Gender Dysphoria & Suicidality in Laura Jane Grace’s Memoir

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Laura Jane Grace playing with Against Me! in Fargo, 2017

I’m a big Against Me! fan, and I recently re-read Laura Jane Grace‘s captivating memoir. I loved learning the stories behind the lyrics and catching Grace’s clever references, like when she said that NoFX never had to wait at the end of the longest line at Warped Tour. I grew up in the Florida punk scene during the late 90s/early 00s and enjoyed the nostalgic recollections throughout the book (e.g., making free copies at Kinko’s, reading zines, and going to concert venues like The Edge). I could write a super-long post about the many poignant parts of the book (see below for a picture of all the pages that I marked to revisit later), but there are people who do that professionally, so I’ll leave it to them.
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Instead, I’ll focus on the angle that I’m more familiar with: discussing mental health research in the context of people’s stories (e.g., 1, 2, 3). Grace identifies as a transgender woman and has described her gender dysphoria as a deeply distressing experience resulting from a misalignment between her self-perception and physical body. Her book opened with her earliest memory of gender dysphoria, which occurred at age 5 while watching Madonna on TV:

Her dirty blond hair was moussed and frizzed to perfection. Her neon and black clothes were ripped and torn to accentuate her curves. Her chunky bracelets and necklaces sparkled and jangled against her arms and neck as she moved to the beat. I reached out my hand and touched her on the screen. That’s me, I thought, clear as day. I wanted to do that. I wanted to be that. 

This sense of wonderment was cut short by confusion. Suddenly I realized that I would never be her, that I could never be her. Madonna was a girl; a confident symbol of femininity, singing and dancing onstage in a short skirt and high heels. I was just a small boy, living in a ranch house on an Army base in Fort Hood, Texas.

My father’s name was Thomas. My uncle’s name was Thomas. My cousin’s name was Thomas. And I was born Thomas James Gabel, the son of a soldier, a West Point graduate who never went to war. That was the name written on my birth certificate, but I never felt that it suited me.

Beginning in childhood and continuing through adulthood, Grace secretly wore women’s clothes (at first, her mother’s and later, clothes she purchased). She felt overwhelming shame about this behavior and tried to stop it many times, but always found herself drawn back to it and the relief it brought her (she referred to these episodes as “binges and purges”). In her youth, she thought she might be gay (though she was mostly attracted to girls), a “pervert,” or that she maybe had schizophrenia. She pled with God, and even the devil, to change her body to match her gender identity.

Grace endured several stressful events throughout her youth, including her parents’ divorce, disapproval from a church she attended, being bullied at school, legal troubles, and an incident where she was assaulted by police officers. Meanwhile, Grace struggled with depression and substance abuse and ultimately dropped out of high school. She started focusing on making her band successful and moved from Naples to Gainesville, Florida, which had a thriving punk scene at the time (shout-out to my friend’s band from that era, FIYA).

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Le Tigre show that I went to in Gainesville, 2000

While the success of Against Me! brought adventures, fans, and recognition of Grace’s skills and talents, there were also conflicts among band members, record label issues, difficulties in her first marriage, and a backlash from some punk rock purists who thought Against Me! had sold out. She tried to distract herself from the gender dysphoria by channeling her attention into music, drugs, drinking, and working out. She tried repeatedly to accept living as a man and tried to push ideas of living as a woman out of her mind. Grace recalled a particular time on tour when she and her band saw a group of transgender women walking together. She joined in with her bandmates to make fun of them, while secretly wishing she was as brave as them. No one in her life was aware that she was going through these struggles, even though she wrote lyrics about her gender dysphoria in Against Me! songs. In 2007, Grace got married for the second time. The gender dysphoria decreased during certain periods of her marriage, but always returned (including during her wife’s pregnancy with their child, who was born in 2009).

Grace decided that she would come out as a transgender woman in a 2012 Rolling Stone article at the age of 31. After beginning her transition, she felt more authentic and experienced relief from her gender dysphoria. Still, she continued to face challenges. She got divorced and her father stopped talking to her after she disclosed that she was transgender. Through the hardships, Grace continued to speak out about the rights of transgender people, talk openly about mental health issues, make really good music, and inspire many people. That’s my brief summary of her book — but seriously, you should read her entire memoir, which concludes with this lovely moment between Grace and her daughter:

It’s the new issue of Rolling Stone. On the cover is a close-up shot of Madonna. She looks exactly the way I remember when I first saw her at five years old, the same age Evelyn is now. Red lipstick, piercing blue eyes, not a single hair out of place. Her skin is delicate and gorgeous.

“Daddy, who is this?” she asks me.

“That’s Madonna, Evelyn,” I tell her. She’s a musician.”

“Just like you?”

“Just like me.”

