Suicidality in LGBTQ+ Youth

ABSTRACT

In this paper I show the ways in which society, culture, family, and intrapsychic conflict come to play a role in the suicidal ideation and behavior of adolescents within the lesbian, gay, bisexual, transgender, queer plus intersex, asexual, pansexual, polyamorous (LGBTQ+) community. I touch on LGBTQ+ history, review risks such as suicidality that are higher in this population, and consider common developmental challenges to transgender children and adolescents. I then present a clinical vignette of a trans girl with newly emergent transgender feelings in puberty who became suicidal when she learned (prior to transition) that there was a spot on the girls’ (but not the boys’) volleyball team. I will try to show how twice-weekly psychodynamic psychotherapy was useful in creating a more resilient and solid identity in the face of lack of family acceptance and how judicious work with the family around medical issues related to transitioning contributed to the patient’s well-being.

KEYWORDS:

• Gender non-conforming
• transgender
• gender queer
• suicidality
• development

Additional information

Notes on contributors

Susan C. Vaughan

Susan C. Vaughan, MD is Associate Professor of Clinical Psychiatry at Columbia University Medical Center and Director, Columbia Center for Psychoanalytic Training and Research. She attended Harvard College, graduating magna cum laude in 1985 with a BA in psychology and social relations. She attended medical school at the Columbia College of Physicians and Surgeons, where she received her MD in 1989. She completed her psychiatric residency at Columbia and remained there to complete her psychoanalytic training and a research fellowship in affective and anxiety disorders funded by the National Institute of Mental Health. Her first book The Talking Cure: The Science Behind Psychotherapy (1997) explores how psychotherapy changes a person’s mind as well as his or her brain structure. In Half Empty, Half Full: Understanding the Psychological Roots of Optimism (2000), she wrote about optimism as a function of our capacity for affect regulation.