The LGBTQIA+ community and psychiatry have had a very troubled past, especially when it comes to schizophrenia. Some of the first theories for the causes of schizophrenia actually centered around bisexual desires. There were even theories that people living with schizophrenia were all asexual due to the negative symptoms of schizophrenia. And those are just two examples.

In this episode, we discuss LGBTQIA+ issues in relation to schizophrenia, what psychiatry got wrong, and what current studies are showing. We also hear directly from an openly transgender man who lives with schizophrenia.

We’re joined by guest Lucas Silveira, a Canadian vocalist, guitarist, and songwriter from Toronto. He was the frontman of The Cliks, and is credited with being the first openly transgender man to have signed to a major record label.

Lucas Silveira

Lucas Silveira, frontman of The Cliks, now a solo artist, made history as the first openly transgender man signed by a major label with Warner Music, Tommy Boy/Silver Label in 2006. He’s graced global stages alongside Cyndi Lauper, The B-52’s, Debbie Harry, Tegan and Sara, The Cult, and The New York Dolls. As co-host of Vice’s Shine True in 2021, he expanded into TV.

With over 25 years of live musical experience, Lucas is a seasoned and heartfelt musician and vocalist. Presently a solo performer, he skillfully accompanies himself on acoustic guitar and piano, and has shared his music across the world, from Canada and the US to Europe and Asia.

He has given keynote speeches for Warner Music Canada, Hydro One, Corus Entertainment, and EGALE Canada, spanning schools to corporations, addressing his experience as a transgender musician in the mainstream music industry, trans community, lateral violence, and mental health awareness.

“The Goddamn Flowers” marks Lucas Silveira’s stark departure, delving into personal turmoil, love, and darkness. Written over nine years, amidst mental health struggles and diagnosed schizoaffective disorder in 2021, this album challenges stigmas. Lucas champions the role of medication in fostering creativity and offers a transformative journey from chaos to enlightenment, proving the power of turning pain into artistry.

Rachel Star Withers

Rachel Star Withers creates videos documenting her schizophrenia, ways to manage and let others like her know they are not alone and can still live an amazing life. She has written Lil Broken Star: Understanding Schizophrenia for Kids and a tool for schizophrenics, To See in the Dark: Hallucination and Delusion Journal. Fun Fact: She has wrestled alligators.

To learn more about Rachel, please visit her website, RachelStarLive.comm.

Gabe Howard

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To learn more about Gabe, please visit his website,

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Inside Schizophrenia. Hosted by Rachel Star Withers, an advocate who lives openly with Schizophrenia. We’re talking to experts about all aspects of life with this condition. Welcome to the show!

Rachel Star Withers: Welcome to Inside Schizophrenia, a Healthline Media podcast. I’m your host, Rachel Star Withers, here with my amazing co-host Gabe Howard. The LGBTQ+ community and psychiatry have had a very troubled past, specifically when it comes to schizophrenia. Some of the first theories for the causes of schizophrenia centered around bisexual desires. People with schizophrenia have delusions. So could the delusion be that you’re homosexual, or are we all actually asexual due to the negative symptoms of schizophrenia? Joining us later in today’s episode is Lucas Silveira, who is a Canadian vocalist, guitarist and songwriter from Toronto. He was the front man of The Cliks, and Silveira is credited with being the first openly transgender man to have signed to a major record label.

Gabe Howard: For me, Rachel, much of this conversation surrounds the phrase Just because you’re paranoid doesn’t mean that people aren’t out to get you. We know that people with schizophrenia can suffer from paranoia and believe things that aren’t true. But we also know that people who live with schizophrenia can in fact and often are victims of crime, negligence, neglect and so on and so forth. The most important thing to take away from this episode is to keep an open mind on all sides. There’s much to learn and there’s much to understand, especially for our family members. Rachel, before we get too deep in this episode, let’s go ahead and define some terms.

Rachel Star Withers: Throughout the episode you might hear me switching between LGBT to just LG. I’m overall, I’m trying to go with the LGBTQ+ community. And the reason that while we’re talking today, I’ll flat out leave out part of that community is that a lot of the studies didn’t even put it into consideration. Many of the studies only focused on something very specific, like male homosexuals or transgender people. So, please, today during the episode, don’t feel that we’re purposely leaving anybody out. I am, however, trying to just reference correctly what has been studied and what hasn’t.

Gabe Howard: Rachel, if I might, I’d like to ground this a little bit in your personal story. Now, you live with schizophrenia. Everybody knows that. But I understand that you also have a letter in the LGBTQIA+.

Rachel Star Withers: It’s like an odd thing to say. I hate when people ask me honestly, is that I kind of consider myself very asexual. I’m just kind of like, uh, like I don’t find people really attractive.

Gabe Howard: Now, if I may ask a follow up question. Do you feel that that’s because of your schizophrenia or your personality?

