Tony Mantor: Why Not Me ? - Dr. Rachel Moseley: Facing Autism's Unseen Crisis: Suicide in the Autistic Community

Episode Date: September 6, 2023

Send us a text Ever wondered about the hidden crisis of suicide among the autistic community? We shine a light on this critical but often overlooked topic with our guest, Dr. Rachel Moesley, an autistic researcher who was diagnosed at the age of 28. Her personal journey towards self-discovery and acceptance, after years of battling self-criticism and conforming to societal norms, is both enlightening and inspiring. In our engaging conversation, we venture into the emotional landscape that can lead to suicidal thoughts, particularly amongst late-diagnosed autistic females. Dr. Moseley's in-depth understanding and perspective on how societal pressures can heighten the challenges faced by autistic individuals is eye-opening. She further stresses on the importance of recognizing the unique distress signs in autistic people and the critical role of connectedness to help them cope with their struggles. In the concluding segment of our conversation, we turn our focus towards the societal factors contributing to the high suicide rates among autistic individuals. Dr. Moseley shares how a rigid mindset, lack of acceptance, and exclusion can have a negative impact on their mental well-being. We also uncover the alarming correlation between late diagnosis and increased mental illness, underlining the urgency of this issue. This episode is not just an exploration, it's a call to action - advocating for a society that is more understanding and inclusive. https://tonymantor.com https://Facebook.com/tonymantor https://instagram.com/tonymantor https://twitter.com/tonymantor https://youtube.com/tonymantormusic intro/outro music bed written by T. Wild Why Not Me the World music published by Mantor Music (BMI) The content on Why Not Me: Embracing Autism amd Mental Health Worldwide, including discussions on mental health, autism, and related topics, is provided for informational and entertainment purposes only. The views and opinions expressed by guests are their own and do not reflect those of the podcast, its hosts, or affiliates.Why Not Me is not a medical or mental health professional and does not endorse or verify the accuracy, efficacy, safety of any treatments, programs, or advice discussed.Listeners should consult qualified healthcare professionals, such as licensed therapists, psychologists, or physicians, before making decisions about mental health or autism- related care.Reliance on this podcast's contents is at the listener's own risk. Why Not Me is not liable for any outcomes, financial or otherwise, resulting from actions taken based on the information provided. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Welcome to Why Not Me the World Podcast, hosted by Tony Mantor. Broadcasting from Music City, USA, Nashville, Tennessee. Join us as our guests tell us their stories. Some will make your laugh, some will make you cry. Real life people who will inspire and show that you are not alone in this world. hopefully you gain more awareness, acceptance, and a better understanding for autism around the world. Hi, I'm Tony Mantor. Welcome to Why Not Me the World. Today's subject is going to be a very tough one. It is said to be the hidden crisis for autistic people. The subject is suicide. Some of the statistics are staggering.

Nine times more likely to die from suicide. Second leading cause of death. for autistic people, up to 66% have considered suicide. That, with 1% of the population, means that 11% of suicides are those which are autistic. This is a subject that my guest and I will be talking about today. Dr. Rachel Mosley, she is autistic, a researcher. She focuses on mentally ill health and suicide. So welcome to the show, Rachel. I think it's amazing and work that you're doing. And it's so wonderful that you're raising attention and awareness to this. So thank you. Oh, it's my pleasure. I really appreciate you taking your time to come on the podcast and give this information. So let's kick it off with, I understand that you're autistic.

And at what age was you diagnosed? So I was 28 years old, so quite late. There were signs way back when I was a baby, and my mother took me to many, many specialists throughout my childhood and teenage years. But back in the 90s and the 2000s, knowledge about non-stereotypical presentations of autism was really poor. So although this label, autism was mentioned to my mother, the doctor said, you know, I don't think that's the case. I won't, they wouldn't put me forward for an assessment. So I grew up without that label, always knowing there was something, just not having a name for it, really. And then I only found out when I did my PhD and my mum happened to mention to me, oh, people said you might be autistic when you were a child.

