Abstract
Introduction: Women and Suicidality
Women in emotional distress have historically been trivialized and socially penalized (Bordo 1993; Schippers 2007). Medical discourses have historically individualized and pathologized women’s distress, positioning women as the problem (Appignanesi 2008). The application of feminist analyses to understand how women in distress are constructed and managed helps us to identify gendered assumptions within these constructions (Bordo 1993). The use of a feminist lens to analyze the social, political, and time-bound context in which stereotypes of women become ubiquitous also helps us understand how gendered expectations are symbolized, understood, reproduced, and protested (Bordo 1993). In this article, I bring a feminist analysis to negative characterizations of young women who died by suicide and illustrate some of the deadly consequences of gendered tropes.
Suicide is one of the leading causes of death of young women 1 (ages under 24 years) in Australia, and over the last two decades, the rate has increased (Australian Bureau of Statistics 2024; Stefanac et al. 2019). In 2003, the age-specific rate of suicide among women ages 15 to 24 years was 3.7 per 100,000 population (Australian Bureau of Statistics 2014). The rates of suicide among women ages 15 to 24 years peaked in 2021 at 8.1, and the most recent (preliminary) rate available, for 2023, at publication was 6.6 (Australian Bureau of Statistics 2024). Young women have the most ambulance attendances and hospitalizations for suicidality, which includes suicidal ideation, planning, and fatal and nonfatal suicide 2 (Australian Institute of Health and Welfare 2023a, 2023b). Suicide is an extremely well-researched topic, yet suicide researchers have demonstrated little interest in understanding women who died by suicide, albeit with some exceptions (Canetto 2021; Mallon et al. 2016). Despite suicidality among women being an ongoing problem, research into men and masculinity has dominated suicidology (Jaworski 2010). Women are viewed as inconsequential to understanding suicide due to their generally lower rates of death by suicide (Mallon et al. 2016). However, what can be learned from understanding suicidal women can be applied to understanding expectations of women more broadly.
Women are often omitted from suicidology because women are considered better help-seekers than men (Canetto 1997a, 1997b see Hallford et al. 2023; Sweeney, Owens and Malone 2015). Some scholars argue that help-seeking is associated with femininity (Cleary 2005) and is therefore antithetical to traditional norms of masculinity, which reward self-reliance (Scotti Requena et al. 2024; The Men’s Project and Flood 2018). This formulation assumes a gender binary: Women are expected to ask for help, comply with treatment, and ultimately survive suicidality while men are not. Furthermore, while communicating intent to die by suicide may not be intended as help-seeking, it is an important moment for suicide intervention and prevention (McPhedran and De Leo 2013). Despite the emphasis on help-seeking in the suicide literature, little research has examined responses to communications of intent to die by suicide (Pompili et al. 2016) or the role of feminine norms in shaping those responses. Applying a feminist lens to understanding how women who died by suicide communicated intent and the responses they received can help us identify the effects of these expectations, and potentially inform researchers about the connections among distress, help-seeking, and femininity more generally.
I argue two main points. First, assumptions that women are good help-seekers hide other factors relevant to understanding why women suicide and therefore disguises other factors relevant to help-seeking more generally. Second, gender bias can be dangerous and/or fatal. I aim to understand how expectations of femininity affect responses to young women who communicated intent to die by suicide and show how these expectations were constructed and interpreted before and after their deaths.
Understanding the role of femininity and how it is perceived may help inform suicide prevention research, policy, and practice and help us understand the implications of gender expectations for enacting “appropriate” responses by women experiencing distress more generally. I begin with how I define gender, the role of gender hierarchies for understanding emotions, and their effects on women. I then explore how women are understood in suicide research. The results demonstrate how tropes of suicidal femininity—especially tropes that emotionally distressed women are “drama queens” and “attention seekers” (two highly feminized terms frequently used to describe people perceived to be “acting out” emotionally)—played into perceptions and reactions of people close to them. Ultimately, I show how some women became stuck in a dangerous bind: the more distressed, emotional, and suicidal they became, the more their distress was trivialized.
Gender, Power, and Stereotypes of Women’s Distress
Understanding the ways women’s distress is interpreted is central to understanding how some people respond to women’s expressions of suicidality and distress more generally. Constructions and expectations of women reflect and reinforce norms of femininity and gender, which are culturally prescribed and which reinscribe frames of reference for how people of different genders are expected to think, feel, and behave (Ridgeway 2009; West and Zimmerman 1987). Historically, women who did not comply with expectations of their gender, or who were read to have performed gender expectations to an extreme, have been constructed as deficient or pathologically unwell and stigmatized (Appignanesi 2008; Bordo 1993).
Hegemonic masculinity and femininity are concepts used to explain a binary gender system that favors men, subordinates women, and creates gender hierarchies that prioritize and reward people who meet gender ideals. Hegemonic femininity, the “ideal” archetype of femininity, is culturally and context specific (McRobbie 2009; Paechter 2018). In the Global North, hegemonic femininity is associated with deference to hegemonic masculinity, being White, middle-class, and emotionally warm, nurturing, and docile (Brown 2011; Paechter 2018; Schippers 2007). Women who do not or cannot live up to expectations of hegemonic femininity can be socially penalized (Paechter 2018; Schippers 2007). For example, women who enact distress through behaviors associated with masculinity, such as being angry, may be designated as representing a “pariah femininity” (Schippers 2007, 95), and be “simultaneously stigmatized and feminized.”
