Probing The Complexities Of Transgender Mental Health

[traci_k]

Probing The Complexities Of Transgender Mental Health

http://www.npr.org/sections/health-shots/2016/03/23/471265599/probing-the-complexities-of-transgender-mental-health

Health News from NPR

Updated March 23, 20164:38 PM ET Published March 23, 201610:21 AM ET
Tara Haelle


Experiencing the world as a different gender than the one assigned to you at birth can take a toll. Nearly all research into transgender individuals' mental health shows poorer outcomes. A new study looking specifically at transgender women, predominantly women of color, only further confirms that reality.

What's less clear, however, is whether trans individuals experience more mental distress due to external factors, such as discrimination and lack of support, or internal factors, such as gender dysphoria, the tension resulting from having a gender identity that differs from the one assigned at birth.
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Interesting read.

[suzifrommd]

What's less clear, however, is whether trans individuals experience more mental distress due to external factors, such as discrimination and lack of support, or internal factors, such as gender dysphoria, the tension resulting from having a gender identity that differs from the one assigned at birth.

Definitely a worthwhile question.

I've heard cisgender people declare that if society were more accepting, trans people wouldn't have to transition. I'm hoping this research won't be leading in that direction. It's a fundamental misunderstanding of why we transition.

[AnonyMs]

There seems to be an enormous gulf between what is blindly obvious to us, and the rest of society.

It would be a more interesting if the rates of mental distress were different to normal without all the other factors.

[Dee Marshall]

Definitely a worthwhile question.

I've heard cisgender people declare that if society were more accepting, trans people wouldn't have to transition. I'm hoping this research won't be leading in that direction. It's a fundamental misunderstanding of why we transition.

I had exactly that discussion with my therapist (a very good one, but I was her first trans client) before she agreed to write my letter. I told her that in my case, and that of many, but not all, the trans people I know (mostly all of you) that while being accepted is nice, even crucial for our mental health, living authentically is really the only thing that can greatly relieve our dysphoria.

One trans woman I know got pulled into the mental health system and is being medicated for depression, etc. Even though she knew that she's trans from a young age she was never brave enough to admit that she's trans to anyone, even therapists, until I came out to her.

Now she's trapped.

I'm absolutely convinced, and so is she, that actively transitioning would relieve many of her symptoms even if she really has bipolar disorder, but her psych team won't approve her transition until they get control of her symptoms. It seems backwards! She's so poor, as are many people in the system, that she can't afford to pay out of pocket as her local informed consent clinics would require. I worry that she might finally take that drastic step that she's threatened in the past.

I really need to find the money to finish my LMHC or even do a PsyD so that I can do this work myself!

[suzifrommd]

I'm absolutely convinced, and so is she, that actively transitioning would relieve many of her symptoms even if she really has bipolar disorder, but her psych team won't approve her transition until they get control of her symptoms.

This is why I believe that a system of gatekeeping, where therapists are given veto power over transition care, is not just paternalistic, patronizing, and oppressive, but is also dangerous.

[AnonyMs]

This is why I believe that a system of gatekeeping, where therapists are given veto power over transition care, is not just paternalistic, patronizing, and oppressive, but is also dangerous.

It is dangerous, but so is the opposite. Until society and everyone in it becomes perfect someone is always going to get hurt, the only question is who.

Obviously I don't want that to be me.

[Dee Marshall]

This is why I believe that a system of gatekeeping, where therapists are given veto power over transition care, is not just paternalistic, patronizing, and oppressive, but is also dangerous.

Sadly, an alternative exists where she lives, but her (state/federal) insurance won't cover it.

[Peep]

Definitely a worthwhile question.

I've heard cisgender people declare that if society were more accepting, trans people wouldn't have to transition. I'm hoping this research won't be leading in that direction. It's a fundamental misunderstanding of why we transition.

