Being transgender is not a mental illness. But people who are transgender face unique challenges, such as gender dysphoria and discrimination, which can affect their mental health. Getting support and assistance from a qualified provider can bring healing and help you live a healthier, more fulfilling life.
Healthcare providers assign a baby a sex at birth. Babies may be assigned female at birth (AFAB) or assigned male at birth (AMAB) based on their external physical genitalia. The term “cisgender” describes people who identify as the gender that matches their assigned sex. (For example, if you’re born biologically female and you identify as female, then you're cisgender.) But for some people, as they grow up and understand themselves better, they find that their gender doesn’t match their assigned, biological sex.
The definition of transgender is evolving with new generations. The term “transgender” falls into the broad category of “gender diverse.” A person who identifies as trans may be:
A person who is intersex has biological characteristics of both sexes. Some, but not all, intersex individuals identify as transgender. The two terms aren’t interchangeable.
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Some trans individuals don’t experience mental health issues at all. Others have mental health issues that aren't related to being transgender. But for some, mental health and gender identity are related. Generally, this isn’t due to being transgender, but to the social stigma that often exists.
Transgender children, adolescents and adults often face discrimination and other challenges in society. If you’re transgender, you may feel unwelcome at home, school, work or in social settings. More than half of transgender students who are out (publicly open about their transgender status) in K-12 school experience verbal harassment. One in 4 experience a physical attack, and more than 1 in 10 are sexually assaulted.
Among transgender adults, almost half report being verbally harassed in the past year. And 1 in 10 are physically attacked or sexually assaulted in a given year. Trans people may also experience:
As a result of these painful and traumatic experiences, 39% of trans individuals report experiencing severe psychological distress. By comparison, only 5% of the general U.S. population report this type of distress.
No. Being transgender (or trans, for short) isn't a mental health disorder. If you’re transgender, it means that you have a different gender identity than the one you were assigned at birth. (Gender identity is defined as the personal sense of one’s own gender.) The desire to convey your gender in the way you feel most authentic is a normal aspect of human expression.
Gender dysphoria is a condition that affects many transgender people before they transition (begin living as their authentic selves). It describes a sense of unease regarding the mismatch between assigned sex and gender identity — and it can occur at any point during life, from childhood to adulthood. Left untreated, gender dysphoria can lead to severe emotional and psychological distress.
Gender dysphoria can lead to other mental health challenges, including:
The social stigma that many trans people face can cause them to feel unwanted or overwhelmed. They may try to ease these feelings with harmful behaviors that can result in:
If you or someone you know is experiencing suicidal thoughts, seek emergency help. The National Suicide Prevention Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, seven days a week, at 800.273.8255.
If you need help for a substance use disorder, SAMHSA’s National Helpline, 800.662.4357, offers confidential, free help in English or Spanish, 24 hours a day, 365 days a year. It provides referrals to local treatment facilities, support groups and community-based organizations.
Research indicates that transgender people are somewhat more likely to have a psychiatric diagnosis. The most common are anxiety and depression. But some conditions are more common among trans people, including:
The first step often includes finding a mental health provider you trust. You or your trans child may feel more comfortable with a provider specializing in transgender issues. Sharing details about your life with someone who understands your needs can help you heal faster.
If you experience gender dysphoria, you may wish to explore options for expressing your authentic gender identity. Your mental health provider can help you work through concerns and come up with a plan. Doing so can help you feel more confident and move forward with your life.
You can support your own mental health by:
Your mental health is critical to your well-being. It’s important to find a provider with whom you can speak openly. There are many ways to search for providers:
You can also reach out for help to trusted national organizations. These include:
A mental health provider can help you understand and find healthy ways to explore or express your gender identity. They can provide individualized care to help you:
If your child has gender dysphoria, you can help them find comfortable, healthy ways to express their identity. Family and youth support groups can be helpful. It’s also important to find a healthcare provider who can support your child’s overall well-being.
Some children and teens wish to prepare for hormone therapy or gender-affirming surgery when they are older. Some want to change their name, pronouns or the bathroom they use at school. Others prefer to express their gender difference at home but not in school. Let your child lead the way. The most important thing is to support your child and listen to their needs.
This is a highly personal decision. You’re the only one who can decide what’s right for you. While some people choose gender-affirming surgery, it isn’t necessary if you don’t want it. Many trans individuals feel they can represent themselves — and maintain healthy self-esteem and self-image — with a nonsurgical approach.
Nonsurgical transition may include:
If you're considering surgery, therapy may be an insurance requirement. Speaking with a mental health provider can help show that you:
Having a mental health issue is often a lonely experience. The first thing you can do is to let your loved one know you're there for them. Even if you don’t know the specifics of their struggles, this simple act can make a difference.
Here are some other steps you can take:
A note from Cleveland Clinic
Mental health is a state of well-being that everyone deserves. If you're transgender, you may face gender dysphoria and discrimination, which can affect your mental wellness. Many trans individuals can experience anxiety, depression, sadness and isolation. Receiving help from a mental health professional who specializes in gender identity can help you feel better. They work with you to get to the source of negative feelings. They can also assist you in progressing toward your affirmed gender identity.
Last reviewed by a Cleveland Clinic medical professional on 10/10/2021.
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