“There are still ways to live a fulfilling life in this incredibly messed up world”: Community advice for clinicians working with transgender, nonbinary, and gender-expansive Black, Indigenous, and other people of color with experiences of suicidal ideation.

Transgender, nonbinary, and gender-expansive (TNGE) Black, Indigenous, and other people of color (BIPOC) communities tend to experience alarmingly disparate levels of suicidal ideation and attempts. Such levels of suicidal thoughts and behaviors are exacerbated by systemic exclusion within medical systems and a limited interest within scientific research to center community narratives. To better understand potential avenues of effective crisis intervention and suicide prevention, the present study surveyed 110 TNGE BIPOC participants about their advice to mental health professionals who work with community members experiencing suicidal ideation. Given that much of the extant suicidology literature about TNGE BIPOC tends to be deficit-based, the overarching motive of this study was to recenter information regarding suicide prevention to include the perspectives of TNGE BIPOC community members. A conventional content analysis approach resulted in four major themes and 16 subthemes to guide mental health professionals in the work of self-education, systemic change, clinical intervention, and community. Contributions to counseling in suicide prevention include (a) engaging with self-education as an ongoing process, (b) conceptualizing the clinical role as one of systemic change with therapeutic support that is contextualized within resistance to oppressive systems, and (c) valuing community connection as an integral psychological resource.