This! I see cis people asking all the time that if gender is fluid or 'meaningless', why we physically transition at all (as if life isn't easier for binary appearing cis or trans people - as if you could transition socially and not physically and expect to be 100% accepted in the today's society) or asking why we can't 'just wear mens clothes' but still have feminine bodies, names, pronouns... (or the other way around)

I feel like this comes from the fact that they tend to SEE more trans and NB people in the media but not invest time in listening or reading about us or our lives, and so the focus is often on physical appearance alone, particularly fashion choices

[Deborah]

as if you could transition socially and not physically and expect to be 100% accepted in the today's society) or asking why we can't 'just wear mens clothes' but still have feminine bodies, names, pronouns... (or the other way around)

That's actually a pretty good question that I don't know the answer to.  What I do know is that my brain/body feels in synch on HRT and out of synch not on it and that synchronicity grows as my body changes and I see and feel the changes.  What clothes I am wearing means very little. 

Before HRT clothes meant something but then only as a fleeting coping mechanism to fool my mind's visual image.  Even then it usually required alcohol to be effective.

So for me, and maybe others, being able to dress up without condemnation doesn't even begin to address the root issue.

Maybe part of the problem with public misunderstanding is the breadth of the current transgender definition.  It seems to cover a wide variety of different things that are often only peripherally related.

[Lilian J]

"I've heard cisgender people declare that if society were more accepting, trans people wouldn't have to transition."

This is an argument that often comes from 2nd wave feminists as well.

But I think it conflates "gender identity" and "gender expression".
Most elements of my transition are to do with my identity which is how I see myself and some of these lead to expressing an identity to others by signalling how I want to be treated but this is not their primary purpose.
I can easily say that every step for my identity has been positive, affirming and good for me whilst all my stresses and anxieties have been caused by the stereotypes that some others hold towards me.

Maybe a genderfluid, accepting society would be better and I would feel less pressure to transition or maybe just less pressure to pass but I would also like a unicorn as well and it ain't happening anytime soon.

[sparrow]

I've heard cisgender people declare that if society were more accepting, trans people wouldn't have to transition.

Hahahaha!

If people were more accepting of differences, we'd all fall into lock step!

Let's all erase transgender identities because they don't exist in a cisgender person's idea of utopia!

What lovely intentions they've got... try it again from the top, this time with understanding.

If society was more accepting, we wouldn't assign genders to our children, and they wouldn't have to transition!  You know.  Unless they want to as they age.  Genderfluidity can be rapid or have a glacial pace!

[Peep]

What lovely intentions they've got... try it again from the top, this time with understanding.

even if i hadn't been assigned a gender my body would still have grown things i didn't want it to and not grown other things, and I'd still see other non gendered humans with bodies different from mine, non gendered humans that don't have to menstruate, non gendered humans with flat chests and facial hair, and i bet i'd still have the dysphoria. it's absurd that they don't think these things matter at all but why would fabricated clothing matter to me more than my own physical body?

cis people want to live in a world where they can be ok with their bodies as they are because they are okay with their bodies as they are, and society wants them to change them (be skinnier muscular whiter etc), whereas i'm not ok with my body and society doesn't want me to change it

[Asche]

I've heard cisgender people declare that if society were more accepting, trans people wouldn't have to transition.

Left unsaid is "accepting of what?"

For some trans people, it would be enough for society to accept gender-nonconforming behavior.

For one trans man of my acquaintance, based on what he says when he talks about transitioning, complete elimination of sexism in academia and industry as of about 40-50 years ago would be needed.  He's nearing retirement age and just wants to get away from the gender that has been society's pretext for stunting his life.

In my case, it is conceivable that if my nature had been an acceptable way for male people to be, I wouldn't be trans at all.  But that would have had to happen 60 years ago.  By now, aversion to anything even remotely masculine, including my unbearably masculine anatomy and appearance, has become part of who I am.

However, all of that is really moot.  Society is the way it is and shows no signs of being less gender-policed.  Cis people can afford to build fantasy universes, as they don't have to spend a large part of their time and energy simply defending their right to exist.  We trans people don't have that luxury, we have our hands full just figuring out how to survive in the world as it is.

I'm hoping this research won't be leading in that direction. It's a fundamental misunderstanding of why we transition.

There is no one "why we transition."  People transition for a wide variety of reasons.