The second sex: the gender paradox of suicide in Australia
By Emma Pryse Jones
Content advice: This story contains discussion of suicide. Please come back to this piece at another time that works for you.
Suicide is a complex and multi-factored public health issue. Every person with an experience of suicide also has a network of people who are profoundly impacted. Please hold this gently as we discuss some of the mainstream statistics that you will inevitably see in the news cycle today and look after your wellbeing.
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Today is World Suicide Prevention Day and the theme this year is ‘Changing the Narrative.’ But despite the theme, it is likely few mainstream media outlets will do anything beyond the status quo for suicide prevention messaging.
The media’s approach is predictable: focus on the number of lives lost in the previous year and create a sex binary within the numbers, framing suicide as a men’s health issue.Currently there is no reliable national data on suicide and self-harm among transgender or gender diverse people in Australia, so these people are erased from the conversation.
Even when media focuses on the communities who are at the ‘highest risk’ of suicide, they mistakenly correlate identity and personhood with suicide risk, rather than analysing the inequities and structures that make life distressing when a person isn’t white, cisgender, heterosexual, educated and affluent. Equally absent is the recognition that suicide was foreign to Aboriginal and Torres Strait Islander cultures prior to invasion and colonisation. Now, these communities are forced to carry an issue not of their making.
Yes, men make up three-quarters of suicide deaths annually. This is a distressing fact and requires careful responses and support. But it has simultaneously become the foundation on which many men’s health initiatives are platformed and the basis of far-right arguments against feminism and women’s social progress.
Relying solely on the number of people who die by suicide as the centrepiece of suicide prevention allows for one dangerous assumption: our current service systems are working for women. The reality? If the tip of the iceberg is the number of men we lose to suicide each year, the rate of suicidal distress and suicide attempts of women and non-binary people is what is lurking under the surface.
Left out of the mainstream conversations (even by leading professionals) is that while suicide rates in Australia has remained relatively stable, suicide among young women under the age of 25 has risen sharply. Meanwhile, of a conservative estimate of 65,000 suicide attempts each year in Australia, women make up at least two-thirds. Women also consistently have the highest rates of ambulance attendances and hospitalisations as a result of suicide attempts, with women aged 15-19 having the highest rate of ambulance attendance across all genders and age groups and at a rate that is over three times higher than men within the same age range.
The non-fatal nature of these attempts does not diminish their severity, often having a lasting physical and psychological impact on those involved. Women’s distress is often endured silently, with those who do seek help often labelled ‘attention seeking’, based on a foundation of medical misogyny and the legacy of hysteria. Ironically, the phrase ‘don’t suffer in silence’ is central to messaging around men’s suicide, but for many women that is precisely what defines womanhood: suffering in silence.
Arguably, the role of suicide prevention is not only to prevent people from dying by suicide, but also to reduce suicidal distress and prevent suicide attempts. Across Australia there are initiatives that are labelled ‘towards zero suicides’, but what does zero mean? Is our success only ever measured by reducing the number of people we lose? Is it only a tragedy when someone dies? Does it matter how many attempts occur if nobody dies? As someone who had their first suicidal crisis at 13 years old, I don’t accept that metric. If resources and policy are driven by suicide fatality data in a narrow sex binary, we will continue to fall short of supporting people when they need it most.
On days like today, prevention messaging typically leans on the Australian ethos of mateship. “Check in on your mates” is the socially acceptable, non-confrontational approach that allows a narrow culturally coded narrative to dominate. Built on the back of comradery between servicemen in the major world wars, this messaging inherently isolates women who were excluded from service. It excludes men from migrant and refugee backgrounds, men living with disability, queer men and men of many intersections who don’t fit the traditional blue-collar larrikin ‘Aussie bloke’ mould.
What is said is one thing, but who gets to say it is another. In the rare event when people outside of healthcare professionals are invited to discuss suicide, it is most often from those who are bereaved, but rarely those who have survived. This is despite research showing that when people can safely share their stories of how they have navigated through their own personal suicidal crisis, it helps to prevent suicide.
Today on mainstream media you will likely see a focus on the parents and mates who have lost a loved one to suicide. These are important stories, but they cannot be the only ones we hear. It is unlikely you will hear from young people, women, homeless people, those living with a disability, non-binary folks, first nations leaders or people of colour. You will also not hear from anyone who does not fit the ‘hero’s journey’ arc, where their ‘recovery’ is palatable for public consumption or has a level of social currency.
The bigger picture is this: our health is inherently political. Our news cycle rewards tragedy and crisis (when it suits) and directly influences politics (cue News Corp and the successful lobby to ban social media for under 16s). Privileging the voices of specific groups within suicide prevention further isolates the experiences of thousands of others and simplifies an incredibly complicated experience of the human condition.
If we truly want to change the narrative, we must widen the lens. We must centre our efforts on justice, inclusion, systemic disparities and humanity in an increasingly complex world. Until every story counts, our prevention efforts will remain as shallow as the public discussion that drives it.
If this story has raised any concerns for you, you can seek support with any of the following services or resources:
Lifeline - Call 13 11 14 or text 0477 13 11 14 for 24/7 crisis support and suicide prevention services.
Kids Helpline - Call 1800 55 1800 for 24/7 telephone counselling for young people 5-25 years.
13YARN - Call 13 92 76 for 24/7 crisis support for Aboriginal and Torres Strait Islander people
QLIFE - Call 1800 184 527 for telephone and online chat support service for LGBTIQ+ people.
Suicide call back service - Call 1300 659 467 for 24/7 telephone crisis support for people at risk of suicide, carers and bereaved, as well as online resources and information.
Head to SANE forums for 24/7 peer moderated forums about a range of topics.
You can also head to the Lifeline website to create a Beyond Now safety plan.
About the author
Emma Pryse Jones
Emma (PJ) is an advocate, peer worker, and researcher working within the matrix of Australia’s mental health and suicide prevention system. Growing up in rural Australia and drawing on her lived experience of complex mental illness and suicide, she works to place people back at the heart of policy, practice, and research. Contrary to mainstream media narratives, she believes children and young people are deeply resilient and infinitely capable of great things, even in the face of the world they are inheriting.
For more from Emma, you can find her on Instagram at @emmaprysejones, or follow her work on LinkedIn.
Fantastic piece PJ. Broadening the lens is a terrific way to focus in prevention of attempts rather than successes. I've been thinking about a similar approach for domestic and family violence for several years. We (rightly) focus most on deaths, but we also need to prevent trauma, mental and physical injuries. Now I know how to talk about it. I hope many people take on board your excellent points here
A lot of what you are echoing reminds me of the fantastic book "The Gender of Suicide" by Katrina Jaworski who is also Australian I believe. If you haven't read the book I highly recommend it. You had spoken to how suicide attempts in women being higher but deaths lower than men does not say anything in regards to severity of suicidal intent. I concur and so does the book. Thank you for this succinct piece on a matter I care deeply about!