This article is a collaboration between HBO and PAPER Magazine, bringing together premium entertainment such as the new HBO series Euphoria and Paper's 'Break the Internet' sensibility.

When vulnerable populations are under attack, naturally the mental health of the individuals being targeted suffers. The trans community in America is no different, with 41.8 percent of transgender and nonbinary youth reporting attempting suicide at some point in their lives in a recent study. In HBO's Euphoria, Jules (Hunter Schafer) experiences support from her father as she transitions, but her mother is unable to accept her for who she is.

The potential loss of familial support, being denied access to basic services like medical and mental health care, harassment, and violence are just a few of the obstacles facing trans and gender nonconforming people today, not to mention the extreme rhetoric and policies coming from the current administration. It's crucial, then, that trans people have access to support so they feel less isolated — and who better to offer counseling and guidance to trans people, than other trans people?

Enter Trans Lifeline, currently the only crisis hotline run for trans people, by trans people. A viral tweet that resurfaces every few years makes it seem as though Trans Lifeline is brand new, but they've actually been in operation since 2014, and have since grown to be the largest provider of services to exclusively trans people in North America. With eight full time staff operators and 95 volunteers active in the last year, Trans Lifeline has answered more than 10,000 calls in 2019 alone, and more than 72,000 calls in the last five years. We spoke with Executive Director Elena Rose Vera about mental health, why trans people seek out services and how communities sticking together is an act of love:

PAPER: There's a viral tweet that says Trans Lifeline just opened. What's the real story?

Elena: So it's true, but sort of vague. It got a huge spike in popularity because it was shared by Bob the Drag Queen, who has a huge following, and a couple of other folks. A couple of times a year someone famous will come across it on Instagram or Facebook or Twitter and share it around. It is true, but it is also a few years out of date. We've been operating for 5 years now come this fall. It is true to our knowledge that we are the only peer support crisis line that is for trans and questioning people which is to say, we are the only service that serves exclusively trans people for our crisis hotline. We are, to our knowledge, the only service that guarantees all of our operators are trans, so that trans people in distress or in need of someone to talk to can be guaranteed to talk to someone who understands some of what they're going through.

A lot of other lines serve trans people alongside cis people, and that is wonderful, we are glad for the support, but we think there's something really special about trusting trans people to help trans people to empower members of the community to lift each other. There is something special to be able to talk to someone who shares your experience — even a very well-meaning person who hasn't been through it might slip on some things. The service is special. Between our hotline program and our microgrant program, we are the largest direct service provider to trans people in North America.

That's incredible.

We're very proud of what we do. And to clarify also, we don't just serve trans youth. Callers to our hotline are all ages and of many different life experiences. 60% of our microgrant grantees are under the age of 25, but we serve all age groups.

What are some of the more common reasons that people call?

There's a huge variance of reasons. Some folks just call because they need community. A lot of our callers are coming from rural areas, the South, or Midwest where they might have a harder time finding a local community or where they are having a hard time finding an affirming and supportive therapist, psychologist or support group.

They call us for community, they call us when they're having a hard day. We have callers who come for suicidal crisis and callers who just need someone to talk to. All of those calls are welcome. We have people calling to talk about employment discrimination or family rejection or the religious communities they were raised in. A lot of our callers call in about not being able to find housing — about homelessness. We have callers who want to talk about dating issues. Because we get callers from all walks of life, we have people who just want to talk about everything else going on in their life.

Some people are also talking about dealing with racism or talking about the scary climate around those issues in the country right now. We have a lot of callers who are immigrants. Among callers who mention their race, I think about 10% of them are Native American. They're calling to talk about the issues they face both for being trans and for dealing with all of the issues that they face there. A lot of folks are talking about the issues that face the community, whether it's poverty or the high rate of sexual violence that trans people experience.

Yes, we also deal with suicidality. That is an issue that's pervasive in the community because of the material conditions that we face. Trans people are disproportionately denied housing and jobs and economic opportunity and face extraordinary discrimination, and of course are being targeted legally by the government as we speak. So it can contribute to a real environment of isolation and fear.

Why is it so important that the operators also be trans? What makes that experience extra helpful to callers?

We hope that our service is able to help trans people connect to each other and not just be a community who is served, but to recognize also that the people that are helping them can be role models. We're not just people that need to be rescued, but also have extraordinary gifts. There's something really special about receiving help from another trans person who can let you know that so much more is possible in your life and that you too can be someone who helps others.

You have a policy of not calling the police on people who call you because they're suicidal. Can you explain why that's important?

Elena: So for some crisis lines, the policy is essentially to call 911 and loop in the police whether or not the caller is okay with it. And what we have discovered through doing some statistical analysis, looking at surveys of callers and folks who are calling not just our line but others, that a huge percentage of trans people who are calling into crisis lines have the police called on them earlier in calls, and when that happens they report a more frightening and violent intervention than a lot of non-trans people get. So, there's a disproportionate amount of responding to a trans person calling for help by showing up with police and not just paramedics, with having the door kicked down and then experiencing involuntary commitment. Often that traumatizes trans people further when authorities and medical professionals refuse to respect their gender, their name, their pronouns. A lot of our callers were coming to us and telling us that calling the police put them in more danger and increased their risk of suicidality rather than decreasing it. They did not feel safe calling crisis lines that have a policy of calling the police on them.

