Transgender and Mental Health

 Mental for transgender : What to know

Transgender and gender-nonconforming people (TGNC; people who do not identify with their assigned sex at birth, i.e., gender- minority people) experience interpersonal, structural, and cultural discrimination that has significant negative effects on their physical and mental health.

Some mental health conditions are more common in transgender people. Treatments, including hormone therapy, may help alleviate symptoms of mental health issues, though not everyone wants these.

Mental health in transgender

A study in the American Journal of Preventative Medicine notes the difference between markers of mental health in cisgender people of college age and gender minority people. In this context, gender minority means those who identify with a gender other than they were assigned at birth.

In general, gender minority people seem to have a significantly higher prevalence of mental health symptoms.

According to this study, gender minority people are more than four times as likely to have at least one mental health problem compared with their cisgender counterparts.

Possible mental health disorders include:

• depression

• anxiety

• self-harm

• eating disorders

• suicidal thoughts or tendencies

A similar study in BMC Public Health also found that transgender people were more likely to experience reduced life satisfaction and increased signs of loneliness.

There are a number of reasons why this may be the case.

Unique challenges

There are many contributing factors why transgender people may face more mental health conditions than other groups.

Overall, transgender people may have increased stressors throughout their lives than their cisgender peers when it comes to sexual orientation and gender identity.

These stressors may include:

• rejection from family

• rejection by loved ones

• low self-esteem

• poor coping skills

• body image issues

• poor sexual satisfaction

• avoidant behaviours

The effect of these stressors throughout life may contribute to lower mental health.

Loneliness may also play a role in mental health issues.

A study in the Journal of Clinical Medicine notes that social loneliness was the main predictor of poor mental health in transgender people.

In transgender men, specifically, romantic loneliness appears to be the strongest factor. The study associated higher levels of loneliness with lower levels of mental health.

As loneliness may be more likely in transgender people, its effects may manifest as poor mental health.

Societal expectations may also play a role. Social attitudes to gender expression can vary greatly from one place to the next.

Because of this, transgender people may face

discrimination throughout their lives. They may experience:

• possible violence

• personal prejudices

• social stigma

These factors can influence the negative mental health aspects that transgender people sometimes experience.

The stigma surrounding both mental health and gender minority identities may also keep people from reaching out or seeking help.

This silence itself may reduce the access a person has to support and may promote a cycle of needing help, feeling bad for needing help, and feeling even worse because of this trap.

Mental health effects in transgender people

Mental health issues may affect transgender people differently than their cisgender peers, especially if the

person does not have access to gender-affirming treatments.

Treatments that affirm gender identity may help ease symptoms, while treatments that deny someone’s identity may not.

Mental health issues may also affect transgender people differently than cisgender people if they do not have access to a proper support system.

Whether from their peer group, family, or general population, acceptance of a person’s gender identity may be a big step toward improving their mental health.

Drugs, hormones, and mental health

Gender-affirming hormone therapy (GAHT) involves giving a person with gender dysphoria safe doses of hormones to help them transition to their true gender identity.

A review in Current Psychiatry Reports notes that overall, GAHT has positive psychological impacts on

both adolescents and adults.

GAHT reduces symptoms of mental health issues, such as anxiety and depression, reduces markers of social stress, and improves quality of life and self-esteem.

Hormone therapy is often an integral part of alleviating gender dysphoria and may be key to treating underlying mental health issues.

It is important to note that while many transgender people choose GAHT to help affirm their gender identity, not all transgender people will opt for or even desire this treatment.

How to support people during transition

As a friend or family member of a transgender person, it may be difficult to imagine what they are going through during transition. A cisgender person may never completely understand the process or difficulty a transgender person faces during these times.

Crucially, friends and family members of a transgender

person can aim to be supportive.

Creating a gender-affirming environment in a familial or social setting may help ease gender dysphoria. It may also make it easier to facilitate treatment for underlying mental health conditions.

As part of this supportive role, it may help to:

• become educated about transgender issues and solutions

• use the person’s favoured pronouns and name

• keep the lines of communication open

• listen without being judgemental

• avoid making assumptions about someone’s sexual preferences, gender roles, or desire for treatment

• advocate for transgender rights

It can take time to adjust to a person’s identity as they transition, and the change may produce reactions, judgments, or confusion.

Mental health professionals and support groups may offer tools and resources, not just for the transgender person undergoing the transition, but for those close to

them, as well.

Treatment

As the National LGBT Health Education Centre note, the mental illness and mental health of a transgender person are entirely separate from the fact that they are transgender. Proper treatment will reflect this.

Gender dysphoria, or the feeling or stress of a person not having the same gender identity as the sex they were assigned at birth, is a mental health disorder, according to the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5).

While many transgender people may struggle with gender dysphoria, and seek treatment for it, having a transgender identity is not the same thing. It is not in the DSM-5, as it is not a form of psychopathy.

For most people, affirming their gender identity through gender-affirming health practices and treatments can treat their feelings of gender dysphoria.

Some people will need hormone therapy and surgery to

fully alleviate their gender dysphoria, while others may not need either.

In many cases treating gender dysphoria may reduce signs of mental health issues, such as depression and anxiety.

Properly treating gender dysphoria can reduce the stressors on a transgender person and help them focus on any underlying issues.

While focusing on gender-affirming treatments, mental health specialists can also diagnose and treat any other underlying mental health issues, such as depression, anxiety, or eating disorders.

Treatment for individual mental health issues can vary greatly. Therapies may include a combination of prescription medications and various forms of psychotherapy.

It is essential that these treatments also integrate gender-affirming environments and therapies that support favourable outcomes in transgender people.

Summary

Transgender people face unique mental health issues, and working towards a solution is a delicate process.

Some drugs and hormone therapy may alleviate stressful symptoms, though not every transgender person will choose these options.