Drawing on survey data from a UK study of trans people and mental health, the study presented here reports on the experiences of trans people in two health care settings: mental health services and gender identity clinics. An analysis of the primarily qualitative data indicates that in these settings practitioners tend to be poorly informed about trans issues and the realities of trans people's lives. The key observations of this study are that untreated gender dysphoria (due to delays or refusals of treatment), unnecessary and intrusive questioning/tests, prejudicial attitudes by service providers, and restrictive treatment pathways, all contribute to minority stress which is detrimental to the mental health and well-being of trans people.

Purpose -The purpose of this paper is to present findings from the Trans Mental Health Study (McNeil et al., 2012) -the largest survey of the UK trans population to date and the first to explore trans mental health and well-being within a UK context. Findings around suicidal ideation and suicide attempt are presented and the impact of gender dysphoria, minority stress and medical delay, in particular, are highlighted. Design/methodology/approach -This represents a narrative analysis of qualitative sections of a survey that utilised both open and closed questions. The study drew on a non-random sample (n ¼ 889), obtained via a range of UK-based support organisations and services. Findings -The study revealed high rates of suicidal ideation (84 per cent lifetime prevalence) and attempted suicide (48 per cent lifetime prevalence) within this sample. A supportive environment for social transition and timely access to gender reassignment, for those who required it, emerged as key protective factors. Subsequently, gender dysphoria, confusion/denial about gender, fears around transitioning, gender reassignment treatment delays and refusals, and social stigma increased suicide risk within this sample. Research limitations/implications -Due to the limitations of undertaking research with this population, the research is not demographically representative. Practical implications -The study found that trans people are most at risk prior to social and/or medical transition and that, in many cases, trans people who require access to hormones and surgery can be left unsupported for dangerously long periods of time. The paper highlights the devastating impact that delaying or denying gender reassignment treatment can have and urges commissioners and practitioners to prioritise timely intervention and support. Originality/value -The first exploration of suicidal ideation and suicide attempt within the UK trans population revealing key findings pertaining to social and medical transition, crucial for policy makers, commissioners and practitioners working across gender identity services, mental health services and suicide prevention.

The last 10 years have seen a rise in Internet sites commemorating those lost to suicide. These sites describe the life of the deceased and the afterlife of relatives, parents, friends or siblings who have been termed the "forgotten bereaved". It is clear that such sites have implications for continuing bonds and for what many commentators refer to as the continuing social presence of the dead. This paper presents interim findings from ongoing research which focuses on two aspects of suicide memorial websites. First, we explore the extent to which such sites help us understand how the Internet is enabling new ways of grieving and is, in effect, making new cultural scripts. Second, although there is a large body of writing on the management of trauma there is little evidence-based research. The paper draws on face-to-face interviews with owners of suicide memorial sites (family members and friends) and explores how the establishment and maintenance of such a site is an important part of the therapeutic process and how, for grieving relatives, making or contributing to such sites provides ways of managing trauma in the aftermath of a death by suicide.