We wanted to make sure we were doing the best by our callers and that we were operating by practices that prioritize their safety over respectability, and so our policy is if someone calls and asks that you call them emergency services we will absolutely do so, but unless they ask us to do it, unless they give us that consent, we won't do it. It's actually starting to influence other crisis lines who are recognizing that members of a lot of marginalized groups, whether it's trans people or people of color or immigrants, are genuinely afraid of law enforcement showing up and they won't call for help if they're concerned that's going to happen. We have callers who are able to call in and get help earlier before there is a distinct crisis because they can trust we are not going to have them locked up for asking for help.

"This is a labor of love."

How does legal liability come into play?

We absolutely report what we are legally required to report. If we are concerned that someone is a danger to others, if we are concerned someone is going to hurt someone, we absolutely report that. But, it is not a legal requirement for the kind of crisis line that we are to call in the police without consent.

And we are in conversation with our colleagues at other crisis services, with Contact USA, which accredits us, and with the American Association of Suicidology, where we are members. That's an ongoing conversation for a lot of services. It's an on-going debate for a lot of folks right now.

Generally we want to prioritize the safety of our callers and if this policy means someone calls before it is an absolute crisis and they call and get help before it's a situation where someone might have to kick someone's door down, because they trust us to take care of them, that's a better outcome.

Do you see a spike in calls when there are things happening in the news like the memo that Trump put out?

We do, we do. When that Department of Health and Human Services memo went out last November, we had I believe an instant quadrupling of call volume that settled down to — it was essentially about triple what our usually call volume was for awhile. When we've seen each of these policies go out, whether it's the ban on military services, public statements about opposing gender-ideology or whatever, we see spikes in our call volume that we are tracking. When SESTA-FOSTA went out, the legislation that ended up harming sex workers by limiting their ability to talk to each other and basically organize online, we saw a massive increase in our call volume because so many trans people are engaged in sex work and make a living that way, and were frightened about being put into more dangerous conditions at work.

I've been in conversation with other crisis lines looking at our charts of call volume throughout the year, and our specific data has been helpful because there are so many more people who aren't trans than are. When you include trans people in the general aggregate, you don't actually see the data about what trans people are responding to and what they need. It's actually been helpful to be able to provide that information both to other crisis services and also to advocacy organizations for LGBTQ people to say: here are actual numbers on how the trans community respond to these situations in public. And we've been able to gather some of that data anonymously and use it to help other people's organizing efforts. Because we're operating at the scale we are, we have a clear continent-wide picture of how North American trans people respond to public events and we want to make sure we're using that research to serve the broader movement and make sure that trans people are getting cared for in all walks of life.

You've been in existence since 2014, but I would imagine the past few years have been especially difficult for people calling in.

It's a frightening time, and I think it's one of the reasons having trans operators is so powerful. The first lesson for our callers is that they are not alone. They can talk to someone who might be just as scared as they are, and understands why they're scared, and isn't going to downplay it or dismiss it or tell them they are just being paranoid. There's someone who can say, "Yeah it's hard out here and things are scary, but you're not alone. We got you and here's some support."

Another thing that's been really powerful is that we have two major programs. There's the crisis line, and the other is about economic support for trans people. So we're able to say, "Okay, so you're frightened that your ability to have a legal ID that lists your actual name and gender might be taken away, we can give you a small grant and help guide you through the process of getting that paperwork changed now, so that it's harder to take away from you." Our microgrant program has given out, I believe, nearly 1,000 small grants now averaging around 360 dollars to trans people to help them get ID changes, name and gender changes, drivers licenses and passports.

So, one thing that we realized we can do to show trans people that they have support is to give them support directly, and to make sure we're helping them get the legal documentation that gives them better access to jobs and housing and travel, the ability to move from place to place, the ability to vote. If you don't have the right legal identification, your vote gets cast out. Being able to make sure trans people have the right legal documents also ensures they have a say in how things are going in this country (and in Canada where things are also shaping up to be a little scary), and that trans people get to make sure their voice is part of the story that shapes the future, that they're not left out of the narrative. Combining the programs that support trans peoples' emotional well-being with the program that supports their material conditions — helping them get them access to things like healthcare and a roof over their head — has been really powerful.

How do you maintain your own health and passion for this through what are triggering times?

This is a labor of love. Trans Lifeline was founded by volunteers, by people in the community who saw their peers and their loved ones struggling and wanting to help. Nearly everyone who is on the staff here began as a volunteer and does this work because of their extraordinary care for the community and there's no substitute for that, for that genuine devotion. In the last five years, we've grown enormously and especially in the last year, endeavored to improve our training and our tech: the way we take care of our staff and volunteers, to make sure that they don't burn out, to improve our oversight to make sure we're genuinely accountable to the community. We make all of our financials public so the people who support us know where it's going. We are almost exclusively funded by just regular people who want to pitch in because they care about what happens to trans people and they want trans people to thrive. Our goal is to make trans lives worth living, to make life as a trans person something that you would want more of and I think we're on track there. I think I speak for most of us here when I say I'm beyond proud to be apart of this.

You can reach the Trans Lifeline at 877-565-8860 (US) or 877-330-6366 (Canada), or visit them online to access other services here.


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