Artigos

Conteúdo (article):

A interseccionalidade de gênero, raça e classe social nas trajetórias de vida de mulheres que tentaram suicídio
The intersectionality of gender, race and social class in the life trajectories of women who attempted suicide
Authors:
1 Jéssica Pereira Manelli, Psychologist at the Social Assistance Reference Center (CRAS) in the municipality of Piracicaba-SP. Specialist in Mental Health at the Multiprofessional Mental Health Residency Program of the Nursing Department of the Botucatu/UNESP Medical School. E-mail: jessica.manelli@unesp.br. Orcid: https://orcid.org/0000-0002-0258-886X
2 Dinair Ferreira Machado, Assistant Professor, Department of Public Health, Botucatu Medical School -UNESP, Permanent Professor, Graduate Program in Public Health – FMB/UNESP, E-mail: dinair.machado@unesp.br, Orcid: https://orcid.org/0000-0003-3006-7110.

RESUMO
Objetivo: Analisar a tentativa de suicídio de mulheres sob interseccionalidade de gênero, raça e classe social. Métodos: Trata-se de estudo qualitativo nos moldes da história de vida tópica, realizado com 7 (sete) mulheres que relataram tentativas de suicídio durante a vida. A coleta de dados ocorreu por meio de entrevista individual, com apoio de um questionário para caracterização sociodemográfica e um de roteiro semiestruturado. Resultados: A análise integral das entrevistas revelou quatro categorias de análise temáticas: 1) Trajetórias de subsistência e desvelamento da expressão da desigualdade social; 2) A infância e a adolescência marcadas pela violência no contexto familiar; 3) A divisão sexual do trabalho e a desigualdade de gênero como frutos do patriarcado; 4) A dificuldade na autoafirmação étnico-racial como desdobramento do racismo e mecanismo de invisibilidade social. Constatou-se a interdependência dos eixos de opressão: gênero, raça e classe social na trajetória de vida das mulheres que viram no suicídio uma estratégia factível de cessar o sofrimento causado pela estrutura social. Conclusão: Este estudo revelou que as tentativas de suicídio em mulheres devem ser abordadas sob a ótica da interseccionalidade macrossocial, rompendo com perspectivas individualistas e biologizantes.
Palavras-chave: Tentativas de suicídio; Interseccionalidade; Estrutura Social.

ABSTRACT
Objective: To analyze the suicide attempts of women using the intersectionality of gender, race and social class approach. Methods: This is a qualitative study along the lines of a topical life story, encompassing seven women who reported experiences of suicide during their lives. Data collection occurred through individual interviews, supported by a questionnaire for sociodemographic characterization and a semi-structured script. Results: The full analysis of the interviews revealed four categories of thematic analysis: 1) Subsistence trajectories and development of the expression of social inequality; 2) Childhood and adolescence marked by violence in the family context; 3) The sexual division of labor and gender inequality as fruits of patriarchy; 4) The difficulty in ethnic-racial self-affirmation as an outcome of racism and a mechanism of social invisibility. The interdependence of the axes of oppression was verified: gender, race and social class in the life trajectory of women who saw suicide as a feasible strategy to end the suffering caused by the social structure. Conclusion: This study revealed that suicide attempts in women must be approached from the perspective of macrosocial intersectionality, breaking with individualistic and biologizing perspectives.
Keywords: Suicide attempts; Intersectionality; Social Structure.
