Pretty much the title. Every year after the holidays I get a mini surge of people considering detransition or who present with new onset depression and suicidal ideation.

The reason is obvious, people go home to their family, people who should love them unconditionally and it doesn't go so well.

I work really really hard to make sure I don't ever lose patients to suicide. In nine years it's only happened once, and I was completely shocked by that one. It sort of came out of nowhere. Not a day goes by that I don't think about that person and wonder if I'd been a little friendlier in my last portal message with them, if I'd probed a little harder they would have confided in me and I could have done something.

I'll never know how many people I yanked back to reality when they were standing on the edge of the void, but I always think about the one I didn't.

I can't see all trans people on earth, so do me a solid and check in on your trans friends/family/etc and make sure they are doing alright and aren't in a dark place.

I rather openly admit that were it not for a random Facebook message from one of my trans patients a few months after the fire, I would currently not exist. Because of what she said to me, PFM now exists and I still do as well. It really can make a difference, so take a second and send some messages to everyone you care about. It you are not sure what to say, just send something like this:

"Hey, haven't heard much from you for a little while are you doing okay? For real, asking for an honest response, as I care about you"

I credit my life to that patient that did it for me, so I try to pay it forward.