Rachel Star Withers: I honestly don’t know, because if the argument is, well, Rachel, you do have negative symptoms, I’d be like, Yeah, maybe that’s why I don’t want to connect with people. I want to be left alone. I don’t like to be touched. I don’t like when friends come up and hug me like I, I don’t like that. So, it could be tied to the schizophrenia. Um, I’d say it’s a toss-up and that’s why I don’t like to talk about it because there are so many other people with schizophrenia that I’ve met who are not like that at all. So, I don’t want it to be like, okay, well, Rachel said, she’s this, so I guess a lot of schizophrenics are. And of course, that’s also how we’ve been seen in the past by many doctors.

Gabe Howard: One of the standard conversations is where does mental illness end and I begin? This is true of all things. So, it’s not really all that surprising that it’s true in this area as well. And it can be very challenging for people living with mental illness to figure out this ebb and flow of mental illness versus just personality preference.

Rachel Star Withers: And the social climate that so many people have grown up in and still continue to grow up in really affects it. If you grow up in a family that didn’t accept you because of, let’s say, religious ideals who don’t accept that you’re gay. I mean, depression right there, I’m going to have a lot of like issues. LGBTQ individuals are more than twice likely than heterosexual men and women to have a mental health disorder in their lifetime. And the rate of suicide attempts is four times greater amongst lesbian, gay and bisexual youth. 40% of transgender adults have attempted suicide in their lifetime. That is, that’s hard for me. That’s such a high percentage. And people with schizophrenia are already prone, many of us, to suicidal ideations. And you think on top of that, another stressor. Another stressor I’m having to deal with. Another stigma. I can easily see being pushed into a psychotic episode by all of this.

Gabe Howard: And of course, that is where the reaction of our family members really, really matters. These are people’s lives and feelings and choices that they are making. And we must leave room for this. We must leave room for understanding and ongoing conversation.

Rachel Star Withers: There’s even self-stigma. I think anyone with a mental disorder, you have some sort of self-stigma. I can act like I’m all big and tough and yeah, I’m totally fine. Rachel Star, I’m schizophrenic, but I still have a lot of self-stigma about it and certain things that I’m afraid to say because I don’t want to make schizophrenia look bad. When you add in the idea of the LGBTQ+ community, that’s a whole nother type of stigma. A lot of it has to do with your age, where you’ve grown up, your social status. I would never want to speak on stigma for other people, but here in the South, I’ve heard some horrible overt things said to people. I can’t imagine what I would do if I found out someone was saying that to my child. If I found out you were telling my child they shouldn’t be alive, I, I don’t know how I would react. Like, it’s infuriating to me. Many people in the LGBT community described experiences of stigma as being more distressful for having a mental illness than pertaining to sexuality. Carrying the mental illness around on top of the other thing, is just, it’s a lot, Gabe. And I, I honestly, I worry so much for people who do have to carry those two stigmas.

Gabe Howard: Dealing with stigma and discrimination is very difficult. Many people who are listening to this podcast have dealt with that because of schizophrenia. And as you have pointed out, Rachel, this also exists over in the LGBTQIA+ community. I f we’re looking at it from that perspective, both of those things alone are challenging. So, putting them together, ultra challenging and in order to make good decisions for yourself and your loved ones, we’ve got to be able to rise above that stigma, away from that discrimination and look at things for how they are. And that’s the that’s the genesis of this podcast episode.

Rachel Star Withers: Many LGBTQ+ people who also have severe mental disorders describe the stigma towards their sexuality as being overt and violent in nature, usually coming from strangers or acquaintances, whereas the stigma from their mental health disorder tends to be more pervasive and emotionally taxing and comes from friends and family. That’s an interesting statement. No one in real life has ever been violent towards me over my schizophrenia. I’ve been sent many emails and comments that were incredibly violent, people threatening and lots of rape things, unfortunately, because that’s the world we live in. But no one in real life has ever said, oh, you have schizophrenia, and had a violent response. They have had what you would go with microaggressions saying they’ve said, oh, you were demon possessed. You were other things. I. But those are two different types of stigma you’re having to deal with. Both are very scary in their own way. A very interesting quote I found from someone who was part of both communities said mental illness is defined in part as causing distress to the individual experiencing it. I was never distressed by presenting as male. The people around me were. Wow, that’s a kind of powerful thing because you’re dealing yourself with something inside, but everyone else is looking at something completely different and stigmatizing you for something different, and you’re dealing with both those things at the same time.

Gabe Howard: It’s very powerful to think that something that is not causing you any problems is only causing problems because of the reaction of others. Which means if other people controlled their reactions, you would in fact have no problems. And I think it’s interesting to think about that because often that phenomenon is, oh, well, I’m having trouble because of X, Y, Z, but you’re not having that problem because of X, Y, Z. You’re having that problem because of how people are reacting to the X, y, Z, which means you are not the issue. Other people are.

