This FAQ brings insight on what is impacting the health and wellness of the transgender and non-binary population. Overarching factors discussed here include discrimination, mental health, and disconnected identity. As a LGBTQ Life Coach, I help gender diverse folx from all over create their best life against the odds that they encounter.
Question: What discriminatory experiences do transgender and non-binary humans encounter?
According to reports from transgender and non-binary individuals, discrimination stemming from their gender identity is commonplace (Carpenter et al., 2020; Horne et al., 2022). Discrimination prevents transgender and non-binary individuals from equitable access to public accommodations, civil rights, and other freedoms. In an article by the American Civil Rights Union (2021) that is tracking U.S. legislation, over 90 anti-LGBTQ bills were introduced, pending, or passed at the state level.
One example of discriminatory legislation includes restricting adoption and foster parenting access to non-cisgender heterosexual couples. Other unfortunate examples of reported discriminatory acts include access to bathrooms, retail shops, wedding venues, and transportation (Horne et al., 2022). These are just a few examples of discriminatory factors to remember when studying and working with the transgender and non-binary population.
Question: Is it true transgender and non-binary identifying persons have higher mental health risks overall?
Unfortunately, yes. Transgender and non-binary individuals are at a higher risk of suicide, self-harm, and various other mental health issues (Strauss et al., 2017). This is due to the stigma around being LGBTQ+, dealing with microaggressions, discriminated against, and also internally battling with ones identity being mismatched with the sex chromosomes they were born into.
Structural stigma, where the prejudice is directed toward sexual and gender minority groups and restricts opportunities and resources for the stigmatized minority group, negatively impacts the mental health and wellness of those discriminated against (Horne et al., 2022). However, interpersonal, and individual stigmas also drive discriminatory acts that are not structural and increase microaggressions or encounters of transphobic acts. For example, gender-diverse people are more likely to experience neglect, homelessness, bullying, and abuse (Strauss et al., 2017).
These discriminatory events that stem from being in a stigmatized minority group are the driving force behind the reports of trans people wanting to self-harm or acting on the thoughts of self-harm, having suicidal thoughts, and attempting suicide. Additionally, other mental health problems such as eating disorders, anxiety, depression, low self-esteem, isolation, and substance use disorders (Carpenter et al., 2020; Strauss et al., 2017).
Question: What is it like for a transgender or non-binary individual to have a mismatching identity, and what does that even mean?
To start, a basic explanation of what transgender identities and non-binary identities are would help. Transgender is a term used to explain the experience a person has of their gender not matching the term used to describe their sex assigned at birth (Sevelius et al., 2021; Strauss et al., 2017). Non-binary is a term used to explain how a person does not identify with either end of the gender binary (cis-male and cis-female identities) but can be between both at any given time or of the gender binary altogether with their sense of gender aligning with none of the typical masculine or feminine characteristics.
To have a mismatched identity against the appearance of one’s body or when compared to the sex assigned at birth can cause anxiety, a sense of not belonging or being an outcast, and even create a sense of dysphoria (Carpenter et al., 2020; Sevelius et al., 2021). Gender dysphoria is best explained as the disturbance some transgender and non-binary folks feel when their gender identity is opposite of their assigned sex at birth causing significant distress or impairment as their expectations for their gender role and gender identity are not aligned with their sense of self (The National LGBT Health Education Center, n.d.) When the persons’ gender affirmation is not happening, the dysphoric feeling and sense of discomfort are elevated, and the fear of being mistreated and desire to be perceived the way they identify is so great that mental health deteriorates (Sevelius et al., 2021).
Question: How do we affirm someone’s gender identity?
Affirming someone’s gender identity is important to a transgender or non-binary person not only for respect to that individual but also for their mental health and to change public attitudes toward transgender and non-binary persons (Sevelius et al., 2021; The National LGBT Health Education Center, n.d.). Social gender affirmation will improve interpersonal relationships using gender-diverse person pronouns, clothing, name changes, and other non-medical interventions. However, medical gender affirmations will use hormone therapy and possibly even surgeries to help have the transgender or non-binary persons’ body match their identity to stop the sense of dysphoria they are experiencing.
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American Civil Liberties Union. (2021). Legislation affecting LGBT rights across the country. https://www.aclu.org/legislation-affecting-lgbt-rights- across-country
Carpenter, C. S., Eppink, S. T., & Gonzales, G. (2020). Transgender status, gender identity, and socioeconomic outcomes in the United States. ILR Review, 73(3), 573–599.
Gay and Lesbian Medical Association. (n.d.). Guidelines for care of lesbian, gay, bisexual, and transgender patients.
Horne, S. G., McGinley, M., Yel, N., & Maroney, M. R. (2022). The stench of bathroom bills and anti-transgender legislation: Anxiety and depression among transgender, nonbinary, and cisgender LGBQ people during a state referendum. Journal of Counseling Psychology, 69(1), 1–13. https://doi.org/10.1037/cou0000558
Strauss, P., Cook, A., Winter, S., Watson, V., Wright Toussaint, D., Lin, A. (2017). Trans Pathways: the mental health experiences and care pathways of trans young people. Summary of results. Telethon Kids Institute, Perth, Australia.
U.S. Department of Health & Human Services. (2018). Lesbian, gay, bisexual, and transgender health. Centers for Disease Control and Prevention.