Transgender woman

People who are transgender (trans) and gender-diverse have an increased risk of anxiety and depression. However, for a variety of reasons, finding help may be difficult. People in the LGBTQ+ community often have specific mental and physical health care needs that need to be respected and addressed.

Learn more about the risk factors, how to find accepting mental and behavioral health care, and other steps you can take to improve your mental health.

Higher Risk for Anxiety and Depression

People who are trans and gender-diverse have a higher risk of anxiety and depression than those who are cisgender (Cis refers to people whose gender identity matches the sex they were assigned at birth).

A 2021 study found that college students who are trans were twice as likely to have depression and anxiety than cis students. Students who were trans were also four times more likely to attempt suicide than students who were cis.

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Why Trans and Gender-Diverse People Face Higher Risk for Anxiety and Depression

There are many reasons trans and gender-diverse people can be at a greater risk for anxiety and depression. These include:

Discrimination

Transphobia is dislike or prejudice against people who are trans and gender-diverse. It includes discrimination against transgender people in seeking jobs, finding housing, or just going about everyday life.

Transphobia can make it hard to find a job or a safe place to live. These problems can also contribute to anxiety and depression.

Stigma

Stigma refers to a social belief that someone is not worthy of respect because of their identity or health. Those who identify as transgender are more likely to feel stigma if they live in an area with fewer trans and gender-diverse people. Research has found that experiencing stigma can increase the risk of depression and anxiety.

Microaggressions

Microaggressions are subtle actions that cause emotional pain to others. For those who are transgender, such actions can include someone intentionally or unintentionally using the wrong pronoun or not using a person’s chosen or affirmed name. The impact of microaggressions can build up over time.

If microaggressions happen often enough, they can contribute to depression and anxiety.

Reduced access to care

Members of the trans and gender-diverse community can struggle to find care providers who can help them access gender-affirming care. Lack of gender-affirming care and the inability of a trans or gender-diverse person to live as their authentic self can increase stress and the potential for discrimination.

Gender dysphoria, distress related to the incongruence between assigned sex at birth and gender identity, is associated with depression and anxiety. Gender dysphoria is experienced by some trans and gender-diverse individuals, but not all. Being able to access gender-affirming care can help with dysphoria, depression, and anxiety and increase mental well-being, according to a 2018 study. However, even after receiving gender-affirming care, some people who are trans and gender-diverse may still have an increased risk of depression.

Protecting Your Mental Health

You can take steps to look after your mental well-being.

Build a social support community

One of the strongest positive factors for mental health is feeling socially connected to others, according to a 2021 study. Another 2020 study found that social support reduced the depression symptoms that those who are transgender felt from microaggressions.

Building a social support network means finding and building friendships with people who support and care about you and respect your identity. You can find support by reaching out to local organizations for trans and gender-diverse individuals. You can find a list of some local organizations and resources here.

Seek affirming care

Some people who are trans and gender-diverse may feel uncomfortable seeking health care because of past negative experiences or discrimination. But it’s important to get care when you need it. You can take steps to find supportive and respectful healthcare that meets your needs.

Use local LGBTQ+ resources to find doctors who provide respectful, affirming care. For example, staff should ask patients their pronouns and chosen name. Doctors should feel comfortable giving you care at all stages of your transition.

The UPMC Children’s Gender and Sexual Development Program provides resources and more information about gender-affirming care.

Learn more about UPMC Resources for LBGTQ+ patients and caregivers.

Sources

A community-based study of demographics, medical and psychiatric conditions, and gender dysphoria/incongruence treatment in transgender/gender diverse individuals. Biology of Sex Differences. October 6, 2021. Link

Associations Between Transgender Identity, Sleep, Mental Health and Suicidality Among a North American Cohort of College Students. Nature and Science of Sleep. March 16, 2021. Link

Enacted HIV-Related Stigma's Association with Anxiety & Depression Among People Living with HIV (PLWH) in Florida. AIDS and Behavior. Link

GLAAD Media Reference Guide - In Focus: Covering the Transgender Community. GLAAD. Link

Guidelines for Care of Lesbian, Gay, Bisexual, and Transgender Patients. Gay & Lesbian Medical Association. Link

Mental Health and Life Satisfaction on Chilean Gay Men and Lesbian Women: The Role of Perceived Sexual Stigma, Internalized Homophobia, and Community Connectedness. Journal of Homosexuality. Link

Mental Health and Substance Use Diagnoses and Treatment Disparities by Sexual Orientation and Gender in a Community Health Center Sample. LGBT Health. May-June 2021. Link

Negative Healthcare Experiences, Healthcare-Seeking Behavior, and Mental Health in Tampa Bay Area Transgender and Gender-Nonconforming Individuals. Southern Medical Journal. June 2021. Link

Quality of Life in Transitioned Trans Persons: A Retrospective Cross-Sectional Cohort Study. BioMed Research International. April 12, 2018. Link

Relationship of Internalized Transnegativity and Protective Factors With Depression, Anxiety, Non-suicidal Self-Injury and Suicidal Tendency in Trans Populations: A Systematic Review. Frontiers in Psychiatry. May 20, 2021. Link

About UPMC Western Behavioral Health

UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. UPMC Western Psychiatric is the hub of UPMC Western Behavioral Health, a network of nearly 60 community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors throughout western Pennsylvania.