Women are also viewed primarily as nurturers and expected to look after others before themselves (Bordo 1993). Therefore, women who attempt to prioritize their own care or express their feelings beyond the acceptable, narrow range can be socially stigmatized and penalized as “greedy and excessive” (Bordo 1993, 171). A distressed woman, when expressing her emotional needs, for example, may be labeled a “drama queen” (someone who exaggerates their emotions for attention) or an “attention seeker” (someone who is “pretending” in order to gain the attention of others) (Byrne et al. 2021; Dempsey et al. 2022). These terms are deeply gendered and frequently used in English-speaking countries to denigrate women and trivialize their experiences.
Furthermore, attention seeking is pathologized through association with psychological diagnoses. For example, it is a defining feature of histrionic personality disorder (HPD), where “emotions often
Understanding the expectations of hegemonic femininity, the bind in which they place women whose feelings and behaviors do not meet gender expectations, and the limitations they place on female expression is critical to understanding suicidal women and reactions to women’s communications of intent to die by suicide. As potentially an extreme act of self-denial, or gender protest, the suicide of a woman who was trivialized can be viewed as an expression of the “destructive potential [of cultural ideals] revealed for all to see” (Bordo 1993, 176). A dead woman’s body cannot be ignored, 3 and the truth of her distress is exposed.
Trivialization of Suicidal Women and Suicidal Femininities
I conceptualize
Studies that examine women who died by suicide highlight associated suicidal tropes that trivialize, medicalize, and undermine them. Canetto (1997a) outlined how in typical cases of suicide, women are constructed as emotionally manipulative, their feelings trivialized, and their suicidality not taken seriously. Similarly, Mallon and colleagues (2016) compared general practitioner records to coronial records of women who died by suicide. They concluded that the reliance on medicalized understandings of women after their deaths resulted in a “sanitization” of their cases which downplayed histories of sexual assault and instead emphasized vague references to, for example, “severe mental health problems” (Mallon et al. 2016, 669–70). Furthermore, Townsend (2024b) analyzed cases of young women who died by suicide and found that some young women who responded to experiences of sexual assault in “masculine” ways, such as being angry, were constructed as “bad girls” by the human service professionals they asked for help, a construction which continued after their deaths and throughout the coronial process. Another study demonstrated that young suicidal mothers were undermined before and after their deaths due to their inabilities to live up to expectations of being “good” patients and “good” mothers (Townsend 2024a). Such explanations reinforce tropes that suicidal women are pathologically unwell, irrational, and “just crazy” (Canetto 1997a, 143).
These studies, which examined suicidal women, illustrate the impact that gendered expectations have on people who died by suicide and on individuals in distress generally. They also show the extent to which women’s experiences may be pathologized. This is particularly important for understanding how some suicidal women are denigrated, given that male death by suicide is often valorized (Canetto 1997a). Women’s fatal and nonfatal suicides are often constructed, and thus undermined and feminized, as a cry for help (Balt et al. 2021; Canetto 1997a, 1997b; Canetto and Lester 1998), which implies a level of manipulation and trivializes suicidality among women (Canetto 1997a). Furthermore, help-seeking for suicidality does not necessarily equate to useful, judgment-free experiences of treatment (Canetto 1997b). Help-seeking for suicidality—including surviving suicide—may also come at a social cost (Townsend 2024a). A serious and potentially fatal problem arises here: people who frequently talk about or experience suicidality, who are overwhelmingly women, may be dismissed as attention seekers and become social pariahs. Some studies indicate people who are continuously suicidal and deemed attention seekers can become viewed by friends and family as “tiresome” (Balt et al. 2021; Kjølseth and Ekeberg 2012) and “pathetic” (Scourfield, Roen, and McDermott 2011). Finally, these studies show that while nonfatal suicides are associated with femininity and “attention seeking”, when women do die by suicide, the way they are understood (or ignored) and constructed within social contexts, coronial processes, and suicide research can reflect hegemonic gender norms.
The presumption that women are good help-seekers may hide other factors that contribute to women’s distress and suicidality—and may be a reason that no study has investigated the role of femininity and communications of intent. This article offers the first analysis of how gendered norms influence responses to communications of intent by young women perceived to be “attention seekers” and “drama queens.” I conducted a sociological autopsy to contextualize young women’s experiences. I aim to understand the role of assumptions about femininity, emotions, and behavior among a sample of young women who communicated intent but were dismissed or ignored and died by suicide, and how these were constructed premortem and postmortem.
Methodology and Methods: The Sociological Autopsy Approach
This study draws upon Australian data. In Australia, all deaths by intentional self-harm (suicide) are registered in the National Coronial Information System (NCIS), which provides a database of coronial records. The NCIS is a database of coronial files in Australia dating back to 2000 (except for Queensland, which began in 2001) and New Zealand since 2007 (NCIS 2023). The NCIS is hosted by the Victoria Department of Justice and Community Safety. Suicide deaths among young women (ages under 25 years) between 2014 and 2017 were identified on the NCIS. The timeframe 2014–2017 was chosen because they were the most recent years for closed cases when a request to review the data was made in 2020. Young women were chosen due to their high rates of suicidality, which may yield higher numbers of communications of intent and their increasing risk of suicide (see Townsend 2024a and 2024b for further details).
