Understanding The Mental Health Of Transgender Athletes
Content Warning: Please be advised that the below article mentions topics like suicide. If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available 24/7.
If you're an LGBTQ+ youth or young adult in crisis, contact The Trevor Project hotline by calling 1-866-488-7386 or texting "START" to 678-678. You can also use their online chat.
Involvement in sports can be a confidence booster, a self-care outlet, and a way to meet new people. For athletes, however, it often means much more. In addition to serving as a passion, an individual's sport of choice might be their career, way through college via an athletic scholarship, or way of life. However, transgender athletes often face several barriers that their cisgender counterparts don't.
Understanding these barriers and how they might affect transgender mental health can be essential, whether you identify as trans or cis. As anti-trans legislation is passed worldwide, opening the door to conversations about fair and trans-welcoming policies and opportunities can be vital.
Understanding the mental health of trans athletes
Mental health has been a taboo and untouched topic for some athletes throughout history and in recent years. Stigmas about mental health can have a significant impact, regardless of whether an athlete is transgender or not, as it can lead to emotional repression and other consequences.
The rate of depression seen in college athletes ranges from 15.6% to 21%, and the prevalence of depression and anxiety among elite athletes is 34%. Furthermore, athletes often face a higher risk of eating disorders—another prevalent concern in the transgender community.
Statistics on mental health in the transgender community show that transgender people face a heightened risk of the following conditions.
Substance use disorders
Research shows that transgender people face a higher risk of substance use disorders (SUDs).
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.
Depression and anxiety
Compared to the general population, transgender people are as much as six times more likely to experience a mood or anxiety disorder. Major depressive disorder (MDD), generalized anxiety disorder (GAD), and social anxiety disorder may be the most common in this population.
Post-traumatic stress disorder (PTSD)
Transgender people are more likely to be diagnosed with post-traumatic stress disorder (PTSD). This increased risk may be due to a higher prevalence of trauma, including but not limited to an increased risk of intimate partner violence and adverse childhood experiences.
If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.
If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
Eating disorders
Statistics indicate that around 54% of LGBTQIA+ adolescents have been diagnosed with an eating disorder and that an added 21% suspect they may have met the criteria at some point in time. Furthermore, 67.2% of gender-nonconforming and transgender adults report basing self-worth on weight.
Suicide risk
Statistics on transgender and non-binary youth aged 13 to 24 show that over 50% of transgender and non-binary youth within this age range have seriously considered suicide. Transgender adults also face a higher risk of suicide when compared to the rest of the general population.
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Difficulty sleeping
Rates of stress and difficulty sleeping are also more prevalent among transgender people. A lack of sleep can be a risk due to its connectivity to cardiovascular disease, diabetes, and poor health. However, athletes who compete at various levels may be particularly concerned about the impact of physical and emotional stress or difficulty sleeping on their participation in their sport of choice.
What barriers do transgender athletes face?
Minority stress and discrimination play a significant role in the increased risk of various mental health conditions for trans people, which may be increased for trans athletes. Not only do transgender people face discrimination in housing, the workplace, and at school, but transgender athletes face a significant amount of discrimination in athletics.
Hundreds of active youth and adult sports bans affect transgender athletes who play sports. You can keep track of this legislature on the Freedom for All Americans website. Attempts to ban transgender athletes from participating with the team that best aligns with their gender are not supported by science.
Trans athletes may have more to consider compared to cis teammates. Not only do serious athletes in both individual and team sports strive to be at their personal best when engaging in athletics, but many trans and non-binary athletes face the fear or reality of being restricted from engaging in their sport due to their identity. With lower rates of stable housing, employment, food safety, and the various health risks encountered by cisgender and transgender athletes alike, transgender athletes may face an extraordinary range of co-occurring challenges.
Gender-affirming care, supported childhood social transition, the correct usage of pronouns, and opportunity to change one's legal gender marker or name are all affiliated with lower suicide risk and other improved mental health outcomes. Participation in sports can also improve mental health outcomes. It can be vital to push back against anti-transgender legislation in sports and other areas so that individuals can participate and safeguard their well-being.
How to strengthen your mental health as a transgender athlete
The trans community is often resilient, but the need for resilience among transgender athletes can take a toll. Below are a few ways to strengthen and defend your mental health as a transgender athlete.
Prioritize your self-care
Consider taking a break from the news, social media, and other spaces where anti-trans verbiage may be prevalent. Engage in fundamental self-care activities as well as those unique to athletes. Self-care may include getting enough sleep, maintaining sleep hygiene, staying hydrated, and engaging in stress management techniques.