Rachel Star Withers: And this isn’t a new thing. Sometimes you want to just blame it on politics. But. But these have been thoughts that have been around for a while. Your early to mid-20th century, the main circulating theories was that schizophrenia was caused by sexual excesses, meaning you had too much sex in you. You were just too much. You wanted to just go after everybody. And at the same time, there was also theories that, no, no, it’s a deficiency. You don’t have enough. That’s why you’re all asexual or you don’t know what you are. That was one of Freud’s explanations for schizophrenia. This is from a research article, 1927. In most cases of schizophrenia, the combination of homosexual and incestuous cravings can be shown to exist. Incestuous. You see, they put those two things together. Homosexual and incestuous, 1927. 1949, emotional neuroses and psychoses result from conflict and confusion in bisexual differentiation. And you’re like, Rachel, that was so long ago. Like, of course they thought that back then. 2003, there’s a book that came out that unfortunately I came across called “Schizophrenia: The Bearded Ladies Disease.”

Gabe Howard: It? Just? Just, repeat that one more time. That’s 2003. And schizophrenia was the bearded lady’s disease?

Rachel Star Withers: Yeah.

Gabe Howard: Is it? Is that an analogy for something or do they, are they literally insulting transgendered individuals?

Rachel Star Withers: I feel like they’re going right off the bat with the, with an insult. Like when I saw it at first referenced in the citations of this article, I was like, what? And I had to look it up. And the book is absolutely horrible. The whole idea behind it is that homosexuality is the common cause of schizophrenia. And it’s all due to intense bisexual conflict. I was very disturbed by the book. And it is a very it has two volumes, in case you’re wondering, Gabe. But understand this

Gabe Howard: Wow.

Rachel Star Withers: Isn’t just stuff people used to think. And the book itself is a collection from different people with schizophrenia describing hallucinations and delusions they had. And that’s what the book is drawn off of. I mean, you’re basically weaponizing something very personal. If I describe my hallucinations and you, you pick one part of something I describe and you use it as your thesis or your basis for why all people with schizophrenia. It’s a really horrible thing to do. The title tips you off that this is where this book’s going. And it’s easy to see this because I get it. Transgender individuals with a schizophrenia diagnosis are actually usually diagnosed younger than cisgender people. That makes perfect sense, though, because usually it’s stress that begins your first psychotic episode. And I can see transgender people, unfortunately, going under more stress than the rest of us, especially if you’re talking about those teenage years. And stress is thought to trigger and exacerbate the onset of psychosis. And it’s actually called the stress model. Are we saying that being LGBTQ+ will make you have schizophrenia? No, but I think it’s pretty easy to see how it can make things worse.

Gabe Howard: I really think the issue comes in, Rachel, when people understand that something causes stress and that stress can impact schizophrenia. But when we’re talking about certain hot button topics like, like LGBTQIA+ issues that people take out the middle, they’re like, this caused stress and that impacted your schizophrenia. So therefore, LGBTQIA+ issues, one is causing the other. you know, curiosity about your sexuality, having feelings that you don’t know where you belong and trying to work that out or of course, being discriminated against or stigmatized because of your choices, your sexuality or anything on the LGBQTIA+ spectrum. And then people are like, aha! That caused you stress. That stress impacted your schizophrenia. Therefore, that’s the problem. LGBTQIA+ issues caused your schizophrenia or they flip it. Schizophrenia caused your LGBTQIA+ issues and they think that sounds reasonable. No, no, no, no, no, no, no, no, no. Those things may have a relationship. While they may have a connection, they’re not causal.

Rachel Star Withers: An old way of thinking would definitely also be like, well, a lot of these people, they’re young, they’re teens. What do they have to be stressed out about? The math test? Gabe, I can tell you the worst time in my life was middle school. Second worst would been high school. Of my entire life. I hated it. And I did well with grades. But I can’t think of a time in my life where I was more unhappy. A 2019 school climate survey found that 86% of LGBTQ+ youth had reported being harassed or assaulted at school. I think about how horrible middle school, high school was just in general. But no one ever assaulted me. I was never harassed. I can’t imagine adding another layer to all of this. And for me, it’s very easy to see if you’re in fear of being assaulted or harassed every day at school, of course, this is going to that stress is going to bring on a mental disorder that you maybe haven’t been diagnosed with yet. Now, is it going to cause a mental disorder? I don’t think so. But, I think it’s pretty easy to see that. Yeah, that’s going to be something that can set off certain psychotic episodes or depressive episodes or cause someone to start wanting to commit suicide.

Gabe Howard: There’s been a weaponization of mental health against certain societal stigmas that we have. So, for example, if we talk about gun violence, suddenly mental health takes center stage. I really feel like this is happening over in the LGBTQIA+ conversation as well. First, you have very reasonable conversations surrounding a group of people who deserve equal access to rights, and before you know it, suddenly we’re talking about mental health. And I really feel like we’re not talking about mental health in a way to help people, but in a way to discredit them. Mental health, mental illness, mental health crises, etc., are used against people. Sincerely, from my perspective, it seems like mental health issues are being wielded as a weapon against people who we want to silence.