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Against Me! playing in Fargo in 2017

While I’ve been wanting to write this post since I first read the book, my motivation was renewed after the release of the “trans military ban” memo, which states that “transgender persons with a diagnosis or history of gender dysphoria…are disqualified from military service except under certain limited circumstances.”  The link between gender dysphoria and suicidality was cited as one of the reasons for this decision. Estimates vary across studies, and there are methodological components that should be carefully considered, but the existing research consistently finds an elevated risk for suicidal ideation, suicide attemptssuicide-related events, self-harm, and suicide among transgender and gender-nonconforming (TGNC) people. I will unpack some of what we know about this empirical relationship, but I want make it clear that I agree with the American Psychological Association and the American Medical Association that the memo is discriminatory. It’s worth reading both organizations’ statements in full here and here.

Back to Laura Jane Grace…in a 2017 interview, she referred to herself as “part of” the 41% lifetime suicide attempt rate among TGNC people. That statistic should be interpreted within the context of the methodology (the report acknowledged that the rate might be inflated due to measurement and sample recruitment methods). Data were not collected on the timing of the suicide attempts in relation to transitioning, which was another limitation of the study. Grace attempted suicide ~1.5 years after she began transitioning, and she partially attributed it to a serious, adverse reaction to the hormones she was taking. In a 2016 interview, she described having suicidal thoughts at various points throughout her life, “…while I’ve struggled with gender dysphoria for my whole life, I’ve also struggled with depression. Those aren’t necessarily linked.” In her memoir, she points to a family history of mental health problems that may have contributed to her mood struggles as well.

The American Foundation for Suicide Prevention and the Williams Institute identified the following risk factors for suicide attempts among TGNC people (from the Executive Summary, p.2):

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Another study found that twice as many transgender youth (34%) reported suicidal desire in the previous year as compared to non-transgender youth (19%) and that depression and school-based peer victimization explained part of the empirical relationship between gender identity and suicidal ideation. Here again, it’s important to interpret the findings within the context of the methods (in this case, self-report questionnaires with some limitations were used).

A 2017 study sought to build on existing research by testing a general theory of suicide (the interpersonal-psychological theory of suicidality, IPTS) and the gender minority stress and resilience model (GMSR) among TGNC adults (again, it’s important to look at the study details for full context when interpreting the results). They reported two main findings: 1) GMSR variables (e.g., discrimination, victimization, internalized transphobia, non-affirmation) explained 20% of the variance in suicidal ideation in the sample and 2) IPTS variables (i.e., social disconnection and perceiving oneself as a burden on others) mediated the relationship between GMSR variables (internalized transphobia, negative expectations for the future, and nondisclosure of one’s gender identity) and suicidal ideation, accounting for 54% of the statistical variance in the sample. A study in TGNC youth also found that IPTS variables were correlated to suicidal ideation and suicide attempts, while another found that a GMSR-related variable (being addressed by a chosen name in multiple contexts) was linked to lower depression and suicidality among TGNC youth.

In summary, we need more research to fully understand elevated suicidality risk among TGNC people. The available science suggests that depression, discrimination, victimization, and other structural factors (e.g., difficulty accessing medical care and affirmative mental health practice) disproportionately impact the TGNC community and contribute to suffering, as Grace wrote about in her memoir. For an equitable and just society, we must join with those working to break down these societal barriers. It’s the compassionate and right thing to do.

I’ll conclude with this wisdom from Laura Jane Grace:

Interviewer: Do you ever get tired of being part of people’s learning curve and constantly explaining to people?

Laura Jane Grace: I don’t get tired of it in a way…talking about trans issues, trying to educate people about trans issues — translates to a real world thing that does actually save lives and helps make other people’s lives easier, including my own. That’s what it’s about…humanizing things.

I wanted to keep this post relatively brief, but if you are interested in learning more about any of the ideas presented in it, you can check out some of these links:

Learn More about the Diverse Lived Experiences of TGNC People in Their Own Words: Aydian DowlingChaz Bono, ContraPoints, Jazz JenningsJanet MockLaverne Cox, Leelah Alcorn, Live Through This ProjectTrue Trans documentary series with Laura Jane Grace, Trans documentary

Information for Mental Health Professionals about Affirming Psychological Practice With TGNC People: APA Guidelines, A Model for Children & Adolescents

Suicide Prevention Resources: American Association of Suicidology, American Foundation for Suicide PreventionNational Suicide Prevention Lifeline, Trans Lifeline, The Trevor Project, Darcy Jeda Corbitt Foundation

Favorite Against Me! Songs: Park Life ForeverTrue Trans Soul Rebel, Borne on The FM Waves of the Heart, Delicate, Petite, & Other Things I’ll Never Be, Two Coffins, I Keep Forgetting, Pints of Guinness Make You Strong, Black Me Out

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One thought on “Gender Dysphoria & Suicidality in Laura Jane Grace’s Memoir

  1. Pingback: Fact-Checking 5 Suicide-Related Statements from a Viral Ben Shapiro Video | Disordered Eating & Suicidal Behavior Lab

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