Transgender+ Communities and Mental Health

person carries transgender flag streaming behind them

The term transgender, or trans+, is an umbrella term for people whose gender identity is different from the sex they were assigned at birth. There’s an infinite spectrum of identities and labels that people may relate to. Some trans+ people are men or women, while others identify as both, neither, or somewhere in between. Gender is complex and can only be determined by the individual themselves.

Learn more about various gender identities from Human Rights Campaign’s Transgender and Non-Binary People FAQ.

The trans+ community has grown over recent years – it’s estimated that over 2 million transgender and non-binary people live in the United States today. This number will likely continue to rise as younger generations are increasingly accepting of gender exploration. In fact, youth make up the largest demographic of the transgender community in the U.S. – 18% of trans+ individuals are age 13-17.

Around 1.4% of youth ages 13-17 and 5.1% of young adults ages 18-30 are trans+/nonbinary.
Across the U.S., the transgender population has a similar racial and ethnic breakdown as the general population.

Mental Health Challenges in the Trans+ Community

Being trans+, nonbinary, or questioning your gender isn’t a mental health condition, but many trans+ individuals face mental health challenges due to social attitudes toward their identity. It’s hard to feel mentally healthy when you feel unsafe. Unfortunately, the trans+ community faces consistent physical and emotional dangers in today’s world at higher rates than the cisgender population, including:

Misgendering

Misgendering occurs when someone uses a pronoun that does not reflect the gender identity of the person they are speaking about. Oftentimes, this is done accidentally and is not intended to be offensive. Other times, misgendering is done on purpose to harm transgender people. Misgendering someone sends the message to that person that their identity is not valid. Being consistently misgendered has been linked to a diagnosis of PTSD.

Lack of support

Lack of support among family, friends, classmates and/or coworkers can have a significant impact on a transgender person’s mental health. This can include social rejection, discrimination, and verbal or physical harassment. Studies show that transgender people who experience more discrimination from family members show higher levels of psychological distress.

Transphobic legislation

Transphobic legislation has caused significant distress in the trangender community, particularly among young people. Since 2021, there has been a record-breaking number of anti-LGBTQ+ bills proposed. Nearly half of the bills have been aimed at transgender people. These bills are damaging to transgender people’s mental health since they limit their rights, safety, and access to gender-affirming care. The passing of transphobic legislation is linked with a higher number of transgender people seeking suicide information and help.

Barriers to legal identification

Barriers to legal identification can make it stressful and potentially dangerous for a transgender person to show their ID. Some states forbid gender marker changes on IDs. Other states make it very difficult to get a gender marker changed. Nearly 1 in 3 transgender people who presented an ID with a name or gender that did not match their presentation were harassed, denied services, or attacked.

Mistreatment by the health care system

Mistreatment by the health care system often leads transgender people to avoid receiving care. Studies show that when transgender people delay receiving care because of non-inclusive medical providers, they are more likely to show signs of a mental health condition.

Financial insecurity

Financial insecurity is common among transgender people because of discrimination they face in educational and occupational settings. Studies show that 25% of transgender individuals have an annual household income of less than $25,000. The same study found that 79% of transgender individuals in the U.S. are food insecure. These financial barriers increase stress for transgender people, and also make it more difficult to afford quality mental health care.

Discrimination, Hate, and Harassment

93% of transgender and nonbinary youth said that they have worried about transgender people being denied access to gender-affirming medical care due to state or local laws.
37% of transgender and nonbinary youth reported that they have been physically threatened or harmed due to their gender identity.
71% of transgender and nonbinary youth reported that they have experienced discrimination based on their gender identity.
Due to Black trans+ women facing multiple forms of gender oppression in combination with racial oppression, they are at higher risk than other population groups to experience multiple forms of violence throughout their life. This is called polyvictimization and is associated with increased symptoms of depression and PTSD.

Suicidality

According to a three-part study of over 11,000 transgender people of all ages, the lifetime rates of suicidal ideation and self-harm are significantly higher among transgender folks than their cisgender peers.
82% of transgender individuals have considered suicide, and 40% have attempted to take their own life.
86% of transgender youth reported feeling suicidal, and 56% reported a previous suicide attempt.

Affirming Trans+ Identities

Everyone expresses their gender in different ways and has varying parts of their identity that are really important to them. This could be their clothes, haircut, name, pronouns, or anything else that makes them who they are. Feeling supported in being yourself is important for anyone, but especially for marginalized populations. Validating a transgender person’s self-defined identity is a great – and essential – way to support them.

Protecting Trans+ Mental Health

Gender-affirming health care. Transgender adults who began hormone treatment in adolescence had fewer thoughts of suicide, were at lower risk for serious mental health conditions, and had fewer challenges with substance use than those who started hormones in adulthood.
Trans+ community connection. Feeling connected to the trans+ community is linked to improved mental health – as well as increased access to care, supported identity exploration, and an informed transition process.
Family support. Transgender youth who have grown up and socially transitioned in affirming households have similar or only slightly elevated rates of anxiety and depression when compared to their cisgender peers.
School support. Inclusive school policies (like allowing trans+ youth to participate on the sports teams and use the bathrooms that align with their identity) are related to transgender+ students feeling higher levels of belongingness at school.

Trans Resources

Crisis

Trans Lifeline
1-877-565-8860 (United States)
1-877-330-6366 (Canada)
A 24/7 hotline available in the U.S. and Canada staffed by transgender people for transgender people. Confidential, 24/7 crisis support.

Trevor Lifeline
1-866-488-7386
Crisis Intervention and suicide prevention phone service available 24/7/365.

TrevorChat
Confidential online instant messaging with a Trevor counselor, available 24/7.

TrevorText
Text START to 678-678
Confidential text messaging with a Trevor counselor, available 24/7/365.

SAGE LGBT Elder Hotline
1-877-360-LGBT (5428)
Talk and be heard at the SAVE LGBT Elder Hotline. Connects LGBT older people and caretakers with friendly responders for confidential support and crisis response 24/7.

The LGBT National Youth Talkline
800-246-7743
Youth serving youth through age 25.