Cases on the NCIS can include up to four reports about the fatality, including a police narrative of circumstances that may include information from friends and family of the person who died; an autopsy report which can include background information provided by police and/or medical records; a toxicology report that details any substances (medication, licit or illicit) found in the person’s blood and/or urine; and the coroner’s finding regarding intentionality of the death (whether it was suicide), which may include extensive data, if an inquest was held, and can include excerpts from evidence provided.
Positionality Statement
I acknowledge my standpoint as a White, middle-class, educated woman with a background in suicide research. I have read thousands of cases of suicide since my career in suicide research began in 2016. During that time, I have noticed patterns related to how people responded to communications of intent to die by suicide. I also have observed a general lack of interest in suicidal women. The cases, coupled with the blindness toward gender in suicide research, made me sad and angry. I noticed systematic failures in support provided to suicidal women and the gendered nature of suicide research which did not take them seriously. These factors provided the impetus to do this research. I seek to tell the women’s stories in a way that centers upon on their experiences. These factors informed the analysis of the material presented.
Qualitative Sociological Autopsy
This study adapts Fincham and colleagues’ (2011) sociological autopsy method. Sociological autopsies aim to contextualize suicides (and other deaths) and identify social structures and forces that played a role by using coronial data (Fincham et al. 2011). The intention is not to theorize about what people were thinking or feeling. Rather, sociological autopsies aim to better understand the contexts in which suicide occurs and how this knowledge is created and disseminated. They are a conscious step away from traditional understandings of suicide, such as Joiner’s (2005) interpersonal theory of suicide, which has been critiqued for a lack of critical reflection on data collection and reporting (Hjelmeland and Knizek 2020).
A key aspect of the sociological autopsy method is that data are critically analyzed within two “realities”: One is the content of the data (what the data say) and the other is how the data are presented (how and why they were created). For example, how the coronial process gives characteristics and meaning to the death and what effect this has on the content is critical for understanding which deaths are represented as suicide and how suicide is represented (Fincham et al. 2011). This critical reflection on what and how data are created, the way in which the legal and medical process constructs death categorizations, and an emphasis on social context are what set this method apart from psychological autopsies (Fincham et al. 2011). A sociological approach, therefore, retains the “fuzzy, messy reality” of suicide and provides insight into some of the contexts before and after deaths by suicide (Fincham et al. 2011, 44).
An inductive approach to data collection was utilized, as is common in sociological autopsies (Fincham et al. 2011; Shiner et al. 2009). A total of 431 cases were reviewed, from which a database was created of codes derived from 50 random cases of suicide by young women. Codes included mentions of contextual issues the women experienced—for example, having been to hospital for suicidality and care they received, whether they had children or interpersonal problems, and whether, how, and to whom they communicated intent. These codes were then used as a means of streamlining data collection for the remaining cases.
The initial coding stage indicated the presence of a particular characteristic within each case and was not used to gather anything specific to gender or suicide. For example, if a young woman’s case noted she had communicated intent to die by suicide, this was noted as a potential theme of relevance, depending on the presence of the same issue in other cases. Therefore, the role of femininity among young women who were dismissed or ignored following their communications of intent was identified as a theme of importance from the initial codes to help understand the relationship between femininity and suicide.
Of all the women’s cases, 123 were identified as having made a communication of intent to die by suicide received before death. Of these, 17 of the women were noted as ignored or dismissed following their final communication of intent to die by suicide. These 17 cases form the basis of the analysis presented in this article.
The 17 cases were then subject to more detailed coding. Again, rather than having a pre-coding framework organized, codes were grounded in and created from the data, using analytic induction as per the initial stages of a grounded-theory analysis. For example, the term “attention seeker” was not in the initial coding framework but was identified as an axial code that helpfully explained the experiences of several young women who were dismissed. As per contemporary versions of grounded theory, analysis involved a process of review and revisitation of the codes, themes, cases, and literature (Charmaz 2014). Coding also identified both data “realities” associated with the sociological autopsy: what occurred and how it was described and explained.
Twelve of the women were 18 to 24 years old. Five were noted to be First Nations women. The recipients of final communications of intent included parents/family members (seven cases) and intimate partners (ten cases). All communications of intent occurred within 24 hours of death; 14 occurred within hours or minutes of death. All names have been changed and identifying information omitted. Mechanisms of suicide have been omitted for privacy reasons and to align with the Mindframe guidelines of discussing mechanism and locations of suicide (see Everymind 2024).
Identifying Themes: “Drama Queens” and “Attention Seekers”
Once the initial coding was completed, cases and codes were reviewed and overarching themes—“
“
Limitations
Race and ethnicity are not always clear in coronial records. Although a “country of birth” field exists, it does not indicate race or ethnicity. An “Indigenous origin” is available by special request, but was not applied for in this study because the focus was on gender and women broadly rather than First Nations women’s experiences specifically. Through information obtained by friends and family, some cases mentioned whether a woman was First Nations. Some, but not all, jurisdictions routinely collect and reported this in the coronial files reviewed. Furthermore, cases on the NCIS do not usually mention the race or ethnicity of people who provided evidence to the investigation into a death. While gender, race, and ethnicity are intertwined, it is not possible to adequately determine the roles race and ethnicity played within the responses using these data. Doing so risks conjecture and essentializing race by assuming that a person’s parent or partner shared their race or ethnicity, or that this did or did not play a role in their relationship and decision-making, and, if so, to what extent. Therefore, I have noted First Nations status as a gesture toward this important factor, but one about which conclusions cannot be drawn in this study.