Rachel Star Withers: What’s important to also bring up in this discussion is that a lot of this is being currently targeted at transgender and gender identity issues. In the DSM-5, the Diagnostic and Statistical Manual, gender dysphoria is included. That’s where there starts to be a lot of issues of, okay, so is it a disorder or not? Or is it part of a different disorder? Where does all this come from? I’m not a doctor and I can go ahead and tell you that most doctors don’t know because it’s undecided. Um, it. It has to be a very difficult thing if you’re already dealing with schizophrenia. In this year, April 2023, the attorney general of Missouri introduced a emergency rule. It would have required all clinicians providing gender affirming medical care to screen their patients for autism and ensure that they have no current psychiatric symptoms. Um, so okay, that means if no psychiatric symptoms. Although wait a second. Gender dysphoria is listed in the Diagnostic and Statistical Manual.

Rachel Star Withers: So if you’re telling me that you have a gender identity problem and I diagnose you as that. You see, there’s this, yeah. Thankfully, a judge did block this policy, but that’s where we are. That was in April of this year. It’s a catch-22. There is no getting out of it. Yeah, that’s the point. That’s the point. You can’t escape it. It’s hard to talk about this, Gabe. And I feel worried that we’re going to offend people out there because I don’t, I don’t really know what it’s like to have a gender identity crisis, so it’s hard for me to be like, Oh, well, of course it’s not. Has nothing to do with delusions. It has nothing to do with schizophrenia. I don’t think it does. But I also have never experienced it and I don’t really know. It’s hard for me to be like, Well, no, it’s not possible. So, we’re going to talk to someone who can lead us into this area.

Gabe Howard: Lucas has accomplished a lot in his lifetime, and I feel like he does a really good job of explaining what his life is like. He makes it clear that he does not speak for the entire community. He’s only telling his personal story. But I really feel like through his lived experience perspective, he shines a light on things that are more difficult for us to understand because it’s not our lived experience. As we’re fond of saying on this show, we can only see the world through our own eyes. And I’m really excited that you were able to talk to Lucas and that Lucas was able to give us a little bit of what the world is like through his eyes.

Rachel Star Withers: Today I’m speaking with Lucas Silveira, who is the former front man of The Cliks and now a solo artist and made history as the first openly transgender man signed to a major music label. Thank you so much for joining us, Lucas.

Lucas Silveira: Thank you for having me.

Rachel Star Withers: Now tell our audience who may not be familiar with you, what’s your musical background? Because you’ve done a lot in the industry.

Lucas Silveira: Yeah, I’ve been around for a bit. Probably about 30 years as a professional musician. I started out in Toronto as a solo artist. Pre-transition, I’m a transgender man, so from the ages of 18 till about 32, I was living as a woman, living as a lesbian, and finally, at the age of 32, I decided I had already known who I was. But I came out at that time and I thought that my music career was going to end when I came out as trans. What strangely happened was I recorded an album with my band, The Cliks, and this like magical thing happened. And that’s what led to my band getting signed to Warner Music Canada and in the States to a label called Tommy Boy Silver Label, making me the first out transgender man to be signed to a major label. And then after that, sort of things just like took off. I toured with people like Cyndi Lauper and the B-52’s, The Cult, The New York Dolls, Debbie Harry, a bunch of folks. And we all we did a ton of tours like all over the world. I actually decided to physically transition was about five years later because I’d had issues understanding what was going to happen to my voice. And I’d been told I was going to lose my voice. And so, I discovered five years later, through a bunch of trans guys sort of gone public on YouTube, how to do it. And I did it. I started on a bit of a solo career and I’ve been around since.

Rachel Star Withers: Now, has your voice changed?

Lucas Silveira: Oh, yeah, massively. So, I had two solo albums before I changed my name. And then I had a Cliks album and another Cliks album, so four of them with my old voice. So, you can hear if you go back, you can hear my voice. Um, at the time, like it was just very, very difficult to go into a studio and sing and think like I knew what I heard in my head and then have it like come back in a different way. It was like actually very dissociative and caused me like a lot of mental health issues when it came to like gender dysphoria in that capacity. So, like, depression and all that. But after I transitioned, it was like my vocal range. It took a while to get to like a, like, like a level that I had, but of course it dropped, right? So, if you even hear me talk, like sometimes I see videos of myself talking before and I’m like, who is that? Like, what voice is that? Because it’s so like it’s bizarre. It’s it kind of makes me a little bit dissociative when you’re trans and you see like footage of yourself prior. But yeah, I changed a lot.

