Transgender people often encounter stigmatization, oppression, and discrimination, which can all contribute towards adverse mental health outcomes.

The term transgender refers to a person with a gender identity or expression that differs from the cultural or conventional expectations based on the sex a doctor assigns them at birth. It is an umbrella term that can describe people who identify as non-binary, genderfluid, and genderqueer. It can also include those with no gender, multiple genders, or other gender identities.

People who identify as transgender have higher rates of mental health complications than those in the general population due to stigma and discrimination. In addition to a higher prevalence of mental health issues, transgender people typically experience barriers to healthcare, such as refusal of care, violence, and a lack of provider knowledge.

This suggests that these experiences, and not being transgender itself, may predict and contribute towards mental health difficulties.

This article will discuss mental health conditions prevalent in the trans community and provide a list of resources where people may find support.

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The World Health Organization (WHO) states that transgender people, and other gender minorities, comprise roughly 0.3–0.5% (25 million) of the global population. The WHO adds that transgender people often experience disproportionately high levels of mental health conditions.

They note that cissexism, discrimination, violence, and barriers to healthcare can all contribute to the increased chance of mental health concerns.

Research suggests that transgender individuals are almost four times as likely as cisgender people to experience a mental health condition.

The U.S. Transgender Survey reveals that many of the respondents frequently experience mistreatment and discrimination. Of the respondents, 39% report serious psychological distress, compared to just 5% of the general United States population.

Furthermore, 40% of respondents noted that they had attempted suicide in their lifetime, which is nearly nine times the attempted suicide rate in the U.S. This is consistent with findings from the 2019 Trevor Project National Survey, which notes that more than half of transgender and non-binary youth have seriously considered suicide.

Depression is a mood disorder that involves a persistent feeling of sadness and loss of interest in activities that used to bring joy. A 2018 paper suggests that transgender people can have a nearly 4-fold increased risk of depression. This is consistent with a 2015 study noting that transgender youth have a two- to three-fold increased risk of mental health outcomes, such as depression.

Transgender youth face further health disparities, as they are twice as likely to experience depressive symptoms, seriously consider suicide, and attempt suicide compared to cisgender lesbian, gay, bisexual, queer, and questioning youth.

The 2019 Trevor Project National Survey adds that more than 2 in 3 transgender and nonbinary youth report symptoms of major depressive disorder.

It also highlights that more than half of transgender and non-binary youth have seriously considered suicide. Of the respondents, 29% had attempted suicide. A 2021 article notes that factors such as barriers to care, victimization, and cissexism.

Anxiety disorders refer to a group of mental health conditions that cause persistent or recurring feelings of nervousness and worry. A 2016 comparative study suggests that transgender people experience more significant anxiety symptoms and have a nearly threefold increased risk of probable anxiety disorder.

Stressors can contribute to the development of anxiety. Research highlights the role of gender dysphoria, gender incongruence, and internalized cissexism in contributing toward anxiety.

Transgender people are likely to experience minority stress. This refers to chronically high levels of stress that people within stigmatized minority groups face.

Transgender people may experience this in the form of environmental stressors, such as exposure to discrimination, interpersonal stressors, such as expecting discrimination, and personal stressors, which may reflect internalized cissexism.

Research notes that expecting rejection is a frequent and noticeable stressor for trans individuals. Findings indicate that exposure to several social stressors contributes to mental health problems.

Substance misuse includes the use of illegal drugs and the inappropriate use of legal substances, such as alcohol. A 2021 investigation indicates that substance use disorder diagnoses are significantly higher among transgender adults than cisgender peers.

Risk factors for substance use disorders are considerably higher for trans individuals. A 2020 systematic review suggests that cissexism, discrimination, violence, unemployment, sex work, and gender dysphoria likely play a role in the higher prevalence. Trans people may turn to certain substances as a coping method to attempt to deal with the intense stresses of daily life.

Self-esteem typically refers to how positively a person views themselves. This can reflect their self-image, accomplishments, and success. A 2018 study notes that in addition to anxiety and depression, transgender youth are at an increased risk of developing low self-esteem.

A 2014 study notes that trans people may experience low self-esteem due to experiencing gender dysphoria and incongruence. A 2020 study adds that trans individuals who are comfortable with their appearance and gender identity have more self-esteem.

This emphasizes the importance of supporting others to feel comfortable with their appearance and accept their gender identity to improve mental health.

Eating disorders refer to a range of conditions that involve abnormal or disrupted eating. Research suggests that LGBT individuals experience a greater incidence of eating disorders. A 2015 study indicates that eating disorders are more prevalent among transgender people.

A 2016 study emphasizes that disordered eating behaviors are widespread among transgender youth. Another 2016 study also suggests that transgender youth are more likely to engage in unsafe weight management behaviors than their cisgender peers.

In addition to the stigma and discrimination that trans people experience, body dissatisfaction may also contribute toward disordered eating. A 2019 study notes that many trans individuals may engage in disordered eating behaviors for gender-affirming purposes.

The barriers and difficulty that trans people experience when trying to access gender-affirming healthcare may further add to this.

While mental health complications are more prevalent among transgender people, support is available. People may want to consider:

  • Therapy: People may want to seek help from a therapist who supports trans and gender nonconforming individuals.
  • Healthcare: Similarly, people may only want to work with doctors who support and affirm trans identities.
  • Advocacy groups: Joining local transgender advocacy groups may enable people to feel welcome and part of a community.
  • Community: Establishing connections with other trans or gender nonconforming people can help dispel stereotypes and stigma.
  • Activism: Involvement and taking pride in trans identities can spur activism and may help with confidence and a sense of identity.
  • Identity: People can choose when and to whom they disclose their trans identity. No person is under any obligation to tell someone else about their identity.

Additionally, the Gay & Lesbian Alliance Against Defamation provides a comprehensive list of resources for transgender people. Some organization that can provide help include:

Click here to learn more about available mental health resources.

Transgender people can use national hotlines to access free, confidential assistance from trained professionals. Available 24 hours per day, these hotlines may benefit anyone experiencing difficulties with their mental health or those who want or needs to speak about their feelings.

There are also online messaging and text-based support options available for those who may not be comfortable talking on the phone or discussing their emotions verbally.

If a person believes that someone is at immediate risk of suicide, they should call 911 or a local emergency number. People should attempt to supply as much accurate information as the emergency services require.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Transgender people are more like to develop mental health conditions than other people. They are also more likely to contemplate and attempt suicide. Many factors, such as stigma, discrimination, and oppression, contribute to these adverse mental health outcomes. These factors can also present barriers to healthcare options.

However, support options are available. People may be able to find support and advocacy from several organizations. Additionally, trans people should attempt to find therapists and doctors who support and affirm trans identities.