And we went through this process of getting you checked out, only, you know, they didn't, they didn't want to take it ahead. but I'd never had that word. I knew that I'd been taken to all these specialists, but I'd never had that word attached to it. So once I knew that word, it made a lot of things make sense. And hence I went for a proper diagnostic interview and got the label. So once you were diagnosed and they actually said that you are autistic, did that allow you to look at your life, things that you'd gone through and then it made more sense to you now that you're older? Absolutely, absolutely, because my childhood and teenage years were very difficult. And the thing I always think is that even if you don't have that autistic identity that you know about, you're very aware that you're different and everyone around you is aware that you're different. And you can't fit in, you can't do the things that everyone else seems to do easily. So if no one gives you an explanation for that,

have to find your own explanation. And I had various ideas about what was, in inverted commas, wrong with me. For instance, for a long time, I thought I might be a psychopath because I knew there was something terribly bad and wrong about me. And as I got a bit older, and I came to understand a bit more about what a psychopath is. I kind of moved away from this idea of thinking I was a psychopath, but there was this fundamental idea that I was fundamentally bad, worthless, unlovable, a terrible person, and that belief just because I had no other explanation for why I was bullied, why I didn't have any friends, why I was bad at lots of things. I had to find my own explanations, and they all tended to be really negative ones, which means if you're growing up with these beliefs,

you're really on your way to develop quite serious mental health problems and possibly suicidality. So you basically found out about your autism because you was going to college to get your PhD, is that correct? I was learning all about the way autism presents differently in people of different sexes and genders. And I'd wanted to go into autism research in the first place because I felt a great empathy for autistic people. because I too had felt like I never fitted in and I got bullied and I couldn't make friends and so forth. So I felt this great empathy with people who struggled with these things. I learned quite a bit about myself when I did this. Sure.

Now that you've been diagnosed autistic, you've gone to college, got your PhD, has everything that you've learned helped you not only with others but help you accept yourself? I would say so, yes. I just studied once where someone had a fantastic analogy. They said that they'd gone through their life believing that they were like a broken horse. They couldn't do all the things that other people could do. Life was really difficult for them. But now they realized they were actually a zebra, wherever you say it.

And it frees you from all these things that I likewise thought, it's my fault that I got that wrong and that I deserve to be treated badly there. it sort of frees you from the weight of all that self-criticism and all these sort of expectations, well, I should be, all the shoulds, you know, I should be independent by now, I should be doing this, I should be doing that. When you know you're autistic, you know that neurotypical expectations don't necessarily apply to you. And there's a reason why it's more difficult for you. It's not just that you're stupid or rubbish or any of the things I believe. Right, right. So once you completed your PhD and you started getting into the doctorate part of it, we're going to go into something that a lot of people don't like to talk about, but it's something that needs to be put out there. And that's one in four diagnosis or female. Even though I've talked with other people that think that the number is much greater than that, but it's because females tend to mask it more. They try to fit in. They look at every. single way that they can to avoid whatever they're trying to avoid. And then ultimately, because sometimes they can't fit in, their mental state, they get depressed, and then they think about suicide. What's your relationship with that and how do you approach it? My personal relationship or my professional take on it. I suppose I could maybe talk a bit about both if you like. Yeah, yeah,

absolutely. I would say that I was personally not a very good campus life. If I had been, maybe I would have had more friends and I wouldn't have been bullied so much. But certainly, suicidality was throwing up in my life when I was 13 onwards, ever since really. And I think that a lot of autistic people who have missed for diagnosis, which, as you say, very often, these are people who either identify as female or maybe they, on the surface, present as female, maybe have less stereotypical presentations of autism. They didn't have picked up. As you say, they may be very good at learning techniques

which allow you to blend in so that you're not bullied, so that you don't stand out. And it's unfortunate in a way because it protects you at the time. We know that autistic people camouflage because they're trying to protect themselves from stigma, from victimization. but it comes at this terrible cost, firstly, of being less likely to be identified as autistic and hence not given any support. But secondly, we know research-wise that camouflageing is very much associated with burnout. It's exhausting.

And it seems to also really strengthen this belief that I'm not good enough as I am. I have to pretend to be someone else because if they knew the real me, they wouldn't like me. Camouflaging seems to kind of reinforce these ideas. And many of us do it, and we can't switch it off because it's safety and it's automatic. But it seems to incur a real cost in terms of the energy it takes from us. And hence there is this link between camouflaging and burnout and suicidality. I've spoken with a few that have said they think about suicide almost on a daily basis. They actually set dates of when they're going to do it.

