Transgender Day of Remembrance, observed annually on Nov. 20, was first celebrated in 1999 to honor the life and death of Rita Hester, a trans woman murdered the prior year, as well as to memorialize all transgender victims of similar hate crimes.
In the past 18 years, massive strides have been made in terms of the visibility of transgender individuals; however, several issues, ranging from discrimination and victimization to inadequate access to healthcare, continue to negatively impact the behavioral health of this population.
While about 10 percent to 25 percent of Americans suffer from depression at some point in life, depression rates are more than doubled in the trans community. What’s more, a study conducted by the American Foundation for Suicide Prevention found that almost 40 percent of trans individuals have attempted suicide. These findings may, in part, be explained by gender dysphoria, the distress occurring when someone’s birth-assigned gender differs from their gender identity, the sex they personally identify as.
Studies have shown that medical interventions, such as hormonal treatments and gender affirmation surgeries, aimed at aligning a patient’s physical sexual characteristics with their gender identity, can help ameliorate gender dysphoria and improve mental health outcomes. In one such study, the American Academy of Pediatrics followed adolescents through their transition process while simultaneously monitoring their mental health. They found that the transition not only alleviated gender dysphoria but also reduced rates of depression and anxiety, reaching levels of well-being similar to people of the same age in the general population.
However successful such interventions may be, they often present a significant financial challenge for a population that has higher unemployment rates, lower average incomes, and less social support when compared with the general public. Additionally, gender dysphoria is only one small factor influencing the behavioral health of trans individuals. Chronic stressors such as societal stigma and experiences of victimization and discrimination are thought to play a much larger role.
Until we work to ensure equality for every member of our community, with something as seemingly simple as using a public restroom or as significant as serving in the military, such stigma will likely persist and continue to negatively impact the mental health of trans individuals.
Austin W. Kollefrath is a third-year medical student and Samir A. Sabbag, M.D., is assistant professor of clinical psychiatry at the University of Miami Health System. Call 305-243-6400 to schedule an appointment with a mental health professional at UHealth.