INTRODUCTION
The widespread awareness of suicide as a serious global public health problem that requires priority and rapid response interventions has been signaled since 2014 with the publication of the report Preventing Suicide: a Global Imperative by the World Health Organization. It is estimated that more than 700,000 people in the world die by suicide every year, with 80% of these deaths occurring in the most impoverished countries, showing a strong relationship between suicide and poverty.1-2
Brazil has seen a growing increase in suicide deaths over the years. In a study carried out between 2000 and 2018 analyzing mortality trends from non-communicable diseases, it was found that the country had an average annual increase of 1.4% in suicide death rates. ³ Suicide among young people aged 15 to 29 was the fourth leading cause of death and among adolescents aged 15 to 19 the second leading cause of death in 2019.4-7
Against this backdrop, suicide in Brazil presents itself as a complex multidimensional problem that requires to be tackled, demanding to be prevented and understood in its different meanings and different historical moments.8-10 Historically , the hegemonic paradigm guiding society is that suicide is an individual phenomenon, often related to mental disorders and the abuse of psychoactive substances. Therefore, it has repeatedly been approached by health professionals from a biologicist and psychologizing perspective, which reduces the complexity of suicide to the individual, removing from the scene the socio-cultural and historical context of oppression and class struggles.11
Suicidal behavior is divided into three categories: suicidal ideation, suicide plans and suicide attempts. The first refers to thoughts that life is not worth living, which may or may not be transient. The second refers to the planning of ways, means, place and time to commit suicide. And finally, suicide attempts, the focus of this study, which refers to the execution of behaviors with the intention of death, but whose outcome does not result in death.12
Regarding to suicide attempts, it is estimated that the number exceeds self-inflicted deaths by at least ten times, and suicide attempts are more frequently carried out by women.12 The motivations can be explained by socioeconomic, racial and gender inequality, the result of capitalist, racist and patriarchal societies that naturalize the inequality of power between men and women, constructing crystallized social roles for subjects and leaving women vulnerable to all forms of oppression and violence.12-15 According to IBGE data, the majority (56 %) of the Brazilian population is made up of black persons, and this category includes browns with 46.5% and blacks with 9.3%.16 From a sociological and political perspective, both groups, blacks and browns, are included in the “black” category, since they have similar and inferior living conditions to whites.17
When women are denied their status as subjects of rights, they experience life trajectories marked by family, social and political neglect. This process makes them more susceptible to psychological suffering, and suicide is often taken by them as an alternative to end their suffering. However, it should be emphasized that the category of woman is not homogeneous, but rather ordered and crossed by the three axes of oppression: social class, race and gender, which have coexisted inseparably since the formation of Brazilian society and, at the same time, they are weaved in an intersectional manner along women\'s way of life and worldview, making some groups even more vulnerable than others, depending on their financial condition, skin color, gender identity and sexual orientation.18-21
In this way, intersectionality is conceived as a transdisciplinary theory that aims to incorporate identities and their complexities against the backdrop of social inequalities from the integrated perspective of race, gender and social class. It is an approach that denounces the repercussions of structures that discriminate and create inequalities, based on patriarchy, racism and capitalism, exposing how oppressions develop along all three axes and are legitimized by specific policies that contribute to active processes of disempowerment.22-25
From the perspective of intersectionality, it is possible to understand how social inequalities occur in the group of women, discrimination and the overlapping of oppressions. The intersectional perspective allows us to analyze the social structure and the greater vulnerabilities of black women within this organization.26-27 This context show why suicide needs to be approached from a social perspective, since every death or attempted death denounces aspects of the current model of society.11
Therefore, this study sought to answer the following research question: What do suicide attempts by women reveal about the Brazilian social structure? The aim was to analyze suicide attempts by women from the intersectionality of gender, race and social class.
METHODS
This is a qualitative study based on a topical life story with women who had been treated at a Health Teaching Unit in a city of São Paulo countryside.
The study encompassed seven women over the age of 18, living in the area covered by the unit, who had attempted suicide in their lives and who had been undergoing therapeutic follow-up for more than a month with the multi-professional team from the Mental Health Residency at the Health Teaching Unit. The number of participants was selected using the information power technique. The information power technique was proposed with the aim of guiding researchers in qualitative studies on the number of research participants, since determining the number of subjects in advance is not always possible and continuous analysis of the number of participants throughout data collection is necessary.28
After the research was cleared by the ethics committee, under opinion 5.410.457, the inclusion and exclusion criteria were discussed with the team of residents from the Multiprofessional Mental Health Residency (to which the researcher belongs), in order to find out which service users could be selected to take part in the study. The women were invited to take part in the study through a telephone call made by the researcher herself.
