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Understanding mental health in the transgender community

Written by Deb Thorp, MD

Mental health challenges are common. In fact, one in five people will experience a mental illness like depression or anxiety. But unfortunately in the transgender community, that number is even higher at nearly one in two. Even worse, 41 percent have attempted suicide.

It’s important to know, though, that we can help. And that starts with educating ourselves and offering support.

What does it mean to be transgender?

Typically, transgender means your gender identity does not fit the physical sex with which you were born. Sex implies binary or “two.” But the reality is we are on a spectrum, or “range.”

What transgender definitions should we know?

Using the correct terms isn’t always easy. “Transgender,” “trans” and “trans*” are all widely accepted terms for implying all forms of trans identity. That is, when they are used as adjectives. You should never refer to someone as “a transgender.”

A person may identify with many more specific terms, though, underneath that umbrella. GLAAD provides a robust list of different identities and their definitions. Also included is a list of terms that should not be used or are outdated. Don’t assume how someone identifies, though. Be sure to be thoughtful and ask what they prefer.

Is being transgender a mental illness?

No. For years though, gender identity disorder was listed as a sexual dysfunction. This was right alongside homosexuality. It was also improperly linked to pedophilia. It was in the early ‘70s that homosexuality was no longer classified as such. But the concept of being transgender was removed only recently.

Now, mental health professionals have a better understanding of the challenges that members of the transgender community face. Being a transgender person is not a mental illness. But a transgender person may experience an emotional condition known as gender dysphoria. This can happen if the discomfort with one’s physical self is very distressing. It is most commonly experienced prior to a person transitioning. And it can cause dysfunction in their day-to-day activities like work or social events.

Why are mental health challenges more common among trans individuals?

When a person decides to transition, it’s obvious. And unfortunately, not everyone is understanding.

The individual may be bullied and not accepted by their loved ones as they transition, and after. And they may face medical insurance issues, too. The anticipation of these barriers might even cause someone to believe that they have no realistic path to transition.

There is a high level of emotional pain that can come with transitioning. And there is a high level of emotional pain that can come with continuing to live with gender dysphoria. This pain (just like the pain that comes from living with any chronic disease) is what can lead to depression and anxiety. And it is these mental illnesses that can make a person feel like they have no way out and have thoughts of ending their life.

How can someone help a loved one who is transgender?

Be really supportive. Help them get into seeing a mental health professional – especially someone who is confident in helping their clients work through gender identity issues. These services include mental health providers who specialize in LGBTQ help. But they also cover the wide range of what someone might need.

Knowing what to say or not to say is a common concern I hear from loved ones. If you accidentally use the wrong pronoun, apologize. But don’t dwell. Keep in mind that being transgender is not their entire identity. Really, just treat them like any other friend. Ask the questions that you would ask anyone else, like, “How are you doing?” Or if they are in distress, ask, “How can I help?” You would never pry into the details of someone’s gastric bypass, colonoscopy or pap smear. In the same way, don’t ask trans people about their transition surgery.

You can find more tools and resources for helping a loved one on This campaign works to end the stigma that surrounds mental illnesses. That’s a big part of what prevents people from getting the help that they need.

Remember, if things feel too overwhelming, the trained crisis counselors at CommUnity are here to help. You can reach out to our 24/7 crisis phone or text lines, or if you need to speak to someone in person, our 24/7 Mobile Crisis team.
Call/Text: 1-855-325-4296
Mobile Crisis Outreach: Call 1-855-800-1239 and ask to speak with Mobile Crisis.