trivially affected by the level to which they are ‘out’ in society. If both partners are closeted (and living together), then they are certain to feel alienated from society, indulge in deceptive acting in hetero sexist society, be at the receiving end of poor medical support. Trans women may simply avoid routine medical check ups because of the situation, while cis women may also avoid because many doctors are not knowledgeable enough on what constitutes non-discriminatory behavior. Otherwise being closeted (if it is an option) has its short-term advantages.

Most post-op trans lesbians would have left (or have abandoned) their parents and relatives – this is a common way of escaping from related problems. The same applies to cis lesbians as well, though it is also true that many parents are supportive of their daughter’s choices.

Proper rehabilitation of trans women, then requires lot more than the NALSA judgment and its implementation.
It is necessary to;
Eliminate archaic colonial laws that criminalize same-sex relations.
Provide for marriage equality.
Make feminist sex education compulsory for all.
Impose remedial courses (for discrimination-free treatment) for all medical professionals, heavily subsidize medical treatment for trans people.

Provide reservations and subsidies for trans people and women in all sectors for at least twenty years to compensate for the systemic damage and means of damage that are already in place.

[1]. Injustice at Every Turn – National Transgender Discrimination Survey: Full Report Sept’2012, NCTE Download Link (http://transequality.org/issues/resources/national-transgender-discrimination-survey-full-report )
[2]. EU LGBT Survey’ December’2014: Results at a Glance
EU Agency for Fundamental Rights, Dec’2014, Download Link (http://fra.europa.eu/en/publication/2014/eu-lgbt-survey-european-union-lesbian-gay-bisexual-and-transgender-survey-main)
[3]. Labia Collective: Labia Collective Survey’ April’2013. Download Link (https://sites.google.com/site/labiacollective/we-do/research/report_btb/btbReport.pdf?attredirects=0 )
[4]. Russell, D. ‘UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure’,Journal of Personality Assessment, 66, 1996, 20–40.
[5]. AIPC Article Library: July’2012, Link to Article (http://www.aipc.net.au/articles/symptoms-causes-and-effects-of-loneliness/ )(accessed on 15th June’2015)
[6]. AIPC Article Library: ‘Counseling Strategies for Dealing with the Lonely Client’, July’2012, Link to Article (http://www.aipc.net.au/articles/counselling-strategies-for-dealing-with-the-lonely-client/ )(accessed on 15th June’2015)
[7]. Aspel, Melaine, Ann. Let’s talk about feeling lonely. New York; Rosen Publishing, 2001.
[8]. Hackney, H., Cormier, S., The professional counselor – a process guide to helping. Boston: Allyn & Bacon, 2005.
[9]. Stokes J, Levin I. ‘Gender differences in predicting loneliness from social network characteristics.’ Journal of Personal Social Psychology 1986 Nov.51(5).1069–74.
[10]. Yang, J. ‘Relationship between gender traits and loneliness: the role of self-esteem’. Master’s Thesis, Brandeis University Feb 2009. 41pp
[11]. Jessie Shipps, ‘RIP : Suicide Note Discussion’ (http://www.reddit.com/r/DeadRedditors/comments/3awh7w/rip_ulumberchick/ )Jessie Shipps: Reddit Userpage (https://www.reddit.com/user/Lumberchick )
[12]. Natalie Yeh, ‘The Lonely Journey of a Transsexual Woman.’ 2013, Blog Post (https://menopausebeforepuberty.wordpress.com/2013/11/07/the-lonely-journey-of-a-transsexual-woman/ )
[13]. Naomi Ceder, ‘Thoughts on a Trans Teen Suicide.’ 2015, Blog Post (http://whataboutnaomi.blogspot.in/2015/01/thoughts-on-trans-teen-suicide.html )
[14]. Rebecca Williams, ‘Loneliness.’ 2013, Blog Post (http://rebeccakeiko.blogspot.in/2013/03/loneliness.html )
[15]. Brenda Jacks, ‘Acceptance and Denial.’ 2012, Blog Post.(http://orinam.net/acceptance-and-denial/ )
[16]. Anamika, ‘Fear Can Hold You Prisoner, But Hope Can Set You Free: Being a Transgender Girl at IIT Kharagpur.’ Blog Post (http://www.scholarsavenue.org/ga/fear-can-hold-you-prisoner-hope-can-set-you-free/ )
[17]. Moody, C., Smith, N. G. ‘Suicide Protective Factors Among Trans Adults’, Arch Sex Behaviour (2013) 42:739–752
[18]. Mani, A., ‘Femme Dialectics,’ 2014+ My Blog (http://logicamani.blogspot.in/)

Prof A. Mani is an active researcher in algebra, logic, rough sets, vagueness and foundations of Mathematics. She has published extensively on the subjects in a number of international peer-reviewed journals. Her current affiliations include the University of Calcutta. She is also a course developer, teacher, free software contributor, advocate, consultant in statistical and soft computing. As a functional feminist, she has been active in many lesbian and women’s rights groups as well. She is an active lesbian, her homepage and blog are respectively at http://www.logicamani.in and http://logicamani.blogspot.in