Today, Synthia Roy works at a tattoo parlor in Jacksonville’s Edgewood area, she does set design and makeup for horror films and recently produced her second movie.
But seven years ago, in her mid-30s, her life was a blur. In college, she’d turned to alcohol and drugs, finding they helped her express herself. Roy was a closeted transgender woman living a life that felt like a lie. Over time, the coping mechanism became a crutch.
“I was very depressed and sometimes suicidal when I wasn’t drunk,” she said. Eventually she became “a raging alcoholic.”
Like many LGBT people, Roy was terrified of coming out.
“I’m a transgender woman, and that was hard growing up,” she said. “Going through puberty for anyone is like, ‘Who am I? What am I doing?’ Can you imagine if you were — to use the term — growing up or born in the wrong body?”
Sometimes she hurt herself.
“Cutting, in my mind, is the alternative to suicide because it’s a stress relief,” she said.
Then, at age 35, Roy came out.
It was a relief, though it didn’t cure her addictions. A year and a half later, in 2013, she gave up drugs and booze overnight.
“They tell you never to do that,” she said. “I’m a perfect example of why because I had several seizures and went into a coma.”
When she woke up two weeks later, she’d lost her memory and ability to read. She’d also been fired from the tattoo parlor where she’d worked for 17 years.
Still, today, Roy counts the coma as the best thing that ever happened to her.
“My mental health, my health in general, started there,” she said.
Afterward, she was sober, 40 pounds lighter and ready to work on herself in therapy.
LGBT people experience depression and suicidal tendencies at disproportionately high rates. At the same time, bisexual women and transgender women of color are among the groups more likely to experience violence.
There are numerous holes in the data, however, such as the role of guns in the LGBT community. Those holes hinder efforts to address violence and self-harm, advocates and researchers say. But some, including a group in Jacksonville, are working to fill in the knowledge gaps.
Hurting on the inside
The Jacksonville-Area Community Assessment in 2017 found 28% of local LGBT adults surveyed met the criteria for moderate or severe depression, as compared to 7% of the overall adult population. The survey, conducted by the Williams Institute at the UCLA School of Law, found nearly two-thirds of transgender people experienced moderate to severe depression, and 11% had attempted suicide — roughly four times the rate for the cisgender people surveyed.
“For a lot of different transgender people, there are mental health issues all over the place,” Roy said.
She has known multiple transgender people who took their own lives.
One study involving 18 states found that firearms were the second most common method of suicide for LGB people and the third most common for transgender people, the Williams Institute reports. Yet sexual orientation and gender identity/expression aren’t included in death certificates, and national and state databases that track suicide rarely collect this identifying information.
Much more is known about LGBT mental health issues — and the barriers to accessing treatment.
For Roy, therapy helped pave the road to recovery. For others, therapy is out of reach. Dan Merkan, director of policy at JASMYN (formerly called the Jacksonville Area Sexual Youth Minority Network) said that the population it serves — LGBT youth and young adults — often simply can’t afford counseling, partially due to high rates of unemployment and poverty.
“It’s one of the more complicated pieces because a lot of people don’t have access to good insurance,” Merkan said.
Even if they can afford to, it can be difficult to find medical professionals who treat LGBT people in Jacksonville. Roy called doctors for a common treatment only to be told they wouldn’t provide it because she’s transgender. But she eventually found providers — it just took some searching. Some therapists will charge on a sliding scale.
Roy said the stigma around mental health, plus the added stigma about being transgender, may have kept her from coming out earlier.
“I did not want to be ridiculed,” she said.
Manuel Velasquez-Paredes directs the University of North Florida’s LGBT Resource Center.
“The first thing that we need to do is tackle the stigma that mental health is a negative thing,” he said. “We all need someone to talk to.”
Velasquez-Paredes said the LGBT Resource Center will connect anyone in the community to help — student or not. And there are alternatives if therapy is out of reach. Local and national support groups, chats and other online resources specialize in LGBT mental health, like JASMYN’s near-daily chats on its website, and innumerable Facebook support groups, such as one Roy co-founded called Trans and Sober.
But as much as it can help, the internet can also hurt mental health.
“It can have ups and downs. It can be supportive, it can be problematic,” Merkan said.