The study did not include people who did not identify themselves as women, who were under 18, who did not live in the health unit\'s catchment area, who had no previous history of attempted suicide and who had not received mental health care from the Multiprofessional Mental Health Residency team.
Data collection took place through individual interviews, and was initially guided with the support of a questionnaire to characterize the sociodemographics of the research participants; in a second stage the women were interviewed using a topical life story guided by a semi-structured script. The interviews were carried out individually by the researcher herself, in a room at the health unit, providing a private and safe space for the participants to express themselves during the interviews, guaranteeing secrecy and confidentiality.
After collecting the data, the narratives were transcribed in full and organized for analysis. The data was analyzed using Bardin\'s thematic analysis method. The names used in this research are fictitious and were chosen by the participants themselves, guaranteeing their anonymity.

RESULTS
Table 1

According to the table above, the average age of the women was 37.8 years, all identified themselves as cisgender and with regard to sexual orientation, one woman declared herself asexual, one homosexual, one bisexual and four as heterosexual. Two participants had incomplete junior school, two had completed high school, two had completed higher education and one had incomplete higher education. With regard to skin color, one woman preferred not to self-declare, two self-declared as brown and four as white.
The average family income of the participants was R$1,779.14. However, two women were unable to provide this information because they lived with their partner and other family members and did not have access to their income. Regarding occupation, one woman was receiving the Continuous Cash Benefit (Federal poverty cash allowance) due to her health condition and one woman was registered as a Self-employed Microentrepreneur, but declared that she did not have enough income to support herself; one woman was a student and the remaining four were unemployed. Of these, two were part of an association that aims to generate income and get users into the job market, and two did informal work by selling handicrafts or third-party products.
After a full and detailed analysis of the interviews, four thematic categories of analysis emerged: 1) Subsistence trajectories and unveiling the expression of social inequality; 2) Childhood and adolescence marked by violence in the family context; 3) The sexual division of labor and gender inequality as a result of patriarchy; 4) The difficulty in ethnic-racial self-affirmation as an consequence of racism and a mechanism of social invisibility.
Category 1: Subsistence trajectories and unveiling the expression of social inequality
The women\'s subsistence conditions were marked by poverty, expressed in financial difficulties and access to food: “My childhood wasn\'t bad, but it was very poor, we ate what we had and waited for what came, we lived as much as possible. Sometimes we lacked food, cold clothes and even flip-flops." (Natalia). The repercussions of poverty are also expressed in Olívia\'s story: “We went hungry, we took what was left of the school lunch to have something to eat at night and for my mother to have something to eat the next day”.
In the midst of this scenario of inequalities, infant labor was also present in the participants\' stories “I almost didn\'t have a childhood, we were very needy, so my sister and I started recycling because we didn\'t have shoes, we didn\'t have anything, we didn\'t have a backpack to take things to school, we only had flip-flops (Olivia)”.
The narratives show that the interviewees, even as children, were forced to work to support their families. This responsibility imposed by the unequal social organization continued into their youth, marking their trajectories “In my youth, I worked. My father died and my mother lived with my two younger brothers, I was afraid of going hungry, I had to stay here to work, to make sure they had at least rice and beans, so I would never go through what I went through again (Natalia)”.
Category 2: Childhood and adolescence marked by violence in the family context
Recalling childhood and adolescence was a source of suffering for the participants, as their stories also revealed harsh experiences of violence, experienced within the family context, as Maria Julia said: “The only thing I remember was my mother fighting with my father, I remember my mother fighting with my father, stabbing him”.
