Improving Transgender Mental Health Through Education, Awareness, and Support

The Golden Globe-winning television series Pose depicts the diversity, strength, and exuberance of the transgender (trans) community. Its popularity has helped viewers understand the real-life challenges of its characters and cast.

While Pose and other media are raising the profile of trans actors, too many trans people continue to face struggles that can impact both their mental and physical health. As we recognize the International Transgender Day of Visibility on March 31, we must work to dismantle the barriers to health that many trans people still face.

According to recent Centers for Disease Control and Prevention (CDC) estimates, 27.9 percent of Americans surveyed between December 29, 2021 and January 10, 2022 reported symptoms of anxiety disorder. However, among people identifying as transgender, the figure was nearly double — 50.4 percent. And according to the 2015 United States Transgender Survey (USTS), Black transgender individuals are eight times more likely to report psychological distress than the general population. Additionally, more than 30 percent of Black transgender individuals report negative experiences when seeking health care.

A History of Discrimination

Transgender individuals can be challenged to find meaningful employment because of discrimination on several levels, says Lisa Phillips, LCSW, (pronouns they/them). Philips is the lead therapist at Morris Home, a residential drug and alcohol facility in Southwest Philadelphia for transgender people facing chronic homelessness. For example, they may lack appropriate documentation (a legal name change can be expensive), which can create barriers to finding both employment and safe housing, Phillips says.

These difficulties, combined with stigmatization and higher-than-average rates of violence toward transgender individuals, cause financial and social hardship and lead to higher rates of homelessness and substance abuse.

A Health Care Challenge

It was only in 2019 that the World Health Organization removed “transsexualism” as a designated mental disorder and coined the term “gender incongruence” as a classification in the category of sexual health problems. Another challenge that trans people face is access to gender-affirming mental health providers, Phillips says.

Clinicians unfamiliar with working with transgender people can perpetuate harm by misgendering them or making assumptions about a person’s lived experience. Some transgender individuals have been rejected by their families and feel isolated; some cisgender clinicians may not be checking for such issues or assessing appropriately.

Clinicians who are unfamiliar with the transgender experience may overemphasize gender identity when the real medical issue is something else, like depression or an eating disorder. Phillips notes, “A lot of times, when a transgender person is going to see a medical provider, the burden falls on the client to educate the clinician about their experience. That can create mental stress and detract from the quality of care.”

And making a gender-affirming transition can be a lengthy and expensive process. “For trans people that medically transition, there is a great deal of gatekeeping and limited resources, especially for trans communities in more rural or conservative areas,” they say.

A Diverse and Vibrant Community

On the International Transgender Day of Visibility, Phillips encourages people to educate themselves by reading about and listening to the trans community on social media and other sources.

“We have a lot to learn from trans people,” they add. “Trans communities have found creative and brilliant ways to survive, thrive, and create spaces of safety and joy in a culture that has actively sought to exclude trans experiences.”

If You Need Help

The Trans Lifeline provides peer support at 1-877-565-8860. For more information about depression, self-care strategies, and where to find help, visit ibx.com/knowyourmind.

If you, or someone you know, is in immediate distress or is thinking about hurting themselves, call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK (8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide Prevention Lifeline website.