Rachel Star Withers: I’ve just never heard anyone put it the way you just did. So, in your mind, you would hear your voice, let’s say deeper, more masculine.

Lucas Silveira: Yeah. Yeah. It was like what I heard in my head. But then I’d go into the studio, I’d sing, and then it would come out and I’d always be like, oh, that’s not what I wanted. Like, that’s not what I hear in me. It was the same thing as going to the mirror, right? I’d go to the mirror and I’d be like, who is that person? I know it’s me. Logically, I know it’s me, but that doesn’t feel like me. And now when I look in the mirror, I’m like, Yeah, I’m just like a little Portuguese dude with a mustache. That’s me.

Rachel Star Withers: It’s interesting because when you hear so much talk about, I guess, your thoughts not lining up, that leads us into mental health and schizophrenia. Talk

Lucas Silveira: Mhm.

Rachel Star Withers: To us about your mental health background.

Lucas Silveira: So, I had a very traumatic childhood, a lot of trauma, and, you know, everything from sexual child abuse to physical abuse from teachers. I think the trauma that kept following me around started taking its, you know, its course and also the fact that I was trans and knowing that I’d been like, I knew I was a boy when I was four.

Rachel Star Withers: Wow.

Lucas Silveira: It’s always been something inside of me, which is kind of amazing that a child that young would have that kind of like awareness, right?

Rachel Star Withers: Yes.

Lucas Silveira: So, for me as a trans person, knowing that, but at the time, like you just did not come out as a trans person, it was so dangerous. I didn’t even know what transgender was. There was no language for it. And mostly at the time it was seen as sort of like a mental health condition and it was actually seen as a disorder. What ends up happening a lot of the time when you’re a trans person, it did a lot back then was that, and it still happens now. If you say you’re transgender, automatically, you’re seen as being, quote unquote, crazy. Right? So, a lot of people think that you need help, that what you’re going through is not real, that you just have this this like delusion and illusion. So that is the part that for me was really, really difficult, both in coming out as a trans person and being like, No, I’m not mentally ill. This is who I am. I’m a very like, you know, quote unquote sane person. But then and then later on, it was like almost like a little turnaround.

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Gabe Howard: We’re back talking about schizophrenia and the LGBTQIA+ community.

Rachel Star Withers: Lucas, when were you diagnosed with schizophrenia?

Lucas Silveira: I started experiencing my schizophrenic symptoms much later in life. They started probably about eight years ago. And at first I didn’t really know what was going on. But of course, again, didn’t want to tell people really what was going on because it’s horrifying to tell people, hey, guess what? I think all of you want to kill me. I’m seeing your faces as all being evil and I’m horrified to go outside. I ended up being put on medication. I was misdiagnosed as having depersonalization disorder. And so, I became an alcoholic because that was the only thing that I had that kept me from my paranoia. I was told I had a panic disorder. So, every time I started getting scared or paranoid or thinking that somebody was trying to hurt me or that somebody was putting acid in my drink, or that somebody gave me Advil with like a drug in it.

Lucas Silveira: Like all these delusional thoughts. I ended up having an alcohol poisoning incident and that’s what I believe exacerbated and sort of like pushed over my symptoms. You know, I started hearing voices. I started seeing like people that weren’t there. I was watching the TV show Friends, and all of a sudden the same thing started to happen. They were evil. They were sinister. There was something on the show happening that was out to get me. The laugh track was like laughing at me. And I was like, what the heck is happening here? And I thought, oh, as any alcoholic or drug addict does, it’s because I drink heavy booze. So, I’m just going to start drinking beer now and this will go away. And I didn’t tell my doctor and tell my friends.

Lucas Silveira: And then the pandemic happened and that’s when all hell broke loose for me. I was by myself. I started drinking more. My paranoia became like intolerable. I call it the sharp feeling in my brain where, like, the story never stops. And it doesn’t matter what you do, it just keeps going. The urges to act on the beliefs became so incredibly impossible to recognize as not being real. And I think because my schizophrenia came later in life and because I also have major depressive disorder, all of these things tied up. These doctors was like, no, it’s impossible that you have schizophrenia. You’re too old. I had to go to a Swedish psychologist to finally get like a firm diagnosis. Yes, you have schizoaffective disorder. You have a major depressive disorder and, you know, schizophrenic. And then he said it’s late onset schizophrenia, also your low spectrum, which means that you might not be getting the kinds of auditory hallucinations that a lot of people get or the visual hallucinations that people get. Something that I didn’t know. I thought that schizophrenia looked like this, which is what a lot of people think it looks like. And there is so much misinformation out in the world. I became very involved in doing advocacy and speaking very loudly about my condition, even though I knew, um, the stigma around it and I knew that people were going to look at me weird, I knew that I would probably lose work.

