Elsa and Steve Worth of Keene weren’t particularly surprised when their oldest child, Carl, told them he was gay, nor when their son realized he was, in fact, transgender and became their daughter Emelia.

But it was a shock when Emelia, also known as Em, took her own life on Jan. 28 at the Kent School in Connecticut, because Em was loved, supported and accepted by her family and friends.

Emelia had been depressed and the Worths had sought help for their 18-year-old daughter. But they thought, in time, that she was recovering.

She even gave a speech on Dec. 8 in St. Joseph’s Chapel at the private school in front of 570 students and staff about her depression and being transgender and was given a standing ovation for her bravery, her mother said.

Transgender people — those who identify with a gender different than the anatomy they were born with — have a significantly higher suicide rate than the general population. It’s not because they’re transgender, but rather because of the depression that often accompanies the struggle to become comfortable with their own sexual identity and the stigma society often attaches to it, according to an article by Medical Daily.

And although Elsa Worth, who is the rector at St. James Episcopal Church in Keene, grapples with the fact that she has no answers in her daughter’s death, she wants Emelia’s story to help generate support for other transgender people who are silently suffering.

In the United States, 41 percent of transgender people attempt suicide at some point in their lives, compared to 4.6 percent of the general population, according to a study by the American Foundation for Suicide Prevention.

New Hampshire ranks 39th in the country in the number of individuals who identify as transgender, according to a report from the Williams Institute at the University of California Los Angeles School of Law. 

Of respondents to the National Transgender Discrimination Survey, 42 percent of transgender women reported having attempted suicide at some point in their lives, compared to 46 percent of transgender men, according to a 2014 study released by the American Foundation for Suicide Prevention and the Williams Institute.

John Hinman, Em’s four-year academic adviser at the Kent School, told The Sentinel, “I don’t see this so much as the tragedy of someone who was coming out as transgender, but someone who lost a battle of depression ... being transgender is a huge risk factor for depression.”

Often, the reason why transgender people are suicidal is misunderstood. Solely being transgender isn’t the cause, but the “minority stress” that is attached plays a big role, according to an article from The Huffington Post. Individual experiences of prejudice or discrimination, family rejection, harassment, bullying, violence and victimization causes depression that can lead to suicidal tendencies, the article said.

But Emelia never experienced many of those things.

Instead, she was a well-liked, high honor roll student, a gifted musician and a friend to everybody.

“She was the face of the school,” Hinman said.

Hinman laughed when asked how to describe Em. His response: “A once-in-a-generation person.”

Both Hinman and Em’s mother said Em made it a point to ensure everyone felt a sense of inclusion.

“She went out of her way to make people feel loved, accepted and welcomed, and that’s what she wanted for herself. And in many ways, she did receive those things, but there was more suffering than any of us could know,” Worth said.

“Being transgender may create the disconnect in your life that causes depression, but depression is what causes suicide,” she said.

Many transgender people struggle with gender dysphoria — the feeling that they are stuck in a body that doesn’t match the way they feel on the inside, according to an article by Psychology Today. Worth speculates that’s how her daughter — and many other transgender students — feel.

Worth explained that Emelia, then named Carl, came out as gay in the spring of 2016, but still didn’t feel liberated. Carl became depressed during the summer and realized he was transgender in the fall.

“Our reaction was one of support and acceptance, knowing that she’d been struggling with something and suddenly understanding what it was,” Worth said.

Worth said the family got help for Emelia to cope with her depression and suicidal tendencies, and they thought her depression was lessening.

Emelia took her own life after the annual guitar concert at Kent School — what had been the highlight of Em’s year, Worth said.

“There was no indication,” Worth said. “And it just makes me think again there are kids that are suffering and they keep it to themselves … We knew the issues but we didn’t know the profoundness of her pain.”

Jenna, 19, a second-semester freshman at Keene State College who asked that only her first name be used in this report, said her experience as a transgender person has been “pretty decent” compared to others she knows who are transgender, but she has experienced bullying and depression.

She struggles with gender dysphoria, which she says is the hardest part of being transgender.

“There are still days when I am so uncomfortable in my body I can barely get out of bed,” Jenna said.

Jenna was born a boy and hasn’t started any gender transformation yet, due to the expense, although she presents herself as female.

But she has advice for other transgender students.

“The best thing anyone can tell anyone who may be questioning their identity, be it their gender, sexual or romantic orientation, or anything like that, is that what they’re going through is completely normal and everything will end up great in the end,” she said.

“I know that sounds kind of dumb, but it really is true,” she said.

Jenna also suggested transgender people get involved with support organizations or groups in their local communities. She’s the secretary of KSC Pride at Keene State College, which she says offers a sense of belonging and inclusiveness.

“We are always willing to help anyone out with whatever problems they might be having,” she said.

Other organizations for transgender people and the LGBTQ community are PFLAG-NH, The LGBQ/T Community and Connection Group, and Antioch University Couple and Family Therapy Institute.

St. James Episcopal Church on West Street is also a safe place, said Worth, the rector there.

“I hope people know I’m a safe person and this would be a safe place to come,” she said.

Worth’s advice to transgender people: Find your people.

Transgender people “find relationships. They find love and purpose and meaning and jobs. As they say, it gets better, and I think for teenagers who might have a momentary sense that all is lost, it’s a tragedy because when you make the decision (to take your own life), it’s done,” Worth said.

“I don’t have any answers for anyone about anything, but I do know that when we connect and support and love each other, things get better. And I know that Emelia’s life was a good life despite the pains ... Find your people that support you in the kindness and the caring and your higher nature. Even if some people think that’s not right, you need to be who God made you.”

Callie Ginter can be reached at 352-1234, extension 1409 or cginter@keenesentinel.com. Follow her on Twitter @CGinterKS.