Avalon\'s life story was also marked by situations of violence within the family “The issue of my mother beating me was very difficult, the things she did to me, all kinds of violence, not just physical, I not only suffered violence but I saw my brothers suffering violence and I couldn\'t do much about it, I had nowhere to go, I suffered sexual harassment”
The narratives showed the control and violation of women\'s bodies from an early age, as Natalia pointed out: “I menstruated when I was 9, I was beaten up by my mother because I menstruated, because my cousin told my mother that I menstruated when I was 9 because I was addicted to men. And I still got beaten up, I was afraid of menstruating”.
Neither home nor parents protected these women, who suffered all kinds of violence, from physical to sexual “I remember that I suffered a lot, my father, he bullied me and my mother a lot, my father was an executioner, he beat my mother a lot, my own father tried to take advantage of me when I was a child (Larissa)”. When the abuse didn\'t come from their own family, it came from people they knew who had access to the house and the women “When I was ten, I was molested, it was a friend of my stepfather\'s, it smelled of plaster, I remember the smell and it made me sick, it made me sick, I needed a psychologist, a psychiatrist (Tereza)”.
The repeated overlapping of violence experienced favored the weakening and/or breaking of family ties and was the main motivation for leaving home and getting married “He (father) came with arrogance, slapped me in the face, made me swallow the cigarette, burned my mouth. I started arguing, got my things, called my boyfriend and left (Olivia)”.
Category 3: The sexual division of labor and gender inequality as a result of patriarchy
The life stories of the women interviewed were crossed by the control of their desires and possibilities in the face of the father figure and, in general, the male figure within the family institution “My father said that he was already doing too much by letting me study and I was going to work? When my parents got married, my mother worked, he took my mother out of work, with the support of her own father (Solange)”.
The sexual division of labor could also be observed in the participants\' trajectories: “My brother told me: I\'ve made up my mind, I\'ve dismissed the caregiver and Mom is going to live with you, since you don\'t do anything, you\'re going to take care of her and take her to her treatments (Solange)”. However, Solange didn\'t accept the imposition and criticized the model of society structured on the sexual division of labor “I feel comfortable not having taken on that responsibility, but that\'s not what they expect of me, they expect the children to take care of their mother and I\'m bothered by society\'s judgment that I abandoned her”.
The roles and tasks to be fulfilled and determined by gender were configured in the narratives as constituents of the women\'s subjectivity, permeating their desires, dreams and relationships or love affairs: “We were friends, I wanted to have a child and I couldn\'t have it with someone else, so I decided to have it with him who was a friend and who said he liked me, but then I found out that I entered a hell there and I\'ve never been able to get out, I\'m still living in it today!” (Natalia)
For Olivia, the desire and joy of motherhood clashed with reality and the lack of social and family support “I wanted it too much, so you know when all the feelings come together: fear, joy, everything! I cried and screamed: I\'m pregnant. After giving birth, I almost couldn\'t sit down, I started crying and at the same time that I wanted my child, I didn\'t want it anymore, that despair wouldn\'t leave, I felt like disappearing, running away.”
In addition to motherhood, marriage also appeared in the narratives as an imposed task, to be fulfilled, socially charged and internalized by the women as a duty, as explained in Olivia\'s speech “At first, I was disgusted to kiss him, because I didn\'t like him and I didn\'t love him, but I didn\'t want to be alone, I wanted to get married before my sister, because I was older, I wanted to get married soon, I didn\'t want to be left to be the aunty”.
But the marriage didn\'t go as the women had hoped. For some of them, their partner was already practicing different types of violence right from the start. “It all went wrong, because after I had a child, he felt he owned me and then he started putting his foot on my neck (Natalia)”. From then on, the aggression intensified in different ways “It\'s hard to talk about what I experienced, because there were things I\'m ashamed of, you know? There are things that will die with me, because I\'m ashamed. I remember how many times I was attacked for not wanting to have sex! I feel disgusted by men, because I was forced to have sex many times feeling pain, sometimes menstruating, with a migraine, sometimes tired (Natalia)”.