Lucas Silveira: But I’m so passionate about having people understand. Because what ends up happening to folks like us or folks with bipolar disorder or even borderline personality disorder, depression is we get, we get demonized by the system. So, all of a sudden somebody’s like, Oh, you’re schizophrenic. I’m not going to be in a band with you. I’m not going to write songs with you. I’m not going to hire you to do this. I’m not. And I’m like, Actually, I’ve been going steadily on an uphill climb with a couple of dips and recognizing that the dips are going to happen. And part of my uphill climb is knowing, okay, I need to stay here, I need to rest. And when I have the energy, I’m going to start doing that again. But a lot of people don’t think that that’s possible. So, I’m vocal about it because I want people to see I am a quote/unquote normal human being. But the biggest issue for me in coming out as a schizophrenic was because I was transgender and was because of the political climate. Right now, where there are people trying to make laws that prohibit people from transitioning, telling us that it’s a mental disorder and all of this stuff. So, when you tie in the intersection of being trans, being schizophrenic and the stigma and as well and as well this belief that it’s a multiple personality disorder, I’m put in this position where I’m like, I’m going to make the trans community look bad. I’m going to put my community in danger of repercussions by these people who are spreading misinformation about who we are. We are not mentally ill.

Rachel Star Withers: Do you think that your schizophrenia is connected to you being trans?

Lucas Silveira: Here’s the thing about me being schizophrenic, has nothing to do with me being transgender. I am a transgender person. I’m also schizophrenic. Those two are not related like in the least. It’s just that’s just not the case. It took a lot for me to be able to say it out loud. But then, you know, me and my girlfriend. And it’s been like a road of healing for the two of us to get to where we are. But she did the research. She listens, you know, I send her the podcast. I’m like, listen to this part where Rachel says X, Y, and Z. That’s what happened. Nobody told me that that was a thing. So, shows like this are you know, I don’t know if you guys understand, these save lives. This podcast was is one of the hugest impactful things that happened in me healing and

Rachel Star Withers: Oh, thank you.

Lucas Silveira: Me understanding. Oh. That thing that happened. Like I was just listening on my dog walk to you talking about how when you go into like when you’re starting to sort of like go into psychosis, how you sound like you’re on drugs and that you’re your voice starts slurring.

Rachel Star Withers: Mhm.

Lucas Silveira: That happened to me right before I went into a psychotic event. And my girlfriend at the time was like, I thought that you had just started drinking and that you were getting drunk. And I was just like, no, I’ve been sober. I’m like, I’m totally sober. So, I was thinking, why was I slurring? Why was that happening? Nobody told me that that happened. I had to come here to find out. So, now when I feel like I call it my tongue being held in my mouth,

Rachel Star Withers: Mhm.

Lucas Silveira: Almost like I can’t really get the word out,

Rachel Star Withers: Yeah.

Lucas Silveira: I’m like, oh, I have to be careful right now. Is that what you experienced too?

Rachel Star Withers: It’s like I guess my tongue is swollen. Almost

Lucas Silveira: Yeah,

Rachel Star Withers: Like I know how to say it, but it’s like my tongue is too big for my mouth. Like, I’m stumbling.

Lucas Silveira: All right.

Rachel Star Withers: Yeah. And so, everything’s not coming out. It’s I’m saying the words, but yeah, they definitely sound slower and I’m not pronunciation saying them correctly.

Lucas Silveira: Yeah.

Rachel Star Withers: I’m already from the south, so very strong Southern accent. So, I have that working against me.

Lucas Silveira: Wow. But like you saying that, like, blew my mind. [Laughter]

Rachel Star Withers: [Laughter] So, help me understand. So, before you transitioned, you felt different. You knew you were different.

Lucas Silveira: Yep.

Rachel Star Withers: Your thoughts were, like you kind of said earlier, you heard it one way, but it physically came out a different way.

Lucas Silveira: Mm-hmm.

Rachel Star Withers: And then with schizophrenia, you have disorganized thoughts. What would you say to someone who’s like, well, how are those two not connected?

Lucas Silveira: Aha. Yes. Well, one is identity based. And I know this might sound like a very hippie thing to say, but is literally about how you feel in your physical self. Do you feel comfortable? Do you feel like who you’re seeing in the mirror is who you are and you are moving through the world in a way where you just feel like you’re holding the secret. And you know that if you took these steps that you would feel more in your body. The interesting part is when people are like, oh, trans people are you know, that’s the mental disorder. Is it a mental disorder? Because it’s so interesting that as soon as I started my transition, all of my gender issues went away. So, for me, my wellness in that aspect came from going on hormones, finally taking the steps to do surgeries, things that a lot of people think are body mutilation, which is like the most horrific and violent thought to have about a trans person. Because the thing is, what’s violent is the way we feel about ourselves when we are living in a body that we do not feel connected to. And the thing is, when you are dealing with those feelings, you start having mental health issues. Not because you’re mentally bill, but because people are telling you that you are not allowed to be who you are. So, it’s like this flip, flip around, which is that the mental, that degrades when you are dealing with the inability to be fully who you are in your identity as a trans person.

