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Transgender Mental Health

Transgender Mental Health

This material has been reviewed for accuracy by: Renee Albers, PhD

Young person holds a transgender pride flag against a clear, blue sky.The 1999 film Boys Don’t Cry tells the true story of Brandon Teena. Brandon Teena was a transgender man who was raped and murdered by two of his former friends after they found out that he was transgender.

Advocates have used his story to embody the continuing struggles faced by transgender people.

One of those struggles could be mental health. Members of the trans community often face discrimination, rejection by their families, and constant bullying. These struggles can lead to long-term mental health challenges, including depression, post-traumatic stress syndrome and other psychiatric conditions.

Transgender Depression

 The statistics describing depression in the transgender community are sobering.

Nearly half of transgender individuals suffer from depression and/or anxiety, according to Psychology Today.

A 2019 study published in the American Journal of Preventive Medicine found that students who identify as transgender, gender nonconforming, genderqueer, and nonbinary were over four times more likely to have at least one mental health problem compared to cisgender students.

Hand holding a transgender symbol in a crowd of people in a city street.According to the Trevor Project’s 2019 National Survey on LGBTQ Mental Health, more than half of all trans and non-binary (those who experience a gender identity that is neither exclusively male or female or is in between or beyond both genders) young people have seriously considered suicide. In fact, of those transgender and nonbinary individuals subjected to “conversion therapy,” nearly 6 in 10 youth reported a suicide attempt.

The discrimination that transgender individuals face on a daily basis can be triggered by an act as simple as going to the bathroom. The survey reported that 58% of transgender and non-binary youth said they were discouraged from using a bathroom that corresponds to their gender identity.

Violence Against Transgender Women of Color

In the TV series “Orange is the New Black,” actress Laverne Cox plays a transgender woman who encounters violence while serving time in prison. While this situation played out on a TV show, it is not fiction.

According to the Human Rights Campaign (HRC), in 2019, at least 27 transgender or gender non-conforming people in the U.S. were killed, in some cases by people with a “clear anti-transgender bias.” The majority of those killed were Black transgender women.

“While the details of these cases differ, it is clear that fatal violence disproportionately affects transgender women of color – particularly Black transgender women – and that the intersections of racism, sexism, homophobia, biphobia, transphobia and unchecked access to guns conspire to deprive them of employment, housing, healthcare and other necessities,” wrote HRC in its report.

Gender Transition and Transgender Depression

Transitioning to the gender an individual feels born to is both a social and medical process, according to the University of California San Francisco’s “Transition Roadmap.”

Social transitioning may include presenting in public in your identified gender, coming out to people you know, and changing your legal documents to reflect your chosen name, gender identity, and pronoun used.

Medical transitioning may include hormone therapy and gender-affirming surgeries. Trans people who didn’t have access to hormone therapy were four times more likely to experience depression than trans people who did have access to gender-affirming medical care.

A study published in the American Journal of Psychiatry showed that when trans individuals chose surgical options, they weren’t as likely to utilize mental health treatment in the subsequent years.

Participants were six times more likely than their cisgender peers to be diagnosed with a moodor anxiety disorder and were also six times more likely to have been hospitalized for suicidal ideation. After surgery, however, the study found that trans folks were 8% less likely to utilize mental health treatment for mood or anxiety disorders per year since having surgery.

Gender-Affirming Mental Healthcare

Pride parade with people holding signs asking for transgender rights.Discrimination for transgender individuals doesn’t end when they seek mental healthcare. In fact, nearly 20% of respondents in the National Transgender Discrimination Survey: Adversity Related to Gender Identity, reported they were refused care due to transgender or gender-nonconforming status. Additionally, 28% of respondents said they postponed necessary medical care when sick or injured due to discrimination.

Healthcare providers need to ensure a safe and welcoming space for their trans patients. The National LGBT Health Education Center at the Fenway Institute included this list of tips for health care providers and their teams in its webinar Meeting the Health Care Needs of Transgender People:

  • “Be non-judgmental, open, professional”
  • “Be an ally. Educate yourself so you are trans friendly in your field of expertise.”
  • Include “assigned sex at birth,” “current gender identity” and “EMR flags indicating trans patients” on intake forms
  • “Call people by preferred name/pronoun”

Those struggling with trans-specific issues can reach out to the Trans Lifeline or 877-565-8860. This trans-led organization connects trans people to the “community, support, and resources they need to survive and thrive.” The hotline has been used nearly 100,000 times since its inception in 2014.

For more information about this important topic, please visit our LGBTQ+ page.

Our articles are for informational purposes only and are reviewed by our Medical Information team, which includes PharmDs, MDs, and PhDs. Do not make any changes to your current medications or dosing without consulting your healthcare provider.

The GeneSight test must be ordered by and used only in consultation with a healthcare provider who can prescribe medications. As with all genetic tests, the GeneSight test results have limitations and do not constitute medical advice. The test results are designed to be just one part of a larger, complete patient assessment, which would include proper diagnosis and consideration of your medical history, other medications you may be taking, your family history, and other factors.

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