And then as it gets closer, they'll talk themselves out of it and then maybe set another date. Have you run across that at all? Personally, myself, I think to a degree, there's some really interesting research about suicidal thoughts and what they do to you mentally. So I think to some extent, thinking about suicidal thoughts can sometimes help someone to kind of regulate their emotions. And I think for me, throughout my life, it has sort of been an escape route, as in if things get too terrible, if I can't bear it, then I have that way now. But what we do know about suicide is that it's very much a fluid transitional state, hence people can move in and out of suicidal states quite fluidly. And the more time you spend thinking about these things, as you say, making plans, the easier it is to get back to that state on another occasion. So if you do have someone who, as you say, they plan it, they plan it all, they have very concrete, clear plans, it seems that something about making these plans kind of desensitizes you.

And hence, even if you don't go through with them on that occasion, it might increase your future. a suicide risk because you're able to get there easier. You've already done that thinking. I had a friend of mine that tried to commit suicide. I told that I didn't understand because she had kids and she had all these people around her that cared. And she described it to me. It didn't matter because she wasn't thinking about anyone else other than the pain she was going through. And even though that wasn't physical pain, it was mental pain, it's still pain just the same. So how do you help those that are going through that pain to get past that so they can start thinking more towards having a better life.

Really difficult. I say a couple of things. I can identify with what your friends said because I think from personal experience, when you're in that state, it's like being in a hole and you simply can't see anything. It's just a wall in front of your eyes. If that's how it has been to me, how you get people out of that state, I think is really difficult. I should preface my answer by saying, I'm not a clinician. I'm a researcher. I don't treat people and help people in this state. However, what research tells us is that connectedness is really

important. So helping people to feel that they are needed and wanted and valued. And also being there with them, talking to them. Because people can move in and out of suicidal states quite quickly, it means that, for instance, there's advice from major suicide organizations that if you see someone and you think they might be in that state, talk to them, talk to them about anything, talk to them about the weather, talk to them about mundane things. It's like a precipice and they're probably having varying degrees of conflicting feelings about whether they want to do this. And because these feelings really fluctuate, it means that if you keep talking to them, if you're there with them, you're giving them time to kind of come back from the precipice,

if that makes sense. Yes, absolutely. Is part of the equation the pressures from the outside world of the newer typical people who do not understand what they're going through, and they think that there's expectations of them to be the homemaker or whatever the situation may be, does that all add up to some of these feelings that they may be thinking? Autistic women, do you mean? Yes. There's multiple things going on for autistic women. There's the burden of not being diagnosed until later, on average.

Hence, you're not getting that early intervention and support. Okay, that makes sense. You're maybe not getting any kind of accommodations, say, in school. The school will be harder for you because school is geared towards neurotypical learner. It's going to be harder. You're not necessarily given any recognition or adaptations, and you are expected to function. If you don't have a label, everyone expects the same of you to fit in.

indeed. And there are elements of gender roles there, which I think do work out badly for autistic women and female presenting people because there are these expectations that women are meant to be worn and nurturing and very feminine and so forth and so forth. And so there are these cultural messages about how you're meant to be. And I think maybe that can create more difficulties for women, especially for instance in the workplace, women very often pick up emotional labor. And if you're an autistic woman, you might really struggle with those emotional labor roles and you maybe don't get the slack that an autistic man might not be expected to pick up those very social roles to the same degree.

What's the answer here, if there is one? How do we help those that are masking it? We can tell that they're maybe acting a little different than other people. but because we don't know they're autistic, we can't assume that. So we'll think, unfortunately, they're just a little weird, but yet they're just hiding those issues that's going around in their mind. How can we help them without pushing them, but still getting them to open up a little bit to where we can change that dynamic of what they're thinking?

It's really tricky. I mean, in terms of identifying the signs that an autistic person's struggling, especially if you don't know they're autistic, that's hard. because distress and also mental illness look different in autistic people. So, for instance, signs of depression in a non-autistic person, a neurotypical person, very often you'll see people crying, whereas a key sign of depression in autistic people is something called anhydonia. It's basically a loss of pleasure or interest or everything around you,

including anything you're passionate about. So if you are looking at someone through a neurotypical lens and you're thinking they don't seem good, but they're not crying, so I don't think they're depressed. This is potentially really problematic. We know that autistic people, including women, can, there's sometimes such good camouflages and they can't turn it off, that they may seem okay on the outside, but they're absolutely breaking. on the inside. And they can actually seem more still, more quiet, more neurotypical than usual. It's hard sometimes to gauge the level of crisis by just the words that someone uses, because they may seem very calm, very logical. Hence, you may not be able to very accurately gauge suicide risk and so on. So basically, it's someone that they have to really seek the help out so that you can really do that deep dive