Remember that your health and safety come first. At times, athletes may be asked to put their health and safety above their sport, so consider your mental health in these moments. Ensuring that you have support in place during these times can matter.
Connect with community
Research indicates that social support can improve mental health outcomes in trans people. You may be able to find support in the form of a local LGBTQIA+ center, meet-ups and events in your area, online resources for connectivity with other trans people, or support groups, whether in person or remotely.
If you are in a situation where you are misgendered frequently or don't have supportive friends, teammates, and family in your life, it can be helpful to find people who understand.
Know your rights
Across the United States, laws vary from location to location and are often evolving. If you face discrimination or harassment, investigate your rights and any legal defenders in your area. Depending on the details of your experience, organizations like the ACLU may be able to help. If you don't live in a trans-friendly location, consider whether you may be able to move. Some trans athletes might consider taking a scholarship or opportunity in another state with trans-friendly legislation.
See an affirming therapist or counselor
If you notice the signs of a mental health condition like depression or anxiety, experience stress related to athletics and other parts of life, or want to discuss anything on your mind, a therapist or counselor may be able to offer support. As much as stigma can make it challenging to do so, especially as an athlete, it can be vital to reach out when you first notice signs of a problem.
Get support with online counseling
There are affirming therapists—both online and in-person—who work specifically with the LGBTQIA+ population. Online therapy through platforms like BetterHelp may be uniquely beneficial for athletes who engage in frequent travel, have busy schedules, or might otherwise benefit from receiving remote care. In addition, when you sign up for a platform, you can opt to see a licensed therapist who specializes in working with the LGBTQIA+ population or is part of the community themselves.
Online therapy platforms can make finding safe, affirming mental health care easier. It may be challenging to find an affirming in-person therapist in some locations. Online therapy is often considered affordable, convenient, and proven as effective as in-person care for concerns like depression.
Takeaway
What is the decision on transgender athletes?
The inclusion of transgender athletes in sports is a complex and evolving issue. Decisions regarding transgender athletes often vary by region, sports organization, and level of competition. Here are some key aspects of the decision-making process and current trends related to transgender athletes in sports:
- Inclusivity and Non-Discrimination: Some argue that sports should be inclusive and that transgender individuals should be allowed to participate in accordance with their gender identity. They emphasize the importance of respecting an individual's self-identified gender.
- Transgender Rights and Policies: Some countries and regions have implemented policies and laws to protect the rights of transgender athletes. These policies may include allowing transgender individuals to participate in accordance with their gender identity, often after meeting certain eligibility criteria.
- Sports Organizations: Various sports organizations, such as the International Olympic Committee (IOC) and National Collegiate Athletic Association (NCAA), have developed guidelines and policies regarding transgender athletes. These guidelines typically focus on hormone levels, particularly testosterone, as a determining factor for eligibility.
- Eligibility Criteria: Many policies include specific criteria for transgender athletes, such as requirements related to hormone levels and the length of time on hormone therapy. The purpose of these criteria is to address concerns about perceived advantages in performance.
- Science and Research: Decision-makers often consider scientific research when establishing policies related to transgender athletes. Research on the effects of hormone therapy and potential advantages or disadvantages is an ongoing area of study.
- Debate and Controversy: The inclusion of transgender athletes in women's sports has been a subject of debate and controversy. Some individuals argue that transgender women may have physical advantages, while others emphasize the importance of respecting gender identity.
- Legal Challenges: Some policies related to transgender athletes have faced legal challenges. Courts have ruled on cases related to the rights of transgender athletes, often considering principles of non-discrimination and equal treatment.
Are transgender athletes allowed in football?
The inclusion of transgender athletes in football, like in other sports, varies based on the policies and guidelines of the governing organizations and institutions. Different football leagues, schools, and sports organizations may have different approaches to transgender athlete participation. Some organizations and regions have adopted more inclusive policies, while others may have more restrictive eligibility criteria.
In many cases, transgender athletes are allowed to participate in football and other sports in accordance with their gender identity. However, eligibility criteria and policies often exist to address concerns related to competitive fairness. These criteria may include requirements related to hormone levels and the length of time on hormone therapy. The specific policies and guidelines can vary, so it's essential to refer to the rules and regulations of the particular league or organization in question for the most accurate and up-to-date information.
What is the definition of a transgender athlete?
