Imagine that, after having taken the most difficult step of deciding to live as your authentic gender, you find yourself losing the support of family members and friends just as you’re trying to adjust to a new social role. Then you walk out on the street and are discriminated against in various ways, from being referred to as the wrong gender, to being prevented from entering bathrooms or dressing rooms, to being verbally and even physically attacked.

Even if you’re fortunate enough to “pass” so that people can’t tell you’re transgender – which few trans people do early in transition – you must reveal your assigned gender when you present identification, and then deal with people’s often extreme reactions when they feel like you’ve “fooled” them simply for being who you are. If you try to change your name, let alone your gender marker on your ID, you’re told that you can’t do the former without a court order or the latter without surgery. But you can’t have surgery without money, and you don’t have money without family support, especially when people won’t hire you because you’re trans. You can easily find yourself homeless when you have neither a job or a support system, even as the shelter system also discriminates against trans people.

The problems are magnified if you’re a trans person of color, in which case you also often have to deal with greater police scrutiny – trans women are often subject to arrest for soliciting or disorderly conduct simply for expressing their gender (widely known in the community as “walking while trans”). If you’re incarcerated, you can easily end up housed in a prison that doesn’t conform to your gender and placed in solitary confinement for your own “safety”.

Unlike other marginalized groups, trans people find it much harder to hide our status or seek support from people close to us. On the whole, being gay is less visible and easier to conceal from bigots than being trans, and members of racial minorities can often rely on their immediate loved ones for support. Trans people are much more visible and prone to isolation even from our loved ones. We also lack a robust body of literature or media that sensitively depicts the nuances of our lives, and current representations – as well-meaning as they may be – largely celebrate only the unrepresentative few who are blessed with conventional attractiveness and can pass, or else turn the difficulties of their transitions into spectacle.

For trans people, discrimination in various forms can literally come from anyone, from strangers to your closest family members, across all categories of identity, whether intentional or unintentional, conscious or not. As a trans woman, I’ve experienced discrimination from straight men who perceive me as fooling them because I exist, from cisgender women who wish to exclude me from women-only spaces because they consider me a man, and from gays and lesbians who consider trans people to be “too extreme” or “mentally ill,” as they replicate the same language that was used to stigmatize them decades ago. So many trans people have seen discrimination come from trusted people so often that many of us find it really hard to trust anyone, and live with the fear that anyone we come to depend on as friends or loved ones can, knowingly or not, perform actions that discriminate against us.

And all the while, you’re also dealing with your internalized transphobia – all the years that you were taught to believe that there’s something deeply wrong with you simply for being who you are, that you’re unlovable and worthless and your experiences only confirm these internalized beliefs.

If you find yourself overwhelmed and burdened by the barrage of problems I’ve just recounted, imagine living this reality, and imagine being able to do it without encountering moments of sheer desperation that can make you suicidal. And imagine that when you do feel this way, you’re told to seek professional help, which – if you’re lucky enough to afford it and find someone who’s not transphobic – makes a valiant attempt to get you to view your objectively desperate situation in the best possible light. And while such interventions are necessary for us to stay alive, there isn’t nearly enough effort to ensure that we have good reasons to live. The established norms of discussion when it comes to suicide, which comes out of research that does not fully account for transgender experience, blinds the public to the effects of transphobia and prevents people from taking concrete steps to reduce the prejudice that permeates almost every aspect of our lives.

Suicide affects the trans community – all ages, races, and practically every other demographic measure – at astronomically higher rates than the general population, according to the National Transgender Discrimination Survey: 41% of us are reported to have attempted suicide. Though the suicide attempt rate among gay men and lesbians goes down markedly as people get older, attempt rates don’t significantly diminish for older trans people.

And while current suicide prevention methods focus on individual mental health, trans people are much more likely to be suicidal for reasons related to specific, ongoing and urgent problems that don’t go away when they seek help from a medical community that is itself prone to transphobia, including discrimination in employment, housing, school, and the justice system. That discrimination can come from both men and women, other members of the LGBT community, as well as our own families and friends.

Multiple trans people I know deal with any number of these problems constantly, and find themselves with few sources of support. And, as more people transition, there are not enough experienced and disclosed trans people to lend assistance, especially as these stressors don’t just go away, and many of us are forced to withdraw to preserve our own psychological well-being.

Author and AIDS activist Paul Monette once wrote that he wanted his epitaph to read: “Died of Homophobia / Murdered by His Government,” to emphasize the real cause of death for people with AIDS. When nearly half of trans people attempt suicide, addressing individual mental health concerns isn’t enough; we have to fix the transphobia that affects so many aspects of our daily lives. Blake Brockington, who had come out as trans and apparently killed himself last week, once carved the words “Hate Kills” into his arm in a moment of desperation as his sister and other family members tormented him for being trans, which he recalled in a documentary. “Fix society”, wrote transgender teen Leelah Alcorn last year, just before she ended her life.

While crisis interventions are important for saving individual lives, mental health care needs to be easier to access and mental health professionals should be less transphobic, chances are that none of those on their own will dramatically lower the suicide attempt rate in the trans community. Instead of listening exclusively to the mental health experts who focus on the average person, we should listen to trans people’s experience with suicide ... and work to fix the transphobia that threatens so many of our lives.