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Advocates suggest a hotline for transgender youth a crucial service for an at-risk community on the margins, one spotlit this week following the death of 17-year-old transgender teen Leelah Alcorn. Just before 2:30 a.m. on Sunday, Ms. Alcorn walked six kilometres from her family’s home in Kings Mills, Ohio, to an interstate highway where she walked in front of a tractor-trailer, according to media reports.

A new Canadian crisis hotline is helping transgender youth who have come out to their families and been shunned – a particularly vulnerable community with staggering rates of depression and suicide.

Launched Dec. 12 in Canada after toll-free lines opened in late November in the United States, Trans Lifeline is exclusively for transgender people and staffed entirely by transgender operators. With nearly 60 volunteers working worldwide across many time zones and 350 more signed up for training, it's the first helpline with this level of specificity.

Advocates suggest it's a crucial service for an at-risk community on the margins, one spotlit this week following the death of 17-year-old transgender teen Leelah Alcorn. Just before 2:30 a.m. on Sunday, Ms. Alcorn walked six kilometres from her family's home in Kings Mills, Ohio, to an interstate highway where she walked in front of a tractor-trailer, according to media reports.

In a suicide note posted on Tumblr, Ms. Alcorn wrote about being transgender and suffering familial rejection from her devout Christian parents, who wouldn't allow the teen (named Joshua at birth) to begin transitioning.

"I feel like a girl trapped in a boy's body, and I've felt that way ever since I was 4," Ms. Alcorn's note read. "When I was 14, I learned what transgender meant and cried of happiness … I immediately told my mom, and she reacted extremely negatively, telling me that it was a phase, that I would never truly be a girl, that God doesn't make mistakes, that I am wrong."

Greta Martela, founder and executive director of Trans Lifeline, said "familial rejection is really common" for transgender people.

"It's just been the holidays," said Ms. Martela, a trans woman who was raised Mormon. "The number of my friends who actually went back to spend time with their families is really low. It's almost no one. It's a huge problem."

Ms. Martela estimated that 30 per cent of the calls are coming from youth rejected by their families, religious and not. Other callers are having trouble accessing transition-related medical care or facing workplace harassment. "The person calling has a problem because the people around them are making their identity a problem. That's different than what the other crisis lines are dealing with," Ms. Martela said in an interview from San Francisco.

Martela herself transitioned later in life, two years ago, calling the National Suicide Hotline when she was in crisis, beginning the transitioning process. She said a male operator answered and conceded that he didn't know what "transgender" meant. After Martela explained, she says the operator grew uncomfortable, directing her to call 911.

Sophia Banks, a 34-year-old Toronto trans woman and advocate, helped bring the hotline to Canada and argues that transgender operators are better equipped to deal with trans callers than volunteers at generalist helplines, who may have no appropriate training.

"The benefit of this service is you're not going to call and have to go over Trans 101. You won't have people messing up your pronouns. You'll get people who have some understanding of what you're going through and who can relate," said Ms. Banks, who pushed for Trans Lifeline to expand its toll-free lines in Canada because "we lose a lot of trans people to suicide."

The suicide rates are alarming: 77 per cent of transgender Ontarians have seriously considered suicide and 43 per cent have attempted it, according to a 2011 report from Trans PULSE, which surveyed 433 trans-identified respondents in the province.

When the researchers homed in on trans youth, age 16 to 24, they found that 70 per cent of respondents with unsupportive parents had contemplated suicide in the year prior; 57 per cent of the individuals in this group had attempted suicide during the same time period. By contrast, 4 per cent of kids with very supportive parents attempted to kill themselves. Advocates say that support from parents helps curb insecurity, depression and suicidal thoughts in trans youth.

In her suicide note, Ms. Alcorn wrote about coming out as gay to her classmates. She alleged that her parents reacted by taking her out of public school, forbidding her from using social media and placing her into faith-based conversion therapy. She described realizing at age 16 that she would be forced to delay puberty-blocking hormone therapy until she turned 18, when she would no longer require parental consent. And she feared never being able to transition successfully: "Either I live the rest of my life as a lonely man who wishes he were a woman or I live my life as a lonelier woman who hates herself."

Ms. Martela said transgender people who are at the beginning of their transitions are most vulnerable: "For a teenager who's already impatient, they get up the nerve to tell their parents and that's a relief. And then they get this terrible reaction and they have to wait till they're 18. For a teenager, that seems like forever."

Ms. Alcorn's mother told CNN Wednesday that when her child expressed a wish to live as a woman, the family could not support it religiously. She said she denied her child's request for transition surgery because "we didn't have the money for anything like that," and that she forbade the teen access to social media for looking at "inappropriate" subject matter on the Internet. "People need to know that I loved him," the mother told CNN. "He was a good kid, a good boy."

Shortly after Leelah's death, the mother wrote in a Facebook post, since removed: "My sweet 16 year old son, Joshua Ryan Alcorn went home to heaven this morning. He was out for an early morning walk and was hit by a truck."

The message incensed readers because Ms. Alcorn's mother continued to identify her child as a boy with male pronouns. By Tuesday, the story spread internationally under the Twitter hashtag #LeelahAlcorn. Later, another hashtag emerged, with transgender people tweeting more hopeful stories en masse under #RealLiveTransAdult.

In the spirit of It Gets Better, an online movement founded by Dan Savage to help prevent suicide among bullied and depressed LGBT youth, people reached out on Twitter as allies to trans youth who might be facing circumstances similar to Ms. Alcorn's.

Many of those who posted under #RealLiveTransAdult feared that Ms. Alcorn will continue being identified as a boy in the words inscribed on her headstone. A widely circulated petition launched on the website Change.org is asking Leelah's mother to use her child's preferred name on her grave.

With a report from Janie Ginsberg

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