The data are reconstructions of events, based on the perspectives of people who knew the women, which were interpreted and reported by police and coroners. Therefore, it is unknown whether what was reported actually occurred (Canetto 1997a; Hjelmeland et al. 2012). Also, because the analysis focuses on situations where a communication of intent was dismissed or ignored before a woman’s suicide, I did not investigate ways in which women used or received help and survived. Furthermore, coronial cases are limited by what informants, who are often in a state of shock and bereavement, thought was pertinent to help legal authorities investigate the death and subsequently what authorities found important to record. Certain information may therefore have been omitted. Nonetheless, there is a rich amount of data and opportunity for analysis (Fincham et al. 2011; Langer, Scourfield, and Fincham 2008).
“Drama Queen” Suicidal Femininity
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Overly and/or Pathologically Emotional, Mentally Unstable, Impulsive, and/or Belligerent “Drama Queens”
Emma’s case highlights how emotions can be pathologized by health professionals and by loved ones and reconstructed in similar ways by the coroner after death. After Emma’s death, her psychologist constructed her as pathologically emotional. Emma’s psychologist described how in the year before her death, “her emotional volatility continued and she remained subject of [sic] outbursts of rage and anger and her relationship with her partner continued to be problematic.” Emma’s psychologist described how she stopped therapy for some months before she “re-presented on [date] in the company of her mother and partner having tried to impulsively [suicide] during an argument with her partner the day before.” Emma made her final communication of intent to die by suicide to the same boyfriend during an argument. Police reported he said: the deceased always makes empty threats to kill herself however has never actually attempted or followed through. He stated he did not believe she meant to kill herself. . . . he believes she wanted him to come save her, and he never went out to follow her.
That Emma’s partner thought she wanted to be saved by him assumes a level of manipulation from Emma. Emma’s mother corroborated the partner’s evidence that she had mentioned suicide but not attempted it.
[Emma’s mother] stated she has lost too many family members to suicide. . . . The family stated to police that the deceased has made threats to kill herself before however has never been precise as to how she would do it and she has not made the attempts before.
The coroner’s report noted that Emma was mourning a loved one and was not close to other family members who made “ongoing negative and critical comments [about her],” which her psychologist believed may have been because of her personality. Emma’s psychologist noted her relationships since childhood were “characterized by difficulty.” Yet despite these circumstances, the coroner’s summary of Emma’s case, which included her history of frequent suicidality, a nonfatal suicide, and her grief, described her death by suicide as “impulsive” and focused upon her apparent emotional instability. The coroner noted: [Emma] had a well-documented history of mental health issues particularly acting impulsively and angrily, usually in the context of relationship difficulties generally, but in this particular incident relating to the breakdown in her relationship with her partner. Consistent with her history it is evident [Emma] acted impulsively when making the decision to end her life.
For Emma, both experiences of nonfatal suicide were described as impulsive, first by her psychologist and then by the coroner investigating her death. Emma’s previous experience of suicidality, including non-fatal suicide as reported by her psychologist, appeared to be trivialized and discounted as nonserious by her partner and mother, as neither mentioned it after her death (“she had never actually attempted or followed through” and “she has not made the attempts before”). After Emma died, her partner did not believe she “meant to kill herself.” Instead, he thought she was trying to manipulate him to “come save her.” Emma’s partner’s interpretation seemed to be confirmed by the coroner following her death, by describing her suicide as “impulsive.” The description associates her suicide with being spiteful, irrational, and uncontrolled, despite other factors, including the deaths of other family members and ongoing suicidality.
Similarly, Clara’s partner described to the coroner that Clara communicated intent during the breakdown of their relationship. Clara’s partner explained that the day before Clara’s death, she asked him to leave her house after she revealed she had betrayed him. He “refused [to leave] as he believed she may hurt herself.” She then began self-harming, but he did not call emergency services “as the cuts were small.” She was taking medications “like they were skittles” and “he told her to go to bed and calm down.” That afternoon “he became worried about her safety again.” He reported to the coroner that she “spoke of not being able to live with herself for hurting him.” Police reported he said: [Clara] was walking around the house crying and [Partner] was sitting inside. He went outside and saw that [Clara] was [organizing her suicide]. He told her not to be stupid and took [means] off her . . . He then went back inside. [Partner] read the [suicide] note. [Partner] went back outside and saw [Clara dead].
Despite Clara’s partner being worried about her behavior, he considered her self-harm not serious enough for him to call emergency services, despite his concerns. Clara was implied to have been overly emotional by her partner (she needed to “calm down,” was over medicating and “walking around crying”). He may have described her this way in part because she may have felt guilty (“not being able to live with herself for hurting him”) and therefore focusing on her own emotions, rather than her partner’s feelings of betrayal, giving a sense that she made her situation about herself rather than him, the one who was hurt by the betrayal. Despite his empathy, he still downplayed her suicidality. His request that she “not . . . be stupid” indicates some level of exasperation with her. It also indicates that her partner seemed to think he had the situation under control, or he might have called for help, for example, if her cuts were bigger.
