By 10 pm on election night, calls were already streaming in to Trans Lifeline, a peer-supported suicide prevention hotline catering to transgender people. Over the following three days, Trans Lifeline saw a 500 percent increase in call volume, said Greta Gustava Martela, the executive director. And that wasn’t a coincidence.

“As a trans person, my gender identity has been politicized in this election,” Martela explained. “And I think we all hoped that this election would have a different result, and we’d be able to have some rest after the election.”

But the prospects of this happening under President-elect Donald Trump and Vice President-elect Mike Pence — one of the nation’s most consistently anti-LGBTQ lawmakers — look slim. The future Trump administration has plenty of LGBTQ people worried. Trans people, in particular, are facing the president-elect’s stated promise to overturn all executive orders issued under President Obama, including a crucial 2014 order that offered nondiscrimination protections for trans government employees and contractors.

The fears pegged to Trump seemed to have manifested when reports circulated among LGBTQ people and activists, via private Facebook groups, that several trans and gender-nonconforming youth had died by suicide in the hours following the presidential election.

Advocates seek balance between spreading awareness of LGBTQ suicides and inadvertently encouraging it

Debi Jackson is the mother of a trans person who moderates one of the aforementioned Facebook groups. Jackson told Mic on November 10 that the election results left many trans people feeling anxious to the point of “self-harm and desperation, including a few suicides and multiple suicide attempts.” Jackson declined further comment for this article.

Two people who spoke to Vox on condition of anonymity said they had seen these reports, and said they were in contact with family members of those who died by suicide. However, Vox and several LGBTQ advocacy groups have thus far been unable to independently confirm that these deaths took place. Still, with the spike in calls to Martela’s hotline, the post-election environment clearly still has trans people on edge.

Nick Adams, the director of GLAAD’s transgender media program, told Vox the reports have also not been confirmed to his organization. But, Adams says, spreading such information without accurate information on social media, for example, “can lead others to attempt self-harm.”

Adams is referring to suicide contagion, a phenomenon in which individuals exposed to concrete examples of suicide exhibit elevated signs of suicidal ideation, according to the Centers for Disease Control and Prevention.

Some anecdotal evidence suggests transgender people, in particular, are almost constantly surrounded by news of self-inflicted deaths, which can compound the contagion theory. Transgender people make up about 0.5 percent of the general population but have long been digitally connected, finding safe havens to communicate online. A recent study led by UCLA assistant professor Ian W. Holloway found that transgender people (especially women) frequently use digital social networks to find information about legal and medical transition and access health care, and to connect with geographically distant peers who can share experiences and wisdom.

While these digital connections can be a source of critical access to lifesaving information, it can also mean that trans people are more likely to hear reports of suicide when they occur in the broader trans community. Martela, the trans woman who founded Trans Lifeline, suspects that the enmeshed social and digital circles of many transgender people mean they are regularly exposed to reports about suicide, making contagion an almost constant factor in trans communities.

That reality makes it an ongoing struggle for Martela and other suicide prevention advocates to balance the competing interests of sharing important information with not contributing to the contagion effect. By being so well-connected to trans people and their loved ones around the country, Martela estimates that “every week and a half or so, in my extended social network, somebody faces suicide.”

But in times like these, Martela firmly believes the sharing of information about a community in distress outweighs the potential risk of contagion. She reported that she had personally been able to confirm at least three deaths since the election, though she declined to share identifying information about those individuals.

“I think it’s dangerous to just not report the deaths,” she said. “It allows people to ignore what’s happening to us. … When I balance whether to talk about suicides and how often to report them, I’m trying to decide if this is an important time for word to get out about what’s happening to this community.”

She continued: “And I think, with this election, this is absolutely a time when it might be more important to talk about what’s happening to us than to worry about triggering this contagion effect that probably can’t be any worse than it already is, to be completely honest.”

Regardless of how many trans people may have died — or not — since the election, Martela stresses that the community is clearly in severe distress.

“We know that if we’re seeing a 500 percent increase in calls, that everything else related to that is going to go up,” she explained. “We know that people are ideating at higher rates. … And so if people are ideating more, it just follows in scope that suicide rates are going to go up.”

She has a point — the American Foundation for Suicide Prevention reports that there are between 12 and 25 suicide attempts for every completion. It’s reasonable to conclude that if the number of people thinking about taking their life (and calling a suicide prevention hotline) has increased, so has the number of people who carried out their plans.

LGBTQ people are already at a greater risk of suicide than the general population, and trans people specifically have an alarmingly high suicide attempt rate. Forty-one percent of trans and gender-nonconforming adults in the US report having attempted suicide, according to the Williams Institute, a progressive think tank based at the University of California Los Angeles. For comparison, the average attempt rate for the general American population is 4.6 percent, and 10 percent among gay, lesbian, and bisexual adults.

Still, Trans Lifeline is not alone in experiencing an avalanche of calls since the election. Both CNN and the Washington Post have reported that suicide prevention hotlines across the country saw a sharp increase in calls beginning on election night. While elections are typically an anxiety-inducing time for Americans, experts across the board have said the panic this year’s election wrought has been unlike any other time in modern history.

“Never have such large groups of marginalized people — their civil rights, their human rights — been in such jeopardy.”

Despite claims that those panicked by the election are overreacting, mental health professionals who work with LGBTQ clients say they have never seen such a visceral reaction to an election.