and getting towards that road to healing? Well, there's signs that you can look out for. It's tricky if we're talking about undiagnosed people. But what we can say is that signs that have been sort of highlighted as possible kind of red flags for suicidality and autistic people are things like if someone is expressing that they have no reason for living, that they have no purpose in life, that they feel trapped, that there's no way out that is hopeless. If they seem to be withdrawing from their typical relationships, maybe their sleep pattern changes,

maybe they engage in risky activities, maybe they seem more anxious or agitated or they have dramatic mood changes. If they seek access to means ending their lives, if they give away possessions or they start looking for home for pets and so forth. These are all really worrying signs. The really key thing to say is with autistic people, it changes in their state that the people around them need to look out for because autistic people will typically differ in the way they socially interact, the way they express their emotions,

the way their sleep patterns, these things are all a bit different from neurotypical people. So if you judge an autistic person by neurotypical standards, you might not pick things up. So you've got to really think about, what's this person like usually? What does their usual way they display emotions or their usual sleep patterns, their usual interests, interactions? Some of these things, if you see changes in them, such as emotions and whatnot, it's really tricky because these things are less reliable. red flags in autistic people since we're so used to judging by neurotypical benchmarks. So it's tricky, but these are a few things that you can think about in autistic loved ones or anyone you might be

concerned about. Okay, that certainly makes sense. So we've talked about the undiagnosed autistic females. What about the diagnosed autistic females? They sometimes have gone through the same thing with the bullying and they're trying to fit in, even though people know they're autistic. Unfortunately, people can still be unkind and treat them bad. So how does that affect them? And then let's go to the undiagnosed female that grows up, becomes diagnosed. And then all of a sudden she has to relive some of the trauma that she went through in her teen years. So how does that affect them?

We don't know enough, unfortunately. There really isn't a lot of research that actually compares people who are diagnosed in childhood versus people who are diagnosed later in life. What we do know, a few things, is that as you say 100% correctly, people who are diagnosed later in life, all of those bad thoughts, those bad feelings, they don't go away. Unfortunately, in the UK at least, post-diagnostic support is virtually non-existent. So you get your label, then you're on your way. So you don't get any help unpacking previous trauma, you know, negative self-worth and so forth. So there is some limited research which suggests that being diagnosed earlier in life may be related to better outcomes. So people who are diagnosed early in life may have slightly better chances of forming a positive self-image. We know that having a what's called a positive

autistic identity. So believing, you know, this is who I am and it's just a difference in my brain. It doesn't mean that I'm inferior. I'm just different. This is associated with having better self-worth. So if you are diagnosed young, it seems that you get support and you also are more likely to be helped to grow up in a way where you have better self-worth. So there is some emerging research to suggest that late diagnosed people do have worse mental health and higher risk of suicidality. But it's really complicated because for instance, there's factors like camouflaging. People who are diagnosed early tend not to be such proficient camouflagers, hence they are picked up. So it's really hard to disentangle why is it that late

diagnosed people have sometimes worse mental health? Is it because they're very good at camouflaging and, you know, that kind of the repercussions of that? Is it because they haven't had any support? Is it because they will tend to grow up feeling very worthless? We're not sure the research is really in such an early stage right now. So unfortunately, the females that get diagnosed later in life have to fight this battle almost on a daily basis. Pretty much. Yeah, and actually the rates of mental illness and hospitalization in autistic women outstrip those seen in autistic men.

So we know that autistic women have higher rates of, hospitalisation for mental illness. And I believe the statistic is something like one in Fort War will be hospitalized for a mental illness before the age of 25, which is horrific. They have higher suicide rates, higher rates of physical illness. There isn't that distinction there between diagnosed women and undiagnosed women, but just that being female or being assigned female at birth seems to be associated with poor outcomes. You've given some pretty good advice how to handle some of these things. For those females that are getting diagnosed later in life that need to have that inner strength to survive this daily battle, what kind of