Blaire’s partner’s recollections of her final moments also typify how “drama queens” were dismissed following their communications of intent to die by suicide. In her case, their final argument, which was the catalyst for her suicide, was described as “minor.” Police reported: the deceased . . . was well effected [sic] by alcohol. . . .[T]he deceased and her defacto partner became involved in a minor argument over their . . . children. The defacto states that during the argument the deceased has stated she was . . . going to kill herself. Apparently she had stated this on previous occasions and as such the defacto did not follow up on her welfare when she left[.]
What Blaire’s partner described as “minor argument” about their children was enough for Blaire to decide to die by suicide. Although Blair may not have described the argument as “minor,” her partner did, potentially leading the police to take this characterization for granted. She was described as drunk, and her reaction to the argument skewed as a drunken overreaction. Like Emma, because Blaire frequently said she was going to die by suicide, her partner did not follow-up with her. It is also possible that Blaire’s partner assumed she was not serious, as suicidality is considered taboo among mothers (Al-Halabí et al. 2021).
The cases of Emma, Clara, and Blaire show how women in emotional distress who became suicidal can be undermined and dismissed by health professionals and their loved ones. Emma’s psychologist described her nonfatal suicide as “impulsive” due to her background of “emotional volatility” and continued “problematic” relationship with her partner, with whom she had argued (a sentiment echoed by the coroner). Emma’s communications of intent to die by suicide were interpreted as “empty threats” by her partner and attempts to gain his attention to “come save her.” Similarly, Clara’s partner described a scene of someone emotionally out of control unable to listen to reason (for example, to “calm down” and “not to be stupid”). Finally, Blaire’s partner did not follow-up with her after she told him she was going to kill herself because he did not think the “minor argument” they had warranted such a reaction. The assumption that the argument was minor was suggested by the vague details surrounding the discussion, which only indicate that it involved their children. That Blaire was a mother also may have underlain her partner’s response to her communications of intent to die by suicide, as motherhood can be assumed to be protective against suicide (Townsend 2024a). These cases show how women’s communications of intent during moments of anger and distress can be misinterpreted and dismissed as overreactions and how these descriptions of them can continue throughout the coronial process.
Manipulative, Threatening “Drama Queens”
Phoebe was a single mother in an abusive relationship. The police described her residence as “scarcely furnished” with “little food,” indicating that Phoebe and her child were likely struggling. Following her death, Phoebe’s partner described her to police as “argumentative” and “running hot and cold” in the days before her death. Her partner told police: this behavior was not unusual for the deceased, she was a drama queen and had been having mood swings since [a few months before death]. [Phoebe’s partner] believed this behavior could have been attributed to a change in her contraception methods.
Mentioning that Phoebe had changed contraception helped to construct her as erratic, with little control over her emotions, resulting in “mood swings.” This link between the female body, hormonal processes, and emotional regulation has historically been used to subordinate women (Appignanesi 2008). The impression given is that hormones explain Phoebe’s aggressive and emotional behavior, rather than external factors—for example, that she may have been struggling as a single mother.
Phoebe’s mother provided more context to Phoebe’s situation. She mentioned that her daughter had had “issues” since childhood. Police noted that Phoebe was in their system for having underage sex. Phoebe’s mother explained that Phoebe had to “get away” from the father of her child, who recently publicly emotionally abused her. Yet the final sentence on her police report stated that “Friends and family both report that the deceased was highly emotional, and was known to have issues that had not been addressed professionally.”
Comments from Phoebe’s mother and neighbors in the police narrative gave no indication that they thought Phoebe was “highly emotional.” Regardless, the police described her that way. The comment that Phoebe had “issues that had not been addressed professionally” implied that Phoebe’s distress was the result of individual psychological problems that she would not address, rather than material issues that she was struggling with. The coroner provided more context to Phoebe’s final evening, which Phoebe’s partner had not disclosed to police. An overview of what the coroner described as “vitriolic” and “highly emotional exchanges,” text messages between the couple, was transcribed in the coronial finding, suggestive of intimate partner violence. The coroner reported:
“I want to kill myself there a room all set up ready to go . . . goodbye.”
Messages from [Partner] indicate he attempted calling.
There are further insults back and forth, then he wrote “Go kill yourself pig.”
[Last reported message from Phoebe], there is a photo depicting [Phoebe] with a sad face and [means of suicide]. She wrote: “Is this what you really want, cause I am read [sic]. Goodbye.”
“All I wanted was a hug.”
[final message from Partner. . .] [2 minutes after her last]: “FILTHY DOG CUNT. I HOPE YOU DIE YOUR [sic] PATHETIC. I HAVE DISOWNED YOU. YOU MEAN NOTHING TO ME. AND I WISH I NEVER SEE YOU AGAIN. I HATE YOU.”
Phoebe’s suicidality was ignored by her partner and in some texts encouraged “Go kill yourself” and “I hope you die.” It seems that Phoebe’s partner interpreted her suicidality as a means of creating drama, as something trivial and something that only someone “pathetic” would do. Phoebe’s case demonstrates the pathologizing and individualizing of distress that can hide more complex issues. Her emotional behavior, which appeared linked to her being in an abusive relationship, and her potential struggles to cope as a single parent were instead blamed on her biology. Phoebe’s partner’s interpretation of her as a suicidal “drama queen” advanced a construction of Phoebe as trying to manipulate him to remain in a relationship with him.