“When people try to say, ‘Oh, this happens every election,’ that is just patently false,” said Emily Clark, a clinical counselor in private practice in Columbus, Ohio, who is straight but estimates 90 percent of her clientele are LGBTQ. “Never have such large groups of marginalized people — their civil rights, their human rights — been in such jeopardy.”

Christopher Torsiello, a gay psychotherapist and social worker based in New York City, agreed. He’s been in practice for eight years, and said he’s seen “little blips” where anxiety among clients spiked in response to a political shift. “But I’ve never seen anything like this before,” he explained. And the fear is universal among his LGBTQ clients.

“One hundred percent of my LGBT clients have felt anxious,” Torsiello adds. “For myriad reasons, but all of them have felt some anxiety around [the election].”

That anxiety is being informed and fed by “real despair,” Torsiello said. He’s witnessed some depression in his LGBTQ clients over the past week, but most of them are still in shock, he said. There was a pervasive belief that Trump could not possibly win the election, Torsiello explained. And the realization that millions of Americans “flat-out endorsed” and “legitimized all of the really horrific things that Donald Trump has said over the past year and a half” hit his clients hard.

“The outcome after the election has also been really dehumanizing to my LGBT clients, specifically my trans clients,” he said. “And my trans clients of color are just really blown over by this.”

While each person has distinct reasons for their specific fears, Torsiello said his trans clients’ post-election anxieties can be broadly summarized into three categories:

Discord and fractured relationships with family members who voted for Trump Legal concerns about workplace and nondiscrimination protections, as well as obtaining updated legal identification reflecting one’s gender identity Losing access to health care, compounded by the possibility of federal legislation that would allow health care providers and individuals to deny service and treatment to LGBTQ people. (That’s the First Amendment Defense Act, a beefed-up version of the Religious Freedom Restoration Act Vice President-elect Mike Pence signed into law in Indiana in 2014.)

Clark echoed the pervasiveness of anxiety among her clients. She said every single LGBTQ client she’s seen in the past week has wanted to “process” the election in some way.

“Fear is a huge theme of what I’m hearing,” she said. “The morning after the election, I opened up my email, and I had an email from one of my trans clients, and it just said, ‘I’m really sad and scared. I don’t know what to do. What do I do?’ And I thought that that just encapsulated perfectly what a lot of folks have been feeling.”

Like Torsiello, Clark has been working to help her clients through the stages of grief, but also with practical concerns. She’s heard from numerous former clients, who had ended their therapeutic relationship with her and were “functioning well and living their lives,” asking for her help navigating the often cumbersome process of updating legal identification.

Those documents become even more crucial in a red state like Ohio, where Clark said her clients are also worried about whether they will be able to safely move about the country, or even just the state.

“Columbus is this liberal, Democratic, mostly tolerant bubble from the rest of the state,” Clark explained. “And I think we often forget, being here, that most everybody else outside of our little city doesn’t necessarily have the same views, and that’s really scary for folks thinking about traveling anywhere outside of our outer belt — into the suburbs, even. People have certainly expressed fear of traveling.”

That fear can contribute to feelings of isolation, which in turn can contribute to the depression, hopelessness, and ostracism that increases a person’s risk of suicide, Clark said.

Even in the supposedly liberal bastion of Manhattan, Torsiello said his clients are feeling trapped. “There’s this idea of, I’m not allowed to ambulate around the country,” he said.

“It’s not that their communities ... are suddenly threatening to them; it’s this idea that federally there would be more protection, and federally things would keep expanding for them [under a Clinton presidency],” Torsiello added. “That there would be more places and spaces that they could go to. That seems to be eroding, and that is causing a lot of fear.”

Both therapists stressed their belief that clients were not “overreacting” to the results of the election. The threat a Trump administration poses, especially for trans people, is real, both Torsiello and Clark agreed. Clark balks at the criticism that people frightened by the election are being “sore losers” or “dramatic.”

“It wasn’t safe before,” she said of the national environment for trans people. “Of course, we tried to talk about building resilience, empowerment, trying to feel safe. But the reality of it is folks weren’t necessarily safe before, and they’re not now. ... I think it’s a very privileged stance to say that folks aren’t in danger in some way.”

Trans Lifeline’s Martela echoed that sentiment, though she did find some cause for optimism, particularly in the outpouring of financial support that is being directed to her organization and others that are now facing a potentially hostile future under a Trump-Pence administration. Martela foresees a necessary return to the grassroots organizing that marked the success of groups like ACT-UP in the 1980s. Her model for community support stems from LGBTQ activists who organized, protested, and held die-ins until the federal government — especially during the Reagan administration — was forced to address the issues facing the community.

“People haven’t had to fight for their rights in the street in a very long time,” Martela said. “And I think, to some degree, that’s what it’s going to take to get through this. I’m really heartened by all of the protests, and I just hope that we can keep it up.”

Note: Trans people struggling with thoughts of suicide can reach TransLifeline 24 hours a day at (877) 565-8860 in the U.S., and (877) 330-6366 in Canada. LGBT youth in need of support can contact The Trevor Project's Trevor Lifeline at (866) 488-7386. And people of all identities struggling with thoughts of suicide or self-harm can contact the National Suicide Prevention Lifeline at any time by calling 1-800-273-8255.