Trigger warning: Mention of suicide, self-harm, eating disorders, gender dysphoria,
I felt it was necessary to create a separate blog post specifically about mental health problems in the transgender community because although (similarly to what was discussed in the prejudice section) there are commonalities that they share with the sexual minorities, the dimension of gender results in differences in what kind of problems are exhibited and why they occur.
Brewster, Velez, Breslow & Geiger (2019) did a study on body image in transgender women. They found that trans women are critical towards their bodies for two reasons: they are women, and they are transgender. Sexist and anti-transgender ideas are directed towards them and often internalized, causing them to have negative views towards their body. They may try to slim down and gain a smaller, more stereotypically “womanly” figure by engaging in unhealthy eating patterns. The researchers found that having an eating disorder was highly related to anti-transgender discrimination, sexual objectification, internalization, and body dissatisfaction in transgender women. This is evidence which supports Meyer’s (2003) minority stress model. It also shows that body image is an important factor in transgender individuals’ mental health- something that studies about sexual minorities rarely touch upon.
o These effects are mirrored in Smalley, Warren, and Barefoot’s (2016) study (explained more fully in the post on mental health issues in the LGBTQ+ population). The researchers found that transgender females were more likely to engage in unhealthy dieting. They also had the riskiest lifestyles, and the transgender community in general was more likely to engage in self-harm, compared to sexual minorities. Even worse, a large portion of the trans individuals who participated in the study reported that they routinely avoided medical care. This is hardly surprising, considering that physicians are less likely to discuss LGBTQ+ identities with patients in general, but especially in terms of gender identities (Kitts, 2010). It’s easy to see how transgender individuals could feel neglected by the healthcare system.
A study by Butler, Horenstein, Gitlin, Testa, Kaplan, Swee & Heimberg (2019) examined whether undergoing a GAMI (gender-affirming medical intervention- such as genital surgery, or hormone therapy) influenced social anxiety in trans and gender nonconforming individuals. They found that social anxiety was heightened in transgender individuals who desired a GAMI but were unable to get it or had yet to get it. They also found that transgender individuals who had already received a GAMI had lower levels of social anxiety. These results are interesting when compared with information from a study by Lefevor, Boyd-Rogers, Sprague & Janis (2019), which investigated differences in mental health across different identities within the trans community. These researchers admit that binary transgender individuals (FTM trans, MTF trans) experience relief after transitioning. However, since genderqueer individuals tend to go for a more androgynous nonbinary look, individuals with this identity may not feel a desire to transition. They are often treated more harshly by society because they refuse to limit themselves to femininity or masculinity. The researchers accordingly found that genderqueer individuals had higher levels of self-harm and victimization than binary trans individuals. However, both groups were far more prone to mental health issues than cisgender participants.
Before discussing the last study in this post, it is important to know what gender dysphoria is. I’m fairly certain it’s defined in the Terminology section, but just in case I shall also include a definition here. Simply put, gender dysphoria is “a condition where a person experiences discomfort or distress because there's a mismatch between their biological sex and gender identity” (Source). Morris and Galupo (2019) found that non-suicidal self-injury was used by members of the transgender community in an attempt to decrease gender dysphoria. They would engage in behaviors like cutting themselves, performing self-surgery, banging parts of their body, stabbing themselves with needles, and so on. Two common types of answers were reported. The first (which has already been mentioned), is that these injuries were used to deal with gender dysphoria- disconnection from the body. These injuries can sometimes be seen an attempt to change the body such that it better fits with their internal state, or as a reaction to being mislabeled, or as a result of being treated poorly because they are trans. The other common type of answer was that it was a way to distract oneself from chronic illness- to take back control of their body.
From all of these studies, we can see that gender dysphoria is an issue which differentiates transgender mental health from the mental health of sexual minorities. The transgender community is an understudied population in psychology. LGBTQ+ research is experiencing a boom right now, but even so transgender identities are still relatively overlooked. When they are studied, the transgender community is often lumped together with sexual minorities. After reading this blog post, it should be clear that there are important differences which should be parsed out between sexual minorities and gender minorities in research.
The following video is a Ted Talk about gender dysphoria and the effect it can have on mental health.
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