In the relationship they experienced all kinds of violence, male control over their lives ranged from the physical to the psychological: “I couldn\'t put on make-up, put on lipstick, he\'d turn around and say I looked awful, I couldn\'t put on cream, the smell of the cream gave him rhinitis and he\'d complain, perfume no way! (Solange)”.
Also noteworthy was a case in which the aggressor invaded the participant\'s work with a gun to beat her “I was beaten by the father of my daughter, he came into my work with a machete and plunged it into my back (Tereza)”. This shows that women are subject to violence, especially in their homes, but also in all the spaces they occupy: on the streets, at work, among others.
In addition, there was one case in which the aggressor took advantage of the participant\'s income “I had a salary and it was a very good salary, but I didn\'t take possession of it, it was my husband who controlled everything (Solange)”.Property violence was also practiced in other ways: “He drank and hid my documents (Larissa)”.
The different types of violence experienced, the non-acceptance of separation by the aggressor and the fear of judgment and shame of being in that situation are factors that distanced the women from seeking help and protection in the services of the care network “I didn\'t go after it, because as I told you, there are events in my life that I\'m ashamed of. So I know about people\'s judgment, today there\'s a lot of openness to these things, there\'s TV advertising about help networks, these things; but all this happened well after, in that period and in the period before that, people think: \'he does it because she deserves it\', you know? (Natalia)”.
Category 4: Ethnic-racial difficulty as an offshoot of racism and a mechanism of social invisibility
The self-declaration of ethnic identity was a cause for attention, as the phenomenon of racial whitening became explicit, signaling the difficulty in identity recognition among women, as observed in one of Natalia\'s speeches “I\'ve always suffered a lot of bullying, all my life since I was a child, I suffered bullying because my nose is long, because my hair was short, because I have brown skin, but today I\'m browner than I used to be, I used to be considered white”.
When the individual doesn’t self-recognize as belonging to an ethnic/racial group, it becomes difficult to identify discrimination and prejudice, making racism invisible in society. This became clear in Larissa\'s speech when she was asked about this experience: "No, because I\'m light brown, right? Not even if I were dark, I don\'t think so (Larissa)." Since ethnic and racial identity is a social historical construct, the lack of definition of identity becomes an ideological strategy for dividing groups and contributes to their exclusion and silencing.
In this way, the experience of racism and xenophobia was only recognized by Natalia, who said in one of her speeches: "His (husband\'s) family never liked me, that I was black, to them I\'m black! They hate Northeasterners and I\'m from Bahia (Natalia)”. Solange preferred not to declare herself, but Avalon, Olivia, Tereza and Maria Julia did not directly address the issue precisely because they are white, which already places them in a situation of privilege and non-vulnerability in this axis of oppression, as Avalon critically pointed out : “I\'m a white person and I know that because I\'m white, I have privileges, I can enter places without fear of being judged, of being followed”.
However, Larissa, who declared herself to be brown, did not associate the influence of color in her difficult life trajectory, but her narratives made explicit the lack of opportunities and access to goods and services, including describing some work carried out in conditions analogous to slavery “I worked from dawn until dusk, every day, I had no salary, I earned a few bucks, I worked for food and medicine”.
Larissa also said that she spent a long time living on the streets "I was sitting there and a man said: Do you want to live at home? I accepted, because I was tired of living on the street”. The man who offered her a place to live was a man she had only just met, so, tired of surviving on the streets, she opted to take the risks inherent in this involvement, as long as she had somewhere to live.