Ashley’s case indicates how the suicidal femininity trope of the “drama queen” can also be invoked by family members. Ashley’s mother described to police that Ashley had “made numerous threats to self-harm over the years.” Her communication of intent was made to her sister, whom she woke after they had been drinking alcohol most of the day. Ashley’s sister reported to police: The deceased came inside [early in the morning] and began throwing things around the room. The deceased grabbed [a means of suicide] and said, “I am going to [suicide]. People think I won’t [suicide] but I am going to.” [Sister] got up, went into [another] room and went back to sleep.
Ashley herself recognized that her suicidality was perceived as a bluff: “People think I won’t . . . but I am going to.” Her sister’s moving to another room to sleep reinforced this, which may also be a response to Ashley being aggressive, violent, and drunk. It appears that her sister ignored Ashley’s communication of intent because Ashley was being irritating and threatening and was intoxicated.
In these cases, communications of intent to die by suicide were dismissed as emotional overreactions. Often this was based on previous communications of intent. Each case of the “drama queen” suggests the extent to which a gendered view of behavior, in which women are perceived as overly emotional, irrational, and dramatic, was applied to them, and manifested in the trope of the suicidal “drama queen”. “Drama queens” could be ignored or dismissed because their emotions were impulsive “overreactions” to arguments, regardless of their history or context, and in Phoebe’s case blamed on her biology. Gendered tropes, then, play a critical role in responses to communications of intent to die by suicide and may contribute to some women’s suicides.
“Attention Seeker” Suicidal Femininity
The term “
The framing of suicidality as a bluff can be interpreted within the frame that men die by suicide and women “just” attempt suicide, as discussed earlier—specifically that women are not serious about killing themselves but are instead looking for sympathy. “Attention seeker” suicidal femininity further highlights a bind: when women asked for help, survived suicide, and/or remained suicidal, the assumed integrity of their intention to die by suicide was questioned and undermined as nonserious each subsequent time they needed help. I examine this trope using the cases of Jean, Bridgett, Holly, and Josie (pseudonyms).
Bluffing “Attention Seekers”
Jean’s psychologist described to the coroner that Jean’s “most significant stressor was school related.” Jean’s mother described to police her last conversation with her daughter: After a short time [Jean’s mother] received a call back from the deceased who said that she had [was going to die by suicide]. . . . [Jean’s mother] stated to police that she did not think too much of the situation at the time as the deceased did not sound upset or distressed, and believed it may have been a way to get attention.
Jean’s mother was not worried about her daughter because Jean was not acting in a way expected of suicidal women. Jean did not “sound upset or distressed,” so her intent was misinterpreted as “a way to get attention.” As discussed in the previous section, being upset and distressed can be interpreted as being an overly emotional “drama queen”. In Jean’s case, not being emotional enough was interpreted as bluffing to gain attention. Given that Jean’s problems were also described as being no more serious than nondescript school-related stress, her anguish also seemed to not be fully realized by those who knew her.
Bridgett, who had survived multiple previous nonfatal suicides for which she had received no treatment, explicitly communicated her intent through her words and actions, as is evident in the extract below. Her final communication of intent was reportedly met with silence: On [date of death], . . . the deceased engaged in a verbal argument with her mother where she refused to go to her scheduled tutoring classes. . . . The deceased said to her mother, and within hearing distance of her younger sister, “I’m going to [suicide] because nobody loves me.” The deceased grabbed a [means of suicide] and went up to her bedroom for a short period of time. . . . A short time later, the deceased returned downstairs with the [means of suicide]. She lingered around the kitchen area before returning upstairs to her bedroom. There were no other interactions between the deceased and her family.
Bridgett died in her room within the hour. The description of Bridgett as having “lingered in the kitchen” gives a sense that she was waiting for someone to talk to her after she said she was going to kill herself, and when this did not happen, it seems her fears that she was not loved were confirmed. Like Ashley’s case, the overt showing of aggression and emotion from a young woman was met with silence. Furthermore, in Bridgett’s case, the reason for the argument seemed banal: a refusal to go to her tutor. As with Jean, the banality of the reason for Bridgett’s anguish and the argument contributed to her communication of intent to die by suicide being interpreted as a bluff, as sympathy attention seeking, and consequently ignored.
Frequently Suicidal, Bluffing “Attention Seekers”
Holly’s mother was more active in her bluff-calling than Bridgett’s family. Holly’s mother confronted Holly’s suicidality on two occasions. The coroner reported: [Date a month or so after a nonfatal suicide] [Psychologist] stated that [Holly] was upset at the time, and reported that she had been told by [her mother] to “do it properly” next time if she planned to die by suicide. . . . Around two weeks before [Holly]’s death, [Holly] and [her mother] argued and [Holly] told her mother that she wanted to die. [Her mother] responded by stating “if that’s what you want to do, then that’s your decision.” [Holly] reported this to both [her boyfriend] and her friend [named], and it appears that her mother’s comments had deeply upset her. [Her mother] stated that she did not say that meaning for her to go and do something, nor did [she] think in a million years that [Holly] would ever do anything like that to herself.
