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Mental Health

I would be lying if I said I hadn’t put off writing this page. The intersection of transness and mental health is a topic near my heart, and the research that went into this page was bleak, to say the least. The first thing I want to do is issue a massive trigger warning, I am going to be talking about sensitive topics like mental illness, abuse, self-harm, suicide, violence, and more.

First things first, being trans is not a mental illness. Some trans people do not struggle with their mental health. Some have mental health issues that are not related to being trans, and for others being trans factors heavily into their mental health.

The Bad News

I'd like to begin by sharing some statistics about the mental health crisis facing trans people. These statistics are all taken from the past few years in the United States. Before we dive in fully, another reminder that we will be talking about potentially triggering content.

  • 82% of trans people have reported contemplating suicide

  • 40% report attempting suicide at least once in their life

    • Of these 40% the highest suicidality was among youth

  • 15% of trans youth report engaging in self-harm

  • Trans youth are 4-5x more likely to be hospitalized as a result of self-harm/suicide attempts when compared to their cisgender peers

  • Trans people are more likely to have a psychiatric diagnosis compared to the general population

  • Some mental health conditions are more common among trans people

    • Mood disorders (depression, bipolar disorder)

    • Anxiety disorders

    • Borderline personality disorder (BPD)

    • dissociative identity disorder (DID)

    • obsessive-compulsive disorder (OCD)

    • Schizophrenia

    • Schizoaffective disorder

    • Attention deficit hyperactivity disorder (ADHD)

    • Autism spectrum disorder (ASD)

    • Some learning disabilities (i.e. dyslexia)

  • Trans people are at higher risk for pretty much everything (substance abuse, homelessness, being victims of physical and sexual abuse, sexually transmitted infections, and eating disorders)

  • More than half of out trans people in K-12 environments reported verbal harassment

    • 1 in 4 reported being physically attacked

    • 1 in 10 reported being sexually assaulted

Why?

There are two main sources that contribute to the poor mental health reported by trans people. The first and most influential is the societal implications of trans identity. The other is the dysphoria experienced by some trans people.

Reason #1: SOCIAL ASPECTS

  • The stigma around being trans

  • Discrimination

  • Microaggressions 

  • Harassment/Bullying

Social stigma and minority stress can cause trans people to feel unwanted and overwhelmed. This can lead to them attempting to cope with the unhealthy behaviors brought up before (substance abuse, eating disorders, self-harm, and suicidality). The social stigma that trans people face can be exacerbated in school environments. In general, trans youth are overwhelmingly represented as victims of bullying both in person and online. Trans youth often find it difficult to come forward about bullying, and those who do can find it harder to be believed or to have action taken about it.

 

Trans people face untold discrimination, even if they haven’t been the direct victim of it, trans people live in a world that equates trans life with suffering. It is indescribably difficult to see the only mass media representation of your community be obituaries. When you grow up with this narrative, it seems like your destiny is to die young. It instills you with fear, you can never feel fully safe and it is exhausting. 

 

Politics of discrimination do not end at trans issues. Intersectionality is an important thing to acknowledge. We have to recognize the intersectionality of identities such as race, ethnicity, sexual orientation, ability, and socioeconomic status, and address the unique challenges faced by individuals with multiple marginalized identities.


 

Reason #2: GENDER  DYSPHORIA

 

Many trans people experience gender dysphoria, the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics. Gender dysphoria can lead to other mental health difficulties like anxiety, depression, sadness or sense of loss, negative self-image or poor self-esteem, PTSD, shame, and social isolation. Living with gender dysphoria is not easy. The one place you can never get away from, your body, feels like a prison. The mirror becomes your enemy, especially before you can medically transition.

The Good News/How To Help

Learning what you just learned, it may seem like there isn’t any good news but there is. 

Because of what we go through, trans people show tremendous strength and resilience. Elijah Nealy, a trans therapist, had this to say in his book Trans Kids And Teens: Pride, Joy, And Families In Transition: “How many people do you know who are this dedicated to their own mental health and well-being? How many people do you know who are so strong in their own self-determined sense of themselves that they can withstand ongoing harassment from others…” Side note, this book was a great read, I would recommend it to anyone who wants to know more about doing mental health work with trans youth.

 

A contributing factor for trans mental health issues is isolation. Just like everyone, trans kids want to feel like they belong. Having even one supportive adult decreases risk factors experienced by LGBTQ+ youth and lowers the odds of them reporting a suicide attempt in the past year. We don’t need the world, we need you. Being an ally saves lives.

As I mentioned, a distressing part of being a trans kid is only seeing trans adults suffering, while it is not always possible, knowing a happy trans adult has a strong positive influence on trans kids. In my experience, connecting with peers who share the same identity also has a positive influence on the mental health of trans people. Having somebody who understands how you feel makes the trans experience less lonely. 

 

Gender dysphoria can be alleviated in many ways without or before medical transition. Things as simple as a haircut, a new wardrobe, and using the right name and pronouns make living with dysphoria a lot easier. Going further, access to transitional healthcare makes a world of difference. Trans people who are given access to medical transition report drastically improved mental health and quality of life. Even non-trans healthcare helps, seeing a mental health professional is wonderful, especially if that person specializes in gender identity. 

 

The best way to avoid reaching a crisis point is by taking preventative action and seeing a mental health professional for maintenance. 56% of LGBTQ+ youth in the US reported wanting mental health care but being unable to access it – one reported reason was fear that a therapist would not understand their identity. In an attempt to remedy this, I have used PsychologyToday’s resources to compile trans-friendly therapists and psychologists by state. The document can be found here. These lists are non-exhaustive and more research can be done into finding a therapist that best fits your/your child’s needs.


 

In cases of crisis, there are places to turn to. The Suicide Prevention Hotline services everyone, The Trevor Project is a 24/7 lifeline that specializes in crisis and suicide prevention for LGBTQ+ youth, and the Trans Lifeline also helps with crisis intervention, but it does not operate 24/7. The Trevor Project also runs TrevorSpace, a community of LGBTQ+ people ages 13-24 that allows community members to make friends with people like them. 

If you or someone else is an immediate danger to themself or others, call 911 or go to the nearest hospital.

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