Self-harm or suicidal behaviour — Experiences of parents and carers of young trans and gender-diverse people

Content warning – this post discusses suicidal feelings

A few of the parents and carers we spoke to told us about experiences of their children's self-harming and suicidal behaviour. In this section, you can find out about their experiences. Self-harm is not uncommon in young people and trans and gender diverse young people are more likely to self-harm than other people their age (Stonewall, 2017). Self-harm describes the act of intentionally damaging or injuring your own body. It can be a way of coping with or expressing overwhelming emotional distress. While some people who self-harm are at a high risk of suicide, many of those who self-harm do not want to end their lives. (NHS, 2020). Research shows that 'more than four in five trans young people (84 per cent) have self-harmed' and 'more than two in five trans young people (45 per cent) have attempted to take their own life' (Stonewall, 2017). Many parents and carers we spoke to were aware of this heightened risk for trans and gender diverse young people.

Ross talks about self-harm. He thinks it’s widespread in trans young people and that there are many parents of trans children in online groups whose children self-harm.

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Although theyre different individuals and everyone’s case is different, there are a lot of really, really stark similarities. Nearly all of them self-harm. Nearly all of them self-harm to a degree that it can get worse to the point of suicide attempts. And talking about your child trying to take their own life is quite a difficult thing to talk about. But there’s hundreds of parents on there that their children have done exactly the same. And now I’m further down the tube, I speak to parents on their children are just beginning and it’s mild self-harming. And you can kind of advise them, keep an eye on that, cause that could quite likely get worse. And it could get worse to the point where they do take an attempt at their own life.

Both Ali and Lesley spoke about the importance of their children not being able to express their gender identity and the impact that had on their wellbeing. They saw it as a factor in their children's self-harming and suicidal behaviour. Ali described how it took her daughter a long time to share her distress around her gender identity with her and with her daughter's therapist. She said: 'I was very aware that they [CAMHS] had a very limited timeframe and we did feel very much that we were on a programme of 12 weeks in and out, and you had to be sorted by then. She still hadnt told me at that point what the problem was. Although, I was starting to get a feel for it.' Lesley emphasised that her son's referral to the Gender Identity Development Services happened 'partly, because, there was a lot of increase in dysphoria and ,he'd made several attempts to take his life.' She added that 'there was lots of things like self-harm and overdose type stuff going on' and that she felt that 'part of it, was around him being trans and it not being supported and validated in that way.'

Ali speaks about her daughter’s mental health issues, figuring out how gender identity might be part of the problem and the difficulties she had trying to access support for her daughter.

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Right my daughter when she was at primary school was very [sighs] anxious and I didnt really have any idea as to why. But we did get ELSA support at school which helped to an extent. And then she went to secondary school and she was very again, extremely anxious. And the SEN support there was not constructive at all. In fact, it was counter, counter forgot the word.

Counterproductive?

Counterproductive. That’s it. So that was fine. And then in the, I think it was year 8 things were getting really bad and I was having difficulty getting her to attend school. I had to drive her to school and be quite assertive at getting her to go in. And she did. However, I did a referral to CAMHS myself through our GP. And because I thought it was getting beyond just something that we could cope with. But just before Christmas she, Christmas that year she tried to kill herself.

And at that point we then got the emergency appointment with CAMHS. And at the same time as our referral came through which had basically taken from the September to just on January. It was, you know, [sighs] Id already been flagging it up, which is a bit disappointing and saying how desperate we were, but hey ho [sighs]. And at CAMHS the therapist was very supportive. But I was very aware that they had a very limited timeframe and we did feel very much that we were on a programme of 12 weeks in and out, and you had to be sorted by then. She still hadnt told me at that point what the problem was. Although, I was starting to get a feel for it [sighs]. So, I had begged them, I literally had begged them to carry on keeping her on until the next start of (school) year, because I knew trying to get her to go back into school at the start of that year would be horrendous. And they did agree but we were seeing a different therapist at that point. And I don’t know what, that after wed had various incidents where shed had actually picked her up from school to go to her therapist session and she cut herself while in the classroom. So I was trying to alert school and the school were trying to help, but there wasnt very much provision in school going back. So CAMHS eventually, just before the first therapist ended, she told me what the problem was that she was trans. And but she didnt, she couldnt get the courage up to tell the therapist. And I didnt want to circumvent how she actually felt. And eventually we managed to tell the other therapist and I knew that they were supposed to do a referral to CAMHS, not to CAMHS to the (GIDS) adolescent services, but I was told at that point that they didnt handle things like that and we were just basically cut loose and left to float. It then took my daughter a great deal of time and soul searching to be able to then go to our GP, who has been extremely supportive, in order to then make the referral to the [Gender Identity Development Services]. By which time, the waiting list had doubled, waiting times had doubled.

However, not everyone we spoke to felt that their child's gender identity was the most important factor. For Kate, the mental health services placed too much weight on her son being trans. She said: 'with thoughts of suicide, they put that all down to being trans.' She also emphasised that 'he doesn't feel that it's all down to him being trans.' Other parents who had experience of their child self-harming or suicidal behaviour, felt that these were part of their child's wider problems. For example, Ross emphasised bullying at school and the relationship between his child and their mother as negatively affecting their mental health.

Kate talks about her son’s self-harm and suicidal thoughts and how mental health services assumed it was because he was trans.

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I was trying to get him back into CAMHS, because he was, he was refused treatment the second time around.

Why was he refused treatment?

They basically said, Everything that he was experiencing was because he was trans. And he is clever and he’s articulate and he’s mature. So, I think because he can express himself well, he’s not particularly emotional and so he won’t sit with a CAMHS counsellor or psychologist and be upset. He would be able to explain to them how he feels. They seem to think he’s fine. They seem to say, Oh well, he seems quite well adjusted. And he has a really he doesn’t really have a sense of himself is one way he describes it. And he does, he does struggle with thoughts of self-harm. He has self-harmed. But he doesn’t do that at the moment.

But with thoughts of suicide and but they put that all down to being trans. Because they think that because his sense of self is changing that that’s why he has got of sense of himself. But he doesn’t feel that it’s all down to him being trans. So, yeah, they basically said, so he was referred to Tier 3 and they said that he wasn’t suitable for Tier 3. We weren’t, we didn’t know what, we still don’t know what Tier 2 is, what Tier 3 is. I guess Tier 3 is more severe or extreme, I don’t know on a higher level of care. But because we didn’t get that, we got nothing. And he was just referred to like self-referral things like off the record is a thing here that kids can just kind of access themselves. But what he wanted was the treatment he’d originally been offered, which we didn’t get. So, I, when he was clearly not coping well, when he joined the sixth form, I spoke we took him out of the sixth form and changed schools.

Self-harm by a young person can have a very serious impact on those who care for them. Both Ross and Ali emphasised the worry and stress caused by their young persons' self-harm. Ali shared that it was 'heart-breaking' and 'horrible to have to go and count knives every night to make sure, theyre still there.' Ross talked about the anguish he felt 'You go in the morning, pull back the duvet to see if theyre alive, almost every morning... Are they still there in the morning. Its not good.' He also spoke about the importance of peer support and the online forum for parents of trans and gender diverse young people where he could chat to others. He observed: 'In the wee hours when youre wondering whether theyve self-harmed and youre sitting up awake, because you cant get to sleep. You can chat to other people on there, the only reason theyre up at three oclock in the morning is cause theyre worried about their child [self-harming].' Read more about support for parents of trans and gender diverse young people or trans and gender diverse children's mental health and wellbeing. You can also find out about parents experience of self-harm in young people.