Holly’s case highlights a few tropes of suicidal femininity: women who express suicidal intent are not serious; nonfatal suicide can be downplayed because girls do not know how to kill themselves “properly”; and therefore, female expression of suicidality is ‘attention seeking’ and trivial. Holly’s mother did not “think in a million years” that Holly was serious about suicide, despite and possibly because Holly had survived a nonfatal suicide. Holly’s mother’s response also frames Holly’s communication of intent as being both passive and ‘attention seeking’. By saying “if that is what you want to do that’s your decision,” she emphasizes Holly’s agency and turns responsibility over to her: if Holly wants to express her agency through suicide (a gendered notion associated with masculinity), then “do it properly.” Perhaps Holly’s mother imagined that by throwing Holly onto her own resources, Holly would realize that expressing suicidality would not get her mother’s attention and stop trying. A particularly lethal implication of the “attention-seeker” trope of suicidal femininity in Holly’s case is that her mother appeared to be withholding empathy and support because she may have thought that by acknowledging Holly’s suicidality, she might encourage Holly’s ‘attention seeking’. Instead, it seems Holly was “deeply upset” by what she may have perceived as her mother’s lack of support.
Similarly, Josie’s case typifies the relationship between bluffing and ‘attention seeking’. Josie’s detailed coronial finding documented her extensive contacts with child and family services due to her experiences of family violence. Josie had a history of repeated nonfatal suicides and hospitalizations for suicidality. During the months before her death, Josie was frequently labeled an “attention seeker” by her parents. Josie’s psychologist noted at the inquest into her death that: At an appointment [3 months before death], [Josie] was depressed and tearful throughout. She reported ongoing suicidal thoughts but denied plans or intent. She felt hopeless about her situation and a burden on her family, and that neither parent was supportive of her. . . . [Josie’s father] reportedly was critical of [Josie] while at hospital recently [for suicidality], and her stepmother stormed out saying that she “couldn’t be bothered with [Josie]’s problems.”
Josie’s parents’ empathy and support seemed to be wearing thin, and her stepmother’s dissipated entirely. Like Clara’s partner, Josie’s father and stepmother seemed to be exasperated with Josie’s need for continued care, and Josie knew that. By casting her as an “attention seeker”, her parents seemed to characterize her problems as an unnecessary, manufactured burden. Like Holly’s mother, Josie’s parents assumed that Josie was not suicidal but instead wanted their attention and sympathy.
Josie’s coronial report stated that a month before her death and following multiple hospitalizations for nonfatal suicides: The psychiatrist noted that in the absence of trust in the adults in her life, [Josie] continued to act out underlying psychological distress through self-harm or suicide attempts. [Josie] was crying incessantly when she started her session. She felt unloved and uncared for by people in her life, after discovering that her father had called her an “attention seeker.” She verbalized frustration that she should “attempt to kill herself again for people to understand her suffering?”
This extract indicates that Josie felt “unloved and uncared for” by her family after finding out she was called an attention seeker by her father. Here we also get a sense of Josie’s thoughts and words at the time: that the only way to be taken seriously, for her suffering to be understood, was through suicide. On the night of her death, Josie’s suicide was interrupted by her father. He responded by undermining her capacity to choose and enact an effective method of suicide. Police reported: The father of the deceased pushed the door open and observed that the deceased had [set up a means of suicide] in her bedroom. The father spoke with the deceased and said, “That will break before it does anything.” The deceased’s father began to remove the [means of suicide] at which time the deceased picked up [a stronger means . . .] and ran from her room[.]
Josie’s father found her suicide note, determined she was serious, and went looking for her. The police found her body some hours later. The stigma of being called an “attention seeker” clearly had profound effects on Josie.
The family members of these women assumed they were bluffing to gain attention, and they trivialized as banal the causes and extent of the women’s distress. When the women expressed their intent to die by suicide, they were ignored because suicide seemed like an irrational response to the problem at hand. In Josie’s case, despite the seriousness of the issues she was confronting in her life, and being frequently suicidal, her communications of intent were interpreted as ‘attention seeking’ rather than intentions to die by suicide. Josie’s case also highlights different ways of understanding suicide. Josie’s psychologist mentioned Josie “felt like . . . [a] burden” which is reminiscent of the “perceived burdensomeness” of Joiner’s (2005) “interpersonal theory of suicide.” Critics of Joiner’s theory point out that some people who died by suicide explicitly mentioned that they were suicidal because they were told they were burdens (Hjelmeland and Knizek 2020). In many of the cases examined here, the young women were constructed as attention-seeking burdens. It seems stigma and social penalization and pariah status of being perceived as “attention seekers” for being suicidal to contributed to their suicides.
The Fatal Effects of Medicalization and Trivialization of Women in Distress and the Utility of a Feminist Lens in Suicide Research
This article critically examines expectations and tropes of femininity among cases of women who died by suicide to understand why some women’s communications of intent were dismissed and ignored. Partners and family members responded to these communications by framing the women as “drama queens” and/or “attention seekers”. These two constructions of suicidal femininity generally elicited different responses depending on the women’s relationship with recipients of communications of intent. “Drama queens” tended to be constructed by (male) partners as argumentative, as overreacting to situations, and as spiteful manipulators who “threatened” suicide as a means to attempt to control them. “Attention seekers” tended to be constructed by parents who assumed their daughters had no intent to die by suicide but were feigning suicidality to obtain sympathy. In both tropes, interpretations of women’s intent to die by suicide are bound up with expectations and assumptions about gender and femininity, and these interpretations became fatal.