Lucas Silveira: I actually know people who dealt with depression their entire lives or did have like lot worse symptoms with bipolar disorder. And then all of a sudden they transition and so many of their symptoms go away. A lot of people like to do this whole thing of like, well, you had a traumatizing childhood and there was sexual abuse in your childhood and had a psychiatrist when I was 21 years old say like the most hurtful, horrible, destructive thing that any mental health care practitioner could have said to me, which was the reason that you think you’re a man is because you are like you are trying to empower yourself with masculinity because your oppressor was a man, so you’re just trying to project and was like, What? What? What are you even talking about? I thought I was a boy when I was four. This is all pre any of that. And those things were not even remotely connected. But people have these ideas about mental health. I mean, being trans was in the DSM.

Rachel Star Withers: Yes.

Lucas Silveira: But so was being gay. And so was like women who spoke up too much. They were seen as having hysteria.

Rachel Star Withers: Right. So, for someone who might be listening, who’s trans, do you think that they should, let’s say, in the first session, even bring up that they’re trans when it comes to talking to a psychiatrist? Or do you think that’s absolutely part of it? You’re going to have to?

Lucas Silveira: Well, not really, because the thing is, that’s twofold. And that’s a really good question, especially, living down south. It can be a safety aspect, right?

Rachel Star Withers: Yeah.

Lucas Silveira: So automatically it de-legitimatize the fact that you have a mental illness because they will automatically, through transphobia, be like, Oh, you’re one of these, like, transgender people. Like there was a Canadian politician who just recently said that gender dysphoria is a mental disorder and that we shouldn’t be like giving kids hormone blockers. And what she doesn’t understand about a statement like that is that is like giving a trans child an empty gun. And then that’s the bullet that you’re going to put in the chamber is you’re going to tell them that what they feel is not real. And that is what creates this, you know, the trans community has one of the highest rate of suicides in any marginalized community for this reason, not because we hate ourselves, but because we feel so unsafe in the world and we are not allowed to be ourselves cause so many people hate who we are. So, the question of should you talk about it in your first session? I think the first thing that trans people need to do is they need to find queer positive, trans positive therapist, psychiatrist, medical centers, find somewhere where you can go and safely talk to somebody. That’s always the best option.

Lucas Silveira: But that’s the thing you have to go to where it’s safe. That’s primary. And safety is with somebody who will hold the fact that you’re transgender, not associated with your mental illness. And if you’re dealing with issues of gender, that they will separate that unless part of what you’re dealing with is depression caused by the fact that you are not being given permission by your government, by your doctors, by the people around you, or that you have like a very toxic life with family where they are transphobic and you’re not allowed to come out. That’s a different situation. So, yes, there are mental health issues that happen if people aren’t allowed to transition or because of the way people have to move through the world. Yes, most likely you’re going to deal with depression.

Rachel Star Withers: Yeah.

Lucas Silveira: Because of the way that you are treated. You never feel safe. And that has physiological and psychological effects. So, we have to talk about what comes first, not you’re trans, therefore you’re mentally ill. It’s like, no, I’m trans. And because all of this violence, emotional, psychological, physical is being thrown at me, that is what’s causing me to have mental health issues. And you can’t get schizophrenia from being trans and being hated, but you can be schizophrenic and be trans at the same time.

Rachel Star Withers: Mhm.

Lucas Silveira: Yeah.

Rachel Star Withers: Your most recent album is kind of a deviation from some of the past ones that you’ve made solo and with The Cliks. Talk to us about this new album.

Lucas Silveira: This album. Interestingly enough, I started writing, um, a lot of it in the pandemic and just before where I think my, you know, what was called my psychosis and my delusions were starting to happen. And a lot of what I wrote was founded on those delusional beliefs. So, the reason it’s called The Goddamn Flowers is because that was the root of what I thought was the first delusional thought that I had. And I call it like the little root that was thrown into the grass that all of my delusions, the web like of conspiracy, started. And like, there’s a song on there that I wrote in like complete psychosis.

Rachel Star Withers: How can our audience learn more about you and your newest album, The Goddamn Flowers.

Lucas Silveira: I have a website that’s It’s C L I K S, and I’ve turned what used to be my band that I’ve founded into a production company. I was also the co-host of a television show called Shine True. That was out that was a production of Vice Television is out in the United States on Fuse TV and in Canada on OUTtv, where I was a mentor to younger trans folks. You can go on my Facebook, which is Lucas Silveira music. And @LucasSilveira on Instagram, where I very often go there and talk about issues, I write about issues. I write a lot about mental health, and where people can see me, like perform on Instagram live or find out where I’m going to be performing.

Rachel Star Withers: Well, thank you so much for sharing your story with us and also sharing your artistry with us and the entire world.

