Transforming transgender and gender diverse mental health care

Transgender and gender diverse individuals experience depression, anxiety, suicidal ideation, and suicide attempts at higher rates than people who are non-trans (cisgender).

If you are transgender, you do not identify with the gender you were assigned at birth. If you are gender diverse or non-binary, you may not identify solely with male or female gender, or with either gender.

Transgender and gender-diverse teens and young adults are twice as likely as gay, lesbian and bisexual teens and young adults to experience depression, suicidal thoughts or attempt suicide, according to a study. study published in 2020 in the Journal of Adolescent Health.

More than 81% of transgender people said they had had suicidal thoughts at some point in their lives, while about 48% had those thoughts in the past year, according to a 2019 study. report from the Williams Institute at the UCLA School of Law. About 40% of transgender people said they have attempted suicide at some point, while about 7% attempted suicide in the past year.

Many transgender and gender diverse people experience depression or anxiety because of their experiences.

Have you or a loved one ever:

• Have you felt distressed because your physical appearance does not match your gender identity (known as body gender dysphoria)?
• Have you felt upset because your family or friends do not understand or accept you?
• Did you feel disrespected because people didn’t use your name or pronouns when talking to you?
• Are you acutely aware of the social stigma associated with being transgender or gender diverse?
• Are you afraid of being rejected by your family, friends or peers?
• Dealt with rejection from your family, friends or peers?
• Are you concerned about being discriminated against or threatened with violence because of your gender identity?
• Have you been a victim of discrimination or violence because of your gender identity?

How gender-affirming therapy helps

Gender affirming therapy helps transgender and gender diverse people feel more deeply connected to their gender identity.

Us Gender Wellbeing Program provides gender therapy to individuals who are questioning or exploring their gender identity. We also provide gender therapy and support to transgender and gender diverse individuals undergoing social or medical transition.

Qualified gender therapists work with transgender and gender diverse patients to help them manage, reduce and learn the resilience associated with gender dysphoria. For many patients, getting a different hairstyle, changing their wardrobe, or learning to wear makeup feels good because it is gender affirming. We can discuss different parts of the body that the patient is uncomfortable with, and then figure out ways to make their appearance consistent with their gender identity. I can provide my patients with resources for gender-affirming products or accessories that will help them achieve that goal.

Gender therapists also spend a lot of time talking to patients about social transition. We can explore the answers to questions such as:

• How do you tell your boss about your gender identity?
• How can you be safe if you tell your family members?
• Would you like to tell your family members individually or as a group about your gender identity?
• Do you want to tell people face-to-face?
• Would email be better if you’re afraid of the response?
• Do you have a friend who you can stay with if your family throws you out or rejects you?
• Do you have a trusted friend to talk to when you experience stress or rejection?
• Do you know that guide lines like The Trevor Project And Trans Lifeline hotline are available if you have suicidal thoughts?

References to gender-affirming medical care

Our Gender Wellness program also refers patients to gender-affirming primary care providers. These providers provide judgment-free gender-affirming care to transgender and gender-diverse patients, and they can prescribe gender-affirming hormones.

According to the 2019 Williams Institute report, transgender and gender diverse people who have access to gender-affirming medical care are less likely to have suicidal thoughts and attempts.

For information about resources for transgender and gender diverse people, or to learn more about ChristianaCare’s Gender Wellness Program, call 302-623-6773 or email genderwellnessprogram@christianacare.org.

How to support transgender and gender diverse people

If you have a family member or friend who is transgender or gender diverse, the way you interact with them can have a positive or negative impact on their mental health.

Supporting and accepting the transgender or gender diverse person in your life can help reduce your risk of anxiety or depression. It is an immensely powerful and positive gesture for individuals in the transgender and gender diverse community when their families are warm and welcoming towards them after sharing details about their gender identity.

The best way to support people who are transgender or gender diverse is to affirm their gender identity. You make them feel more comfortable by:

• Using their pronouns. When speaking to them or about them, refer to them with the appropriate pronouns. If you’re not sure what pronouns they use, ask them. They will be happy to tell you.
• Using their own name. Address transgender and gender diverse people by the name they use when introducing themselves. They often do not use their birth name. If you’ve known them for a long time and they’ve changed their name, call them by the name they use now. It is disrespectful to call them by their birth name, which is sometimes called “dead naming.”

Family members who support transgender and gender diverse people have a powerful impact on their loved one’s mental health. When transgender and gender diverse individuals live with people who respect their pronouns, they are less likely to attempt suicide, according to the Trevor Project. 2023 U.S. National Survey of LGBTQ Youth Mental Health.

If you are in crisis or having suicidal thoughts and have no one to talk to, call one of these hotlines for help:

• The Trevor Project. A trained counselor who understands LGBTQIA+ issues will provide you with confidential crisis support anytime of the day or night, 24/7. Trained counselors are available via phone (866-488-7386), text (text “START” to 678-678), and online chat (visit https://thetrevorproject.org/get-help).
• Trans Lifeline hotline. A transgender person will provide you with confidential support over the phone (877-565-8860). They can talk or listen, and you don’t have to be in a crisis to make the call. They are available on workdays between 1:00 PM and 9:00 PM

Brett HerbDSW, LCSW, is the Pprogram Manager for the Gender Wellbeing Program. Call 302-623-7503 to schedule an appointment with Dr. Herb to plan.