By Daniella Theis

Scotland’s LGBT+ community is facing a mental health crisis and the numbers reflecting the Scottish trans community specifically paint a dark picture.

A 2017 survey conducted by LGBT Youth Scotland revealed that 84% of LGBT young people and 96% of transgender young people indicated that they had experienced mental health problems and associated behaviours. The same survey also found that half of LGBT young people and 63% of transgender young people experienced suicidal thoughts or behaviours. 

In its 2018 ‘Suicide Prevention Action Plan’ the Scottish Government recognised that certain factors are known to contribute to raised suicide risk – one of them being a young LGBTQIA+ person. What the report does not address is the question of why – Why is it that young people who are LGBTQIA+ in Scotland are at a higher risk of attempting or contemplating suicide? Why are the numbers so especially high within Scotland’s trans community? Two trans women – singer-songwriter Peyton, 29, from Edinburgh; and Katy Lawson, 20, a student living in Glasgow – tell their stories to shine a light on how continuing social stigma affects the mental health of Scotland’s trans community.

‘Coming out for me wasn’t made easy at all’

On a cold morning in the winter of 2017, Peyton woke up in hospital. Her insides turned and twisted inside out after a tube was inserted through her mouth and threaded down through her oesophagus; forcibly removing the contents ingested through several nights of heavy drinking. It was a close call. Peyton was previously found unconscious in one of Edinburgh’s streets; her body cold to touch. Last night’s events were the end of a “complete mental breakdown” and formed the beginning of a new chapter in Peyton’s life.

Three years on Peyton tells her story to inspire others to reach out for help when they realise they need it: “When you wake up in hospital and have a nurse tell you that you nearly froze to death after trying to drink yourself to death you question a lot of things. For me, it was either I transition, or I roll over and die. That’s my story.

“People feel so much shame when they realise they are trans because it is something that is not normalised in society,” Peyton explains: “People my age particularly had to grow up with trans people being portrayed in films and on TV as villains and people to be laughed at.”

Talking about a scene in the popular 1994 movie ‘Ace Ventura – Pet Detective’ she now says: “It is really hard to watch.” In one of the movie’s final scenes, private detective Ace Ventura reveals that female chief inspector Louis Einhorn is actually suspected murderer Ray Finkle. During his grand reveal, Ventura rips away Einhorn’s clothes to show that the female inspector has male genitals discreetly tucked away in her pants. The scene ends with police officers violently vomiting and a trans woman being thrown into a pool in her underwear.

Peyton reflects on a time when she too felt shame about her identity: “It took me a really long time to admit that I even needed help. I was dealing with depression, anxiety, and also what I didn’t know at the time was gender dysphoria. Because I didn’t know it was gender dysphoria, I had this overwhelming feeling of shame anytime I would think about anything ‘girly.’ That was what drove a lot of alcohol and substance abuse. I was trying to block it all out. I nearly died doing that.

“Coming out for me wasn’t made easy at all. Whether you make any big change in your life; transitioning, having a baby, moving to another country; you lose people. A lot of people showed their true colours quickly – even my mum. Things got really bad between us for a while. Now, a couple of years later, our relationship is probably the best it has ever been. My bonds with people have gotten a lot better because I am not trying to be someone that I am not.”

‘I go outside, and I have that constant fear in my head: ‘Today I might die.’

Social stigma against trans people does not just have an effect on mental health for trans people before or during transitioning. Stonewall Scotland discovered that trans people who are subjected to a hate crime are more likely to develop signs of depression, anxiety, and suicidal thoughts or behaviours. 

Back in 2017 LGBT Youth Scotland’s survey found that 41% of Scotland’s transgender youth indicated that they had experienced a hate crime or incident the previous year. Three years on, research published by the Equality Network discovered that verbal assault, bullying, discrimination or physical assault against trans people are still common occurrences across Scotland.

For Peyton, this was one of the reasons she chose not to continue her work in the hospitality industry: “You are putting yourself on the frontline to receive a whole lot of abuse. Before I came out, I was transitioning on the down low and I was feeling really unsafe in the place that I worked. Not just because of the customers, but because of the people I worked with as well. Once that penny drops, you cannot pick it up again.”  

Katy describes a similar scenario, stating that transphobia is “a very big thing” in Scotland: “It is a very dark thing to bring up, but I could get up in the morning, leave my flat, walk outside and be assaulted. I know a bunch of Scottish trans people that have been beaten up. I go outside, and I have that constant fear in my head: ‘Today I might die.’ It shouldn’t be like that. I know it is a small possibility, but it is a worrying possibility.”

Waiting times: ‘If things get worse, it is going to start killing people’

Katy regularly suffers from depression and anxiety, but states that support services have done more harm than good due to the long waiting times and access requirements she has faced: “You gain more stress from them than you gain help. Nobody can grab a mental health service easily. If you do it is just waiting, waiting, waiting. At that point, you might as well not bother. It needs to be funded more by government agencies. It needs to be funded for people that are struggling the most which at the moment are LGBT+ people, minority people, and people from certain ethnic groups. They are the ones that not only have the mental health struggle but also the constant societal struggle of being seen as unequal in the playing field.”

Prolonged waiting times are not just an issue when it comes to accessing mental health services. Katy states that she has been on the waiting list to receive further treatment at Tavistock – the largest and oldest gender clinic in the UK – since 2016: “I have been dealing with this for half a decade and it still feels like nothing is working. There is no way it should be this bad.

“I am human as well. I have normal, human stuff that people end up dealing with like friendships or family struggles. I have less mental strength to dedicate to these things because I am also dealing with these LGBT things until I slowly get to the point of where I ask myself how I can deal with all this and still live and function.”

Due to prolonged waiting times, Peyton has funded some of her treatments through costly private providers and has heard of others sourcing hormone therapy through unconventional means. She too believes that the waiting times to access NHS trans health services harm people’s mental and physical health: “One of the biggest arguments transphobes make is their belief that trans kids have instant access to puberty blockers or hormones.” She laughs: “Nothing could be further from the truth. If you were to google right now to see how long the waiting time is for the Lothian gender identity clinic, it would tell you that it is several years.”

Chalmers Sexual Health Centre – Edinburgh’s gender identity clinic – is currently offering initial appointments to people that were referred there in September 2018. Peyton’s laugh has now stopped. After a pause for thought she admits: “If things get worse in terms of how long people have to wait for treatment, it is going to start killing people.”

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Both Katy and Peyton mention that not each person’s journey is the same as theirs. Not every person goes through the same struggles or emotions as they did. However, both hope that there is a brighter future for Scotland’s trans community.

Ten years from now Peyton hopes to see “less transphobes given positions of power in parliament” and less overall prejudice towards the trans community: “We are just people as well. We are just trying to live our lives like anyone else. We are not dangerous. You know, we are actually just trying to stay under the radar and be normal and not be thrust into the media as we so regularly are. I feel like things can only get better. I am trying to be optimistic. The only way is up, right?”