advice can you give to help them hopefully get through this emotion? Pretty tough. I would say that I think connecting with community is so important. Finding your tribe, and that's really hard if you don't have a label. So very often if you don't have a label, you're just weird. You can't find a group of people who are weird, but you can perhaps connect with people who share similar interests to you. But if you do have that label, I think connecting with your tribe, the people who are like you, is really valuable, people who have similar experiences, people with whom you're not weird or you're not different. You're the normal with them. Sure. It's like creating your own community. And this is really emerging as

important in terms of autistic suicide risk, that the absence of community, the lack of belonging is a really big factor, as well as kind of the traumatic life events, the victimization, the exploitation, all of these really, really negative life events, which make it much more likely that autistic people will develop mental illness, which then increases their risk of suicide. a guy in his 20s that was diagnosed when he was like eight. He told me that through his teen years, he was bullied and he felt alone. And he's a guy. So if you've got a female, this feeling those same feelings of being alone, the social impact of that must be just really overwhelming to that. I'd say from personal experience, it's very hard. This is what we see in the literature as well.

we are still quite early in understanding why autistic people are at such high risk of suicide. But it seems to be very much that autistic people aren't at risk of suicide because of their autism as such, but because of the experiences they have the way they're treated. Because autistic people without learning disabilities have to work and live, be educated in a world that's not adapted for them. and they're highly aware of being different, as you say. And we now really recognize that autistic people are a stigmatized minority group, and they are really pervasively excluded, isolated and victimized from a really young age.

We know that neurotypical children like autistic children less. It's just an unconscious bias. difference in our verbal and non-verbal behavior mean that neurotypical people tend to like us slightly less. Very sad. So this is an unconscious thing. They're not even aware of the bias, but something in our different behavior is slightly unnerving to them. So we know, therefore, that exclusion and bullying of autistic children and teenagers has been linked to later suicide.

That's a lot of great information. Here's another topic I think we need to talk about. As females get older, along comes puberty. That is tough on neurotypical females, let alone autistic females, diagnosed or undiagnosed. So how does that affect them? Horrible. Horrible. I think from personal experience, horrible. And there's a lot going on there. So puberty is a really tricky time because, as you say, you do have all these internal hormonal changes going on. But it coincides. with your social world also becoming a lot more complex. So in the UK, we go into secondary school and in the US, you'll have an equivalent. The education system becomes more complicated, whereas before you would sit in a classroom and your teacher comes to you and you stay in the same place, you then have to move around the school and go to all these different classes, different groups, the social relationships, the way that other girls relate to each other

becomes more complicated. It becomes more relational. It's about chatting and sharing confidences, things that might be hard for an autistic girl. So there is the hormonal aspects, the puberty aspects, but there's also all this change in the social world, which means that it is a bit of a perfect storm. And as you say, if you're undiagnosed, you don't know why you're finding it so hard. hence you might be thinking it's my fault. I'm just failing. I'm, I'm useless. And what's quite interesting is if you take a kind of lifespan perspective and you look at someone's whole life, you can see kind of peaks where mental and physical illness, you're at higher risk. So puberty is one of those points. You can see if you look across the whole population, rates of mental illness spike at puberty. So they become

they increase. But if you look wider across the lifespan, you actually see something similar at menopause in women and people with ovaries. So menopause is almost a little bit like a second puberty because you're experiencing a lot of hormonal changes again, as well as changes in your environment. And so what we've seen in some research we've done is that we see a similar thing where people who have grown up undiagnosed, not fitting in, not understanding why they can't hold down a relationship or a job and having terrible self-image. At menopause, we see sometimes that their difficulties become more extreme. They experience crisis point and suicidality. And that's actually when they're picked up for an autism diagnosis because that sort of that turmoil of the hormonal

changes really brings their difficulties to the fore and that's when they get picked up. So you do see some relationship where these hormonal, what we call reproductive transition points where hormones are going crazy, everything's very complicated. You see a spike in struggling in mental illness and hence it seems more likely that someone who was not diagnosed might well be picked up at these times when they appear to be in crisis. That is such good information. That is such good for people to know. That leads me to my next question. Are there any statistics on those that mask it so well seem to get by just about anything that's thrown at them? And then later in life, they're still fighting this. Are there any statistics on those that actually thrive with

everything compared to those that don't? We don't know the answer and this is the really worrying thing. What we believe is that autistic people as a whole might be up to nine times more likely to die by suicide. And there's also a very frightening statistic that may be, if I remember correctly, up to 48% attempt suicide, which is terrifying. We don't have that division of diagnosed or undiagnosed there, but we just know that the suicide rates are horrifically high. And there will be people who have died without being recognized. Yeah, it's awful. Yeah, that's sad. So what could you give for advice to people that don't understand what autistic people are going through, whether they know autism or they don't know autism, what can we do to help them so that they can keep moving forward and move on with their life? In terms of recognizing suicidality, you mean?