DISCUSSION
From the point of view of social determination, subjects are social beings and, as they develop socially, their health-disease process is determined by the prevailing social structure. Thus, when analyzing the health-disease process, it is necessary to understand the historicity of life produced by subjects whose psychological and biological processes are subordinated to a certain model of economic, socio-cultural and historical organization.29
In this sense, the psychic, biological and social dimensions integrate the subjects, but the latter takes a hierarchical position, predominating and defining individual health-disease processes from the collective point of view. Under this logic, the social structure is not reduced to one of the risk factors, but is the element responsible for the dialectical totality which, depending on how it is organized, can produce health or illness.30
Gender and race have been incorporated into the intersectionality literature as interdependent axes of oppression along with social class. In general, in the face of the hierarchy and subordination imposed by patriarchy, women are more prone to different situations of violence and violation of social rights as it organizes and prescribes women\'s behavior and attitudes towards society, patterns which have an even greater impact on black women.21-24
These behavioural rules and norms shape women\'s social roles from an early age, with girls usually replacing their mothers in carrying out domestic activities and caring for other family members, and this process is crucial in the socialization of subjects and maintaining the place historically attributed to women.31 This means that women are in charge of so-called reproductive work, which is characterized by the reproduction and maintenance of the workforce. Against the backdrop of patriarchy, reproductive work can be associated with slavery, as marriage can make women the exclusive property of men.27
Patriarchy is understood as a system of organization in which the authority of the father (patriarch) over the woman and her children has historically been shaped by the construction of private property, thus becoming a structuring dimension in the exploitation and appropriation of women, legitimizing the power of men over women. Furthermore, it is through domination and control over women\'s bodies, work and lives that patriarchy serves two interests: control over offspring (more labor power and reproduction of wealth) and ensuring that offspring are “legitimate” (for the reproduction of inheritance).27,32
The sexual division of labor, which takes place within the family institution, but is not restricted to it, cannot be conceived solely as differences in activities and work carried out by men and women, as it builds and solidifies the mechanisms of women\'s subjection, structuring itself as the basis of hierarchical relations and inequalities. Being born a woman in a capitalist and patriarchal society such as Brazil is an indication of double subordination and exploitation, but if the woman is black it is tripled.27,31
In addition to social inequality and the sexual division of labor, this study also found that some women had difficulty recognizing their skin color, thus explaining the lack of identity recognition. Thus, self-declaration and racial identity were some of the points that came to the fore, along with the experience of racism, expressed through the experience of violence, lack of opportunities and processes of exclusion. According to Devulsky16, racial identity is learned throughout the socialization process, with color being one of the aspects involved in this definition, but not the only one, since identity is also linked to the exercise and guarantee of rights, as well as social advantages and disadvantages.
In this study, only two of the interviewees declared themselves to be brown and talked about life trajectories crossed by poverty and especially by the harshest forms of violence; however, one of them did not identify the impact of racism on her history. The difficulties and doubts about ethnic/racial identity make explicit the complexity and influence of historical and violent processes present in the construction and composition of racial identities, reaffirming Carneiro\'s17 thesis that racial/ethnic identity as a socio-cultural phenomenon can be historically constructed or destroyed.
In this way, Nego Bispo33 not only added new reflections on black resistance in the Brazilian context, but also included and reiterated his own life story as a form of representation in the anti-racist struggle. From the biographical and existential point of view of a quilombola, the author, with a theoretical background and daily experience of struggle and resistance against racism, argues that historicity has contributed to the breakdown of the identity of the black population in Brazil.
For this author, colonization was also a clear and planned strategy for distancing the population from their origins and culture, erasing their memories, hiding their initial meanings and imposing new ways of naming and living, thus deterritorializing subjects and peoples.34 Just as the colonizers replaced the different self-designations of the original peoples, they also did so with the African people, ignoring their differences and calling them blacks. This strategy of generalization was used not only to “domesticate” the different groups, but also to deprive them of their identities in order to finally dehumanize and objectify them.
The absence and/or denial of cultural identity was historically destroyed by the process of enslavement in Brazil, which stripped away the main sociocultural value bases of the African people, attacked their collective and individual identities and imposed a hierarchy of peoples, and historically the original “indigenous” peoples and blacks have been labeled as inferior beings, intellectually incapable, aesthetically ugly and with customs and cultures called savage.33
In present times, there has been a movement, as Nego Bispo33 calls it, of cultural resistance with new ways of reframing and reaffirming these identities in order to confront the ethnocide and prejudice experienced by these groups. However, this movement has not yet had the desired reach in society and there are people who do not identify with the characteristics of their group.
