Mental Health Challenges for TGD Patients
Mental health challenges can be a foremost concern for TGD youth and their families. According to a 2019 report from the Centers for Disease Control and Prevention (CDC), “Almost 2% of high school students identify as transgender, and of those 27% felt unsafe at school, 35% had been bullied at school, and 35% had attempted suicide in the past year.” These are staggering statistics, particularly when compared to their cisgender peers. Hall also shares that her TGD clients experience bullying and social struggle, anecdotally, at higher rates than her cisgender patients.
With such alarming mental health disparities, how can TGD youth get the support they need? “Of course, a significant challenge is finding providers who are trained in the field and have education about gender-affirming care,” Hall says. Since many areas of the U.S. lack informed providers, TGD people can face discrimination, misconceptions, and stigma when they do seek care. Until the 1970s, homosexuality was classified as a psychiatric disorder by the American Psychiatric Association (APA). Public and medical understanding of gender identity has lagged behind that of sexual orientation, and misconceptions about transgender patients prevail to this day, including assumptions of mental illness and disorder.
With the aim to correct these harmful misconceptions, the APA issued a statement in 2012 asserting: “Being transgender or gender variant implies no impairment in judgment, stability, reliability, or general social or vocational capabilities; however, these individuals often experience discrimination due to a lack of civil rights protections for their gender identity or expression.… [Such] discrimination and lack of equal civil rights is damaging to the mental health of transgender and gender variant individuals.” Hall agrees that discrimination is what leads to the mental health challenges faced by TGD people. “Because of things like bullying and harassment, and because people are often experiencing gender dysphoria or body dysphoria, emotional distress happens, all of which can trigger anxiety and depression,” Hall explains. “Those are natural and understandable responses to what’s going on in their lives.”
As pediatrician’s check in with patients for signs of mental health distress, Hall also suggests keeping track of the developmental milestones that their patients are experiencing. “Puberty, for example, is an important moment to keep an eye on,” Hall explains. “A lot of hormonal changes are happening and body dysphoria can develop or worsen during this time.” Pediatricians’ understanding of these pivotal developmental moments is yet another strength that positions them to provide gender-affirming care.