Yes. Or just anything, actually, because if we help them, then hopefully we're helping them to change their direction. kindness is at the heart of it and acceptance of difference. So if you don't know, they're autistic, but maybe they seem a bit quiet, maybe they seem to have difficulty fitting in, just making space for them to be who they are, accepting them being kind. Absolutely. And I would say in terms of thinking about how to recognise signs of distress, going back to what I was saying before, if you know the person well,

changes what you should really look out for. So it changes in their normal behaviour, their normal interests, emotions, interactions, routines. It's slightly difficult because autistic people might talk about suicide in a slightly different way to how non-autistic people talk about it. So some people won't talk about suicide at all. But some autistic people will say things that in a neurotypical person would be really alarming, but is actually very normal for autistic people. So, for instance, examples I've heard of are people saying, I don't belong in this world, I don't fit into this world, I wish I could leave here, be in a place where I belong.

These, they're such heartbreaking statements. They really are heartbreaking statements for sure. But they are the reality of many autistic people who don't feel any sense of social or cultural belonging in the world. They're heartbreaking. Although they're indicative of a person who's very unhappy, they're less of a clear red flag that that person is actively suicidal and thinking about this. So it is tricky, and I think that ultimately we desperately need societal change. That is so true, and hopefully altogether we can make that change. An amazing autistic survivor of suicide and also bereaved by suicide is a person called Lisa Morgan.

She said something once that I thought was really profound. She said that aiming the culture so that autistic people no longer need to camouflage is suicide prevention. That is such a great statement. That aspect of camouflaging of needing to hide who you are so that you're not victimized is so harmful. So we really need to change the culture so that autistic people don't need to hide who they are. I think it's interesting that you use the word culture. I spoke with an autistic man the other day. His wife is neurotypical.

They look at their differences as different cultures. Because of that, they have found ways of working around their differences, and they have two children and everything seems to be going very well for them. I think that's really important. I think there's something in the community right now about reclaiming the word autistic as an identity, just like deaf community have done. And as you say, this is a difference. It's a different culture.

That puts it on an equal playing field. It's not inferior. It's not a deficit, but it's a different style of being. But I think as a society, unfortunately, we don't have a society which recognizes that difference rather than deficit model. I think this is where education and understanding is so important. This is so important when it comes to suicidality because research has shown us that a really strong factor in autistic suicidality. seems to be feeling like a burden, feeling worthless, feeling like a liability. No one should ever have to feel that way.

As societies, we do a really bad job of raising autistic young people who know they are valued for themselves. Hence, we really do need cultural, societal change so that neurodivergent learners are, they have the same opportunities to succeed at school, there's jobs suited for them, and so forth. Absolutely agree. Any last thoughts? We've covered a lot of ground here, and the main topic is about suicide and prevention of suicide. So hopefully we have found a way to say some lives. Well, I think what I'd like to say is I try to get the message out there and get resources out there. So tools, for instance, for health care professionals, healthcare professionals very often struggle to recognize signs of crisis. So I've brought together my favourite resources, tools, which would also be relevant for parents. And you can access those on my website, www.w.combeckermptrum.com. Please read up on those. You can also read accessible versions of my research there. I think the really important thing is that as a society, we need to change. I think the reasons for

autistic suicide, so many of them are not within us. They are. out there, they're the way we're treated in the world. There's certainly features of being autistic which kind of make kind of external factors affect us more seriously. So for instance, having kind of rigid thought processes, I call them kind of sticky thought, means that if you're bullied, you're likely to ruminate on it, so it might affect you worse. So there are internal factors, which certainly make us at high at risk, but so much of it seems to be about how we're treated in the world, whether we're accepting. and fit in and feel that we're worthwhile.

I think that is just an awesome thing to say. I think you hit everything you needed to say. So I really truly love what our conversation was. And thanks for coming on. Thank you so much for having me. It's been fantastic. It's been my pleasure and what a great conversation. Thanks so much.

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