Understanding the Intersection of Gender Identity and Mental Health

Photo by Alexander Gray.

Gender identity significantly influences mental health for both cisgender and transgender individuals. Currently, there is much controversy surrounding the definitions of transgender, gender nonbinary, and gender fluid. In this post, I will refer to both transgender individuals and all gender-variant people collectively as transgender. This controversy often stems from misinformation and politically motivated, transphobic forces aiming to undermine the civil rights and career opportunities of transgender people.

Cisgender women also experience discrimination and face economic and political oppression. The current political climate has intensified conflicts between certain self-proclaimed feminists and transgender women regarding their participation in sports competitions. If we can temporarily set aside the political, legal, and financial implications of gender identity, we can delve into how gender identity influences, and is influenced by, mental health. This post will explore some of these concepts.

Understanding the Increased Risk of Mental Health Issues from Gender Identity

The heightened risk of mental health issues does not occur in a vacuum. Research indicates that transgender adolescents and adults face a greater likelihood of mental health challenges; however, much of this distress arises from social rejection and a lack of acceptance of transgender identities, rather than an inherent predisposition to mental illness. Conditions such as depression, anxiety, post-traumatic stress disorder (PTSD), suicidal ideation, and substance abuse may all stem from environments that expose individuals to rejection, violence, bullying, and oppression.

A critical component of depression is a lack of self-efficacy—the belief that one can effect change in their life rather than being at the mercy of others' actions. This is a crucial aspect of personal development, but it becomes challenging if one is consistently bullied, harassed, criticized, and rejected by peers, all while lacking support from adults in their lives. Such experiences severely hinder the development of a solid sense of self-efficacy.

During childhood and adolescence, individuals rely on adults to instill the confidence and competence necessary to harness their power. This is difficult to achieve when they receive persistent messages that they are inferior to their cisgender or male peers. In extreme cases, these feelings of inadequacy can lead to a sense that life is not worth living, compelling individuals to seek avoidant coping strategies, such as self-harm or substance abuse, to escape the pain and emptiness.

Anxiety and PTSD can also emerge from a profound sense of helplessness when facing threatening stressors. Those targeted by various forms of oppression, violence, and societal erasure often grapple with the question of whether these mental health conditions result from their experiences of rejection and oppression, or whether some individuals possess an inherent predisposition to develop such conditions.

What Causes the Mental Health Issues Regarding Gender Identity?

There's no evidence that gender variance predisposes a person to mental health conditions. Depression and anxiety can be inherited from biological relatives regardless of their gender identities, and these conditions can be exacerbated by adverse childhood events such as poverty, abuse, neglect, and family dysfunction.

However, what the clinical literature on mental health often fails to address is how responding to unjust societal conditions—including racism, sexism, homophobia, and transphobia—impacts mental health outcomes. Gender dysphoria, discrimination, and internalized oppression are the main mental health concerns from gender identity.

Gender dysphoria occurs in less than 0.1% of the U.S. population and is a significant source of mental distress. This condition is characterized by the feeling that one’s gender does not align with their physical body. Many experience discomfort with specific body parts, such as genitals, breasts, and body hair, which feel incongruent with their gender identity.

Unfortunately, access to procedures that align one’s body with their gender identity can be limited by financial constraints and the availability of medical professionals specializing in gender-affirming care. Insurance coverage for gender-affirming care is often inadequate. Consequently, those unable to access or afford these changes may experience profound distress from inhabiting a body that feels misaligned with their gender identity.

It’s important to acknowledge that some individuals also experience gender euphoria—a state of affirmation and pride in their gender identity. This occurs when one transcends negative societal messaging and feels genuine satisfaction with their gender.

Oppression and gender dysphoria can be taxing on your mental wellbeing. Photo: Baliente Agency

Discrimination, as previously mentioned, can also be a significant source of stress. Being unable to pursue opportunities, such as flying a plane or joining the military, due to one’s gender identity can be disheartening. Additionally, barriers to employment, healthcare (especially reproductive and gender-affirming care), financial resources, and community support can contribute to extreme stress. This stress can accumulate over time, leading to either acute events or gradually diminishing resilience. Although the impact may not be immediately dramatic, it cumulatively exacts a heavy toll and can result in the internalization of negative treatment from others.

Escaping internalized criticism can be challenging, whether it stems from harsh caregivers or systemic messages linked to aspects of identity such as race, gender identity, class, or physical ability. It’s difficult to shake off feelings of inferiority, especially if they have been ingrained over time. Even if you consciously reject these beliefs, they can seep into your self-concept on a subconscious level. This may make it feel natural to speak negatively about yourself or accept disrespectful treatment, as you have mentally and emotionally internalized those messages.

What Can You Do to Improve Your Mental Health If Your Gender Identity Is an Issue?

If you resonate with any of the concerns outlined, LGBTQ therapy can provide valuable insights and help you heal in a supportive environment. It’s essential to note that being transgender or LGBTQ+ is not a mental illness; however, the societal treatment you experience can significantly affect your mental health. I would be honored to assist you in healing, thriving, and embracing your gender identity, alongside all other facets of your being. Please don’t hesitate to call me or click the button below.

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