A Brief Introduction to Transgender Mental Health

By Robin Litvins-Salter.

Content warning, this article has discussions of self-harm and suicide.

My name is Robin, and I work here at VMIAC as part of the Communications Team. I am a transgender woman and prior to my work at VMIAC, I was heavily involved within the space of transgender support and advocacy. This backstory should not be necessary, but in light of VMIAC’s “What If?” webinar this week being hosted by Sally Goldner, on the topic of “What If… all genders received equal and equitable mental health support?” I thought it was worthwhile writing a brief companion piece on transgender mental health and the effects of transphobia. What is Transgender? The first thing to look at when talking about transgender mental health is, we must understand what transgender is.

Transgender means someone is disconnected with the sex they were assigned at birth. That means their gender, which could be anything from male, female or an identity outside or in between these binaries, is different to what was assumed when they were born.

Our gender is something that is at the core of who we are, but for cisgender people – people who are not trans, though they may have issues with gender roles and expectations – there is still that inherent connection with themselves that they don’t often think about. The thing is, our gender affects a lot of our day-to-day life; from our sense of self, to who we identify and connect with, to our very core instincts. For transgender people, all of these things can come with our own challenges and hurdles as we try and fit in a binary world, which we have been given the wrong role in, or they may not be a fitting role at all. Transgender Mental Health Being trans is an experience that is historically tied to mental health services. The World Health Organisation only delisted gender dysphoria as a mental disorder last year and the DSM still classifies it as such. If you speak to trans elders, you will hear many stories of involuntary treatment for “sexual deviation” and the like, especially for those who started exhibiting signs in their childhood. Even today the federal government has refused to ban the practice of conversion therapies, palming off the responsibility to the states. But contrary to all of this, being transgender is not the reason why transgender people are over-represented in mental health services, nor is it the beginning and end of their experience.

Transgender people are over-represented in mental health services.

Most recent statistics state that around 35% of transgender people over 18 have attempted suicide, with the most common catalyst for this being experiences of discrimination and ostracisation.

Seeking help for transgender people can be extremely difficult as well. Social issues aside, one of the key topics transgender people will flag is that their access to medical and mental health care is greatly diminished. Doctors have often been quoted as saying “they don’t work with trans people”, or their “transness” is to blame for their various issues, and vice versa, even when they are completely unrelated problems the person is experiencing.

An example of such is; ‘you’re not trans, you are just depressed, or autistic, or bipolar, or ADD’. Alternatively people are also told they need to stop being trans to address these other issues. There are even many cases of physical ailments such as broken arms, being ignored with the same responses. This is especially pressing in times of emotional crisis.

The options for inpatient care can often mean people having their gender denied by a system that will ignore someone’s identity, for what’s on their birth certificate. Couple this systematic oppression with the social and economic hurdles a transperson is more likely to face, it is clear to see why transgender people experience much higher levels of mental health related issues. So What Do We Do? The answer to this is actually very simple. Let people be themselves.

Transgender people have been researched and investigated non-stop for decades now, and though the whole process is quite humiliating, we have some good data on how to improve the wellbeing of transgender people.

Gender dysphoria is treated by letting people embrace the gender they are at their core. Their gender, like for all of us, is a core part of our being and the sooner people are allowed to be who they are the better. Sure, their trans experience may impact their experience of mental health, as do all of our experiences; but it is never the symptom that needs to be treated, it is at worse just a compacting factor that affects the manifestation of mental health issues.

Letting people socially and medically transition will help their wellbeing and socially including trans people, will greatly affect their lives and health; even if that means we have to make some mild accommodations along the way.