A transgender athlete is an individual who identifies with a gender different from the sex they were assigned at birth and wishes to participate in sports in alignment with their gender identity. In many cases, transgender athletes seek to compete in accordance with their self-identified gender rather than the sex they were assigned at birth. This may involve a transgender woman (assigned male at birth) competing in women's sports or a transgender man (assigned female at birth) competing in men's sports.
Gender identity is a deeply personal and individual experience, and transgender athletes are individuals who have taken steps to align their gender presentation and expression with their gender identity, which may include hormone therapy or other forms of gender-affirming care.
Are transgender athletes banned from athletics?
The participation of transgender athletes in athletics is a topic that varies by region, sports organization, and level of competition. While some organizations and institutions have adopted inclusive policies that allow transgender athletes to compete in accordance with their gender identity, others have implemented more restrictive eligibility criteria.
It's important to note that the status of transgender athletes is not uniform, and policies and guidelines are subject to change. Some sports organizations and regions have taken steps to create more inclusive opportunities for transgender athletes by considering factors like hormone levels and the length of time on hormone therapy when determining eligibility.
However, there have been instances of trans women or trans youth facing restrictions or bans in some competitions, particularly in women's sports, with concerns often raised about perceived advantages in performance. Legal challenges have arisen in some cases, and decisions about transgender athlete participation can be subject to debate and controversy.
How does gender affect athletes?
Gender can affect athletes in various ways, including their opportunities, experiences, and the challenges they may face in sports. Here are some of the ways in which gender can impact athletes:
- Access to Sports: Women and gender-diverse individuals have faced barriers to accessing sports and athletic opportunities. This can limit their ability to participate in sports from a young age, including student athletes in middle school and high school, potentially affecting their skill development and interest in girls’ sports.
- Representation: The representation of female athletes and gender-diverse athletes in sports has been historically limited. The lack of visible role models can impact the aspirations and goals of athletes from underrepresented gender groups.
- Gender Stereotypes: Stereotypes related to gender and sports can influence the expectations and perceptions of athletes. Stereotypes may include assumptions about physical abilities, aggression, or competitiveness based on gender. Transgender students and athletes may also face additional barriers in participation in sports consistent with their gender identity when compared with cis women and men.
- Inequalities in Resources: In some cases, female athletes, and gender-diverse athletes may have fewer resources, funding, and support for training and competition compared to their male counterparts. This can result in disparities in opportunity to receive coaching, facilities, and equipment.
- Gendered Norms: Sports can often reinforce gendered norms and expectations. For example, women's sports are sometimes seen as less valuable or entertaining than men's sports, which can impact media coverage and financial support.
- Inclusive Policies: The inclusion of transgender athletes and policies related to gender identity in sports can also be a topic of discussion and debate. The development of inclusive policies that balance competitive fairness and respect for gender identity is ongoing.
- Body Image and Self-Esteem: Athletes of all genders may experience body image issues and self-esteem challenges related to societal ideals of physical appearance. These pressures can impact athletes' mental health and well-being.
- Health and Safety: There may be gender-specific considerations related to the health and safety of athletes, including issues like menstrual health and concussions.
- Barriers to Leadership Roles: In sports administration and coaching, leadership roles have traditionally been dominated by men. This can limit opportunities for female and gender-diverse individuals in positions of authority and decision-making.
What is gender dysphoria?
Gender dysphoria is a medical diagnosis used to describe the distress that some individuals experience due to a significant incongruence between their gender identity (their internal sense of their own gender) and their assigned sex at birth. It is important to note that not all individuals with a non-conforming gender identity experience gender dysphoria, and gender dysphoria can vary in intensity.
Key features of gender dysphoria may include:
- Incongruence: The individual experiences a strong and persistent incongruence between their gender identity and their assigned sex at birth. This incongruence can cause significant distress.
- Distress: The distress related to the incongruence may manifest in various ways, including emotional, psychological, and social distress.
- Duration: To be diagnosed with gender dysphoria, the distress must be present for a significant duration, typically lasting for at least six months.
- Impairment: The distress may lead to significant impairment in social, occupational, or other important areas of functioning.
Gender dysphoria is a recognized condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is a classification system used by mental health professionals. It's important to understand that being transgender or having a non-conforming gender identity is not a mental disorder. Gender dysphoria, on the other hand, is a diagnostic term used to describe the distress some individuals experience in relation to their gender identity.
What is the male-to-female transition?
A male-to-female (MTF) transition, often referred to as transgender women's transition, is the process by which an individual assigned male at birth (AMAB) works to align their physical characteristics and social identity with their true