As with the cases of women who died by suicide studied by Mallon et al. (2016), investigators into the women’s death in this study favored medicalized pathological explanations of the suicides and downplayed the role of social context and stressors. For example, Emma’s loss of a loved one and the apparent constant “critical comments” she received from other family members were portrayed as a problem with her personality. Her family members’ critical appraisals of her were given credence by her psychologist: Emma was the problem (Canetto 1997a). Applying a feminist lens to these situations illuminates how such discourses undermine, trivialize, and penalize women who do not or cannot live up to idealized expectations of femininity. This raises difficult questions: why were these young women perceived to be tiresome, even by those who loved and cared for them? What implications does this have for dealing with young women’s expressions of distress more generally, and why are some women penalized for seeking attention when in distress? And what are the limits in which care can be provided where broader social issues, such as family and domestic violence, are relevant factors as both a context for distress and for how women’s expressions of distress are framed by others? Such factors (for example, poverty, racism, violence, and inadequate social services) might also be factors that hinder efforts for many people to be in a position to provide help, sympathy, empathy, and support.
We can use a feminist lens to see these women as protesting their contexts and taking these expectations to a fatal end. For Bordo (1993), an anorexic body is an extreme and literal protest of ideals of femininity—thinness until death. We might see the young women discussed here in a similar light. If young women’s social issues are constantly medicalized and individualized to the extent that the young women themselves are cast as the problem, it is perhaps understandable that suicide, being so intricately associated with psychological illness, might be their choice. They may think “If I am the problem, then I will ‘fix’ it.” This is a quite different understanding of suicide from more conventional theories of suicide, which tend to overlook women’s social problems and not consider suicide as a protest against them (Kizza et al. 2012). A feminist lens highlights how young women in distress can be caught in a bind between showing “too much” emotion or “not enough.” This echoes other binds faced by women who experience trauma, such as being the “perfect victim” in order to gain justice for a sexual assault (Randall 2010). Where some women who were sexually assaulted are blamed for wearing the wrong clothes or not reacting to an assault in an “appropriate” way (such as going straight to police and hospital), these young women were also doubted for not being emotional in the “right” ways.
Understandings of suicide occur within a broader discourse where suicidal men are considered serious and women are trivial (Canetto and Cleary 2012). Whereas the “decisive” male suicide conforms to aspects of masculinity that are valorized (even if their suicide is not), women in this study were undermined and penalized as pariahs. Owing to their enactments of emotional behaviors associated with masculinity, such as aggression, coupled with references to die by suicide, which are also associated with masculinity, women in this study were stigmatized, (re)feminized, and penalized (Schippers 2007). The sociological autopsy approach helps show how these constructions endured after their deaths.
Many of the women had been suicidal for some time and had multiple interactions with the health system before their suicides. Yet their frequent suicidality and use of services were sometimes used as evidence to undermine and trivialize their intent to die by suicide. For example, Emma, who had experienced suicidality for years, was nonetheless described by the coroner as “impulsive” in her decision to die by suicide. Other women, such as Blaire, Bridgett, and Ashley, were ignored by family members who assumed this communication of intent would be like the others. Josie voiced that she felt she had to escalate her suicidal behaviors for the level of pain she had to be taken seriously by her parents, which ultimately increased their distrust in the depth of her pain. Three alarming repercussions of these constructions of suicidal femininity is that they may reproduce the trivialization of women’s problems, potentially silence women in distress, and propagate a lethal logic that women should not survive suicide. Finally, these cases highlight the importance of social context in understanding women who have died by suicide and women in emotional distress generally, rather than a focus on individualized medical discourses which can hide these contexts (Canetto 1997a; Hjelmeland and Knizek 2010).
Conclusion
Suicide research has tended to overlook the role of social forces in suicide, especially feminine gender norms, favoring biological, individualized explanations for suicide instead (Canetto 1997a; Chandler, Cover, and Fitzpatrick 2022; Cleary 2005; Hjelmeland 2013). Where suicide research has analyzed the role of gender to explain these behaviors, it has overwhelmingly focused on men and masculinities (see Scotti Requena et al. 2024), despite the high rates of suicidality and self-harm and the increasing rates of suicide deaths among women (Australian Institute of Health and Welfare 2023a, 2023b; Stefanac et al. 2019). The prioritization of suicidal men can be explained by and reinforces the trope of suicidal femininity as trivial and nonserious (Beautrais 2006; Canetto 1997a; Mallon et al. 2016). In this article, I explicitly set out to apply balance to the field of suicidology, which consistently overlooks women and often obscures the role of social issues in understanding suicide more generally (Chandler, Cover, and Fitzpatrick 2022; Mallon 2018; Mallon et al. 2016; Townsend 2024a, 2024b). I abandoned taken-for-granted theories in the field of suicidology, such as Joiner’s (2005) interpersonal theory of suicide, which cannot (and does not) take into account the breadth and complexity of suicidal people’s experiences (Hjelmeland and Knizek 2020). Instead, I used the sociological autopsy method to thematically analyze and understand the role of gender in why some women were ignored following their communications of intent to die by suicide. I did this using a feminist lens to highlight often overlooked and/or medicalized understandings of why women die by suicide.
This study makes visible the experiences of young women who died by suicide and shows how tropes of suicidal femininities affected the responses provided following their communications of intent to die by suicide. Constructions of suicidal women who communicated intent to die by suicide as “drama queens” or “attention seekers” enabled partners and family members to minimize, ignore, or dismiss their suicidality with fatal consequences. Understanding the role of gender norms among women expressing suicidality is critical to preventing suicide among women and providing support to women in crisis more broadly.
Footnotes
Author’s note:
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about gendered language in suicidology.