If you are in Florida and experiencing suicidal thoughts, call 211 for help, or visit the United Way website here.
External forces
When researchers ask why the LGBT community has a higher risk for mental health issues, economics, acceptance, awareness and equal rights come up again and again.
Money has a well-documented effect on mental health and suicide. While it may be impossible to buy happiness, it’s harder to be happy when you can’t make rent.
Like other minorities, LGBT people are more likely to struggle financially than non-minorities. One-in-five LGBT people had been food insecure in the previous year, meaning they skipped meals because they couldn’t afford to eat, in a recent survey. That’s nearly twice the rate experienced by the U.S. as a whole.
Acceptance and equal rights go hand-in-glove with economic instability for the LGBT community, Merkan said.
“Because of what LGBT people face, whether it be family rejection, isolation, stigmatization, actual structural discrimination, everyday discrimination, all these things [have] a compounding effect,” Merkan said.
The lack of legal protections can exacerbate discrimination and, in turn, mental health issues.
“It’s been scientifically proven that states that have passed marriage equality laws, the suicide rates among LGBT community dropped,” Velasquez-Paredes said.
“When you hear our politicians saying that LGBT people don’t deserve equal rights … that creates homophobia, it creates transphobia,” he added.
Three years ago, Jacksonville passed an inclusive human rights ordinance that prohibited employment, housing and public accommodation discrimination based on sexual orientation, gender identity and expression. It was a hard-fought victory for LGBT people and allies. Then earlier this month, a court struck down that ordinance on a technicality. The city has appealed the ruling, and City Council is considering a new ordinance that corrects the issue. But for the time being, it’s legal to discriminate against LGBT people in Jacksonville.
On the national level, the U.S. Supreme Court is set to rule this year on whether LGBT people are protected from discrimination under the Civil Rights Act of 1964. The Trump administration is challenging the stance that the prohibition of sex discrimination applies to gender and sexual minorities.
Today, simply displaying a picture of your significant other can legally serve as an excuse to be fired, Velasquez-Paredes said. That’s why coming out can be frightening. But staying in the closet is often detrimental to mental health.
Before she came out, Roy was terrified of losing her relationship with her mother. A great weight lifted when her mother, now deceased, accepted her.
“I didn’t come out until I was 35. That’s 35 years of being someone I’m not. What if someone told you you had to be someone you’re not for 35 years?” she said. “That will drive you to suicide if you don’t express who you are.”
Now 44, she mentors other transgender people. The fear and shame that kept her in the closet and from seeking help are long gone. She may struggle from time to time, but that’s just life.
“Everybody somewhere along the line needs a little help,” Roy said.
Violence against LGBT people
Like with suicide, no one knows for sure how many LGBT people are murdered or assaulted, and domestic violence in this community is largely not tracked.
That’s why JASMYN is working on an online reporting form and community survey to ask about violence, including hate crimes, human trafficking, domestic violence and bullying, with funding from the Arcus Foundation.
Several factors complicate LGBT violence tracking. Sometimes trans people are known by a name other than their legal name. If they are murdered, friends may not find out they were killed because police and media might only report their legal name. Sometimes victims of violence are reticent to reveal the true nature of the relationship to police.
“If they say ‘roommate,’ then that is going to not be marked on the police report as domestic violence,” said Gail Patin, CEO of Hubbard House, a local domestic violence shelter.
LGBT victims of domestic violence might have their sexuality or gender identity wielded as a weapon by their abuser, she said. Some will threaten to out them to friends, family or to the parent of their children.
Hubbard House serves all victims of domestic violence, offering shelter, outreach services, representation in court, support groups and crisis counseling.
“If you reach out to Hubbard House for help, we believe you,” Patin said.
If you or someone you know are experiencing domestic violence, call Hubbard House’s 24-hour hotline at 904-354-3114 or text 904-210-3698 to get help. Outside the Jacksonville area, call 1-800-500-1119. If you’re in immediate danger, call 911.
This story is part of a Northeast Florida-focused series collaboration between WJCT and the Center for Sustainable Journalism, which publishes Youth Today and the Juvenile Justice Information Exchange. This series is part of the Center's national project on gun violence. Support is provided by The Kendeda Fund. The Center is solely responsible for the content and maintains editorial independence.