Lucas Silveira: Thank you. And I’m honestly, I’m so excited that I got to be on this show. I was telling my girlfriend, I was just like, oh, my God, I’m going to be on the show. I’m like, I’ve been listening to this for. And I’m like, I’m actually going to be one of the people on there. And I was just like, I felt like sometimes how people approach me with like fangirling I call it. I feel like I came here fangirling being like, oh my God, talk to them. So, I want to just say thank you to you. I don’t know if you realize what a difference you’ve made in my life and in the life of other people, I’m sure, who are listening. So, thank you for the work that you do. I appreciate you guys more than you ever know.

Gabe Howard: Well, as always, Rachel, great interview. I’m really struck because Lucas is interesting. He’s interesting to me because he is different than the people we discussed before because his schizophrenia didn’t develop until later. Do you think that his schizophrenia could have played a part in him being trans, or is it completely unrelated?

Rachel Star Withers: As he was talking, he mentioned that he knew he was a man since a very young age. So, if you were going to argue that that’s all schizophrenia. I find that to be a very impressive delusion because it would have been a single constant delusion for at least, at least 30 years. I did try and look up how long delusions can last, Gabe. And there’s no definite answer, but usually it’s months to a few years. If you’re trying to argue that schizophrenia is connected to gender identity. I find that to be a hard case to make because, yeah, it’s not like he said that, oh, one day I suddenly felt that I was vice versa, different sexuality for three months. And then it stopped. For my own experience with delusions, mine usually lasts a couple of months. I just I again, Gabe, I’m not the final say, but I’m going to say that No, it’s absolutely to me the schizophrenia was late onset and had nothing to do with him being trans.

Gabe Howard: Rachel, without falling down the rabbit hole of whether I agree or disagree, I want to take it a little bit broader and tell you that there’s large swaths of the country who just completely disagree with what you just said.

Rachel Star Withers: Lucas brings this up and I came across this over and over when I was reading different stories from people on the Internet, kind of saying, okay, well, wait a second, am I trans or am I having this gender identity due to schizophrenia? Repeatedly. What I kept coming across was the fact that, well, when they started hormone therapy, and we’re able to address the gender identity, that that was fine. However, they still had schizophrenia symptoms, but that went away. And on the reverse, when someone would start schizophrenia treatment, anti-psychotics, that many of their hallucinations, delusions and schizophrenia symptoms would subside but not the gender identity. And I think that that’s the core of it was okay well that we’re right there. If your medication, your medication isn’t really just going to pick one delusion and be like, no, no, we want you to keep that one. I’m not saying that’s, you know, a final thing for everybody. And of course, there’s so many different medications and therapies, but that’s a pretty good clue that if someone is allowed to address their trans identity and they’re happier and they’re healthier for it, what does it matter to anyone else? Gabe, what does it matter?

Gabe Howard: When it comes to schizophrenia. Obviously we want ourselves and our loved ones to have the absolute best care that they can have. But the absolute best care involves keeping an open mind and getting them the care that is tailored for them.

Rachel Star Withers: To loved ones who are listening, who may have very strong opinions on the sexuality issue. If someone is dealing with schizophrenia. You need to just be there for them and just be caring. I don’t think you need to be picking apart any pieces of their lifestyle. If you’re not the person that they’re with, then I really don’t see how it concerns you. And I think what’s most important is helping someone with a mental disorder. Helping someone not have the desire to commit suicide, not adding to that. And it’s such a big issue, again, with schizophrenia and with the LGBTQ+ community. Recently I was shopping at one of the big superstores and someone was helping me. They had this beautiful watch on. It was just this rainbow-colored watch. And I just said, Wow, that’s a really pretty watch. And the person leans in and goes, Oh yeah, it’s for Pri-.

Rachel Star Withers: And they stop. And I said, Pride. And they said, Yeah, sorry, I’m not supposed to say that here. And I was like, that, that’s fine. And they go, no, it was not that it matters. Look at me. People can’t help but see me. And I kind of went back to them a little later and I said, Listen, there are so many people in this world who nobody ever notices who just are in the background all the time. And you’re someone who everybody sees. That’s amazing. And I was like, whether it’s better or worse, people see you. People are watching you. That’s a pretty cool, a cool thought. And that’s kind of what I want to say to other people. You shouldn’t hide who you are. But yes, if you don’t hide who you are, people do notice. They absolutely do notice very quickly. And on some level, that’s pretty amazing that that means you get to be seen. Thank you so much for listening to this episode of Inside Schizophrenia. Please like share, subscribe and rate our podcast and we’ll see you next time here on Inside Schizophrenia a Healthline Media podcast.

Announcer: You’ve been listening to Inside Schizophrenia, a podcast from Psych Central and Healthline Media. Previous episodes can be found at or on your favorite podcast player. Your host, Rachel Star Withers, can be found online at Co-host Gabe Howard can be found online at Thank you and we’ll see you next time.