Racism dictates norms and discriminates against groups and people by hierarchizing them. It is therefore a way of organizing and structuring society across the board in all dimensions, thus configuring itself as a marker of privileges and subalternities between groups in the macro and micro-political fields of everyday life.35
In this way, the approach to women who have attempted suicide must take into account the intersectionality between gender, race and social class, seeking to break with the belief that the working class is homogeneous and ahistorical; on the contrary, it needs to be understood as a heterogeneous and socio-historical phenomenon made up of real people in concrete contexts permeated by relations of power and domination according to gender and race.27
From an intersectional perspective, the inseparability and structural interdependence of racism, patriarchy and capitalism, which mark the diversity that exists within the category of \'woman\', becomes visible, because as Lelia Gonzalez 36 argues, the abstraction of universalization contributes to covering up the reality experienced, and cruelly experienced, especially by black women, who are the most affected by all the dimensions of inequality.
Black women have greater difficulties in accessing health care, fewer opportunities for schooling and entering the formal job market, they are the most affected by the worst working conditions and the lowest pay, they are the ones who start fighting for survival from childhood and experience the perversity of child labor.36 Thus, the analytical proposal of the structural interaction of domination emerges as a way of incorporating legal political influences in unveiling the peculiarities of oppression on the different bodies and daily lives of women.21
We need to highlight Berenchtein Netto’s11 criticism by stating that when dealing with suicide, every attempt is made to keep people alive, but no attempt is made to understand why people seek death. Intersectionality is a tool that explains this gap in the motivations that lead women to seek death, revealing that social class, race and gender are categories of oppression that have permeated the subjectivity, bodies and experiences of women at a given historical and social moment.
Thus, the research question in this study: What do suicide attempts by women reveal about the social structure? It was answered by the narratives of the participants who denounced life trajectories marked by poverty, oppression, violence and racism as causes of psychological suffering and the search for death through suicide attempts. The capitalist, patriarchal and racist social structure that denies the existence of women through exploitation, invisibility and violence practices necropolitics.37
From the perspective of necropolitics, it is up to the state to establish the limits between the right to violence and death for a given population. Under the aegis of necropolitics, these limits are made more flexible according to the interests of capital, which classifies individuals and groups according to their capacity for social production. In this way, those on the margins of society are socially irrelevant and can be easily replaced and therefore killed. Necropolitics has the power to dictate which groups are allowed to live and which are allowed to die. In other words, not investing in social protection, gender equality and anti-racism policies is also a socially acceptable way of killing today.37
Suicide is one of the facets of necropolitics, because when the state does not interfere in these social markers, death becomes a viable horizon, a strategy to end the pain caused by the impotence of not being able to advance in the meritocratic steps of the system. By exposing these women to situations of extreme vulnerability, necropolitics, at the same time as exempting the absence of the state and of social determination and race and gender, individualizes and makes the phenomenon of suicide subjective.37
CONCLUSION
This research has made important contributions to the field of mental health from the perspective of the collective within the care provided to women. By the way of broadening the analysis of the socio-cultural and historical organization based on capitalism, patriarchy and racism and its relationship with suicide attempts by women, it has highlighted the lethality of the systems of oppression and exploitation to which they are exposed.
It is worth noting that this research is a qualitative and local study, and it is not possible to generalize its results, so it is important to carry out further studies that can reach other contexts and different intersections, such as the reality of trans women, indigenous women, quilombolas, women with disabilities and other diversities that are encompassed under the ‘woman’ category.
ACKNOWLEDGEMENTS
We would like to thank the women who took part in this study for sharing their life stories, shaping this research and, above all, for fostering new meanings in us, voices that echoed, teaching us about new ways of looking at the world, about care in freedom, about defending the SUS and the fight for a fairer and more equal society.
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