Editor's note: This story includes discussion of suicide. Hawaiʻi Cares 988 Local Crisis counselors can be reached directly at 808-832-3100 or toll-free 800-753-6879.
Jasper Ho was 15 years old when he first called the 988 National Suicide Prevention Hotline. It was the day before Thanksgiving, and three years before the hotline had dedicated options for LGBTQ+ youth.
He recalled the operator being dismissive and was told to spend the holiday with his family.
“The reason I was so depressed and considering suicide was because that was the family that was weird about me being trans. They were weird about me being gay,” he said. “The whole problem was that I was going to have to see my family, and she just couldn't understand the problem.”
Ho woke up in the hospital the next day after attempting suicide.
The 988 National Suicide Prevention Hotline revamped its services in 2022, creating a line that has specially trained counselors for high-risk groups like LGBTQ+ youth and veterans. It has since provided 1.3 million calls, texts and online chats with that community.
But the Trump administration announced this month that it will terminate that option, also known as the "Press 3" option, for LGBTQ+ youth.
A release from the federal Substance Abuse and Mental Health Services Administration said that starting July 17, it would no longer silo services for "LGB+ youth." The statement omitted T and Q from the acronym, which stand for transgender and queer. It's unclear if counselors for lesbian, gay and bisexual young people will still be available.
Shuttering that specialized LGBTQ+ suicide lifeline option could mean that young people in emotional distress may not have easy access to counselors who understand them, service providers say.
Hawai‘i advocates said there is already a lack of gender-affirming resources locally, and cuts to that federally funded service could lead to severe consequences.
“The suicide hotline serves a huge purpose in talking someone away from suicide,” said Rep. Adrian Tam, who made history in 2020 as the only openly LGBTQ+ elected official in the state Legislature. “It’s trying to keep families together instead of breaking them apart, where they have an empty seat at the table now.”
A demand for therapists
Suicide is the leading cause of death for LGBTQ + youth ages 15 to 24, according to the U.S. Department of Health and Human Services Office of Minority Health.
A report from the Centers for Disease Control and Prevention found that 41% of LGBTQ+ youth in the U.S. have considered suicide, higher than their straight, cisgender peers.
While Hawai‘i is considered an LGBTQ+-friendly state, advocates said it's a struggle for the LGBTQ+ community to get access to gender-affirming care, which includes mental health services.
The state Department of Health reported that there are only 31 gender-affirming providers statewide.
“I don't think we have seen the full impact yet of what this is going to do,” said Haylin Dennison, founder and executive director of Spill the Tea Cafe, an O‘ahu-based nonprofit focused on teen mental health that has trained counselors to serve LGBTQ+ young people.
Dennison said Hawai‘i is one of the least resourced states, with just one licensed therapist for every 360 kids — resulting in an over four-month wait time.
The nonprofit has provided individual therapy to 608 young people in Hawai‘i since its launch in 2022.
Dennison said staff are specially trained in suicide and crisis prevention for LGBTQ+ youth. She is a mother of a transgender teenager and said that it makes a difference when someone understands them.
She said that it takes at least one accepting adult to decrease suicide by 40% among young people, especially LGBTQ+ youth.
“Any one of us can save a kid's life by checking in with them on a regular basis,” Dennison said.
Influx of calls
Many organizations that serve the LGBTQ+ community are bracing for an influx of calls for therapy sessions or their suicide prevention line.
Saurav Thapa, senior federal affairs manager at the Trevor Project, said the nonprofit received 231,000 contacts from LGBTQ+ young people through the 988 hotline last year.
The nonprofit handles some of the 988 crisis calls and operates its own 24/7 mental health services.
He anticipates an increase in calls to the nonprofit after July 17, despite cancellation of the hotline.
The day after the 2024 elections, the Trevor Project reported a 700% spike in the overall call volume of crisis contacts compared to weeks prior.
“We're trying to prepare for it, but we frankly don't know how big the surge in volume will be,” he said. “Frankly, we need more resources to be able to meet that surge in volume.”
Thapa stated that there are seven centers nationwide that contribute specialized services for LGBTQ+ youth.
The Trevor Project has more than 200 specially trained counselors who serve the LGBTQ+ community. Thapa said the counselors receive hours of training and practice sessions.
The 988 hotline has about 11,000 counselors across 200 centers nationwide. Thapa said that all counselors should receive competency training on LGBTQ+ issues.
He said the training that 988 counselors currently receive is insufficient.
Hawai‘i's 988 crisis hotline, which is part of the national 988 hotline, has over 40 trained counselors who manage calls, texts, and online chats, according to Belinda Danielson, a community program supervisor of the state Department of Health’s Adult Mental Health Division.
She said the local 988 hotline will get 300 to 500 calls per day, although there's no disaggregated data on which groups are calling the lifeline.
“We want to make sure that we are meeting the needs of the community, especially the safety net,” she said.
Battling mistreatment and stigma in society
While LGBTQ+ youth are at high risk for suicide, it's not inherently because of their sexual orientation or gender identity. Instead, they are at higher risk because of how they are mistreated and stigmatized in society, according to the Trevor Project, a nonprofit with a mission to end suicide among LGBTQ+ youth.
That stigma can come from a combination of discrimination, family disapproval, social rejection, or bullying. LGBTQ+ youth also struggle with accessing gender-affirming care.
Myles Dunn, 19, recently went to rehab after relapsing on cocaine.
While at a treatment facility, Dunn said he would consistently ask other people to respect his identity as a transgender man.
Dunn was the youngest in the group session with older men, in which he said they had opinions on trans people.
“It was a generally accepting environment, but still, people asked some things, and a lot of the things were said that made me feel very unsafe in that supposedly healing environment,” he said.
Dunn said the counselor was dismissive of his feelings and told him to educate people when they asked.
“I like education, but I was there to get better,” he said. “I did not feel like I had to explain and justify my existence to these other people.”
Dunn's experience underscored the need for specialized LGBTQ+ services, which are essential for helping someone in emotional distress.
Jasper Ho, who called 988 on the day before Thanksgiving when he was 15, is now 21 years old. Ho said the most helpful service he had when using a suicide and crisis prevention hotline was the Trevor Project.
Ho said the counselor he was connected with didn't bring up his gender identity. Instead, the counselor asked if he was safe.
“I knew I wouldn't have to justify who I was in order to get care, and that wouldn't be a topic of conversation when it didn’t need to be,” Ho said. “I wasn't being judged for who I was even though it was completely unrelated to the crisis I was going through.”
Building a community
Jasper Ho and Myles Dunn both said they didn't expect to live past 14. Now, as young adults, they have overcome many obstacles together.
Ho and Dunn have known each other since the 6th grade. They both started their medical and emotional transition around the same time, being there for each other almost every step of the way, including receiving their first testosterone injection.
“We’ve seen each other grow, our voices getting deeper and one of us growing facial hair,” Dunn said.
Ho said that there's no issue with asking trans people questions, rather it's when is the right place, time and approach.
“People often forget that there is no one universal trans experience, and one trans person could never possibly talk for all trans people,” Ho said, who added that he got surgery before he went on hormones.
Ho said his advice to other LGBTQ+ youth is to surround themselves with their community.
“There are people that care about you,” he said. “There are people who are fighting for you. You just need to find them, and the most radical and important thing you can do as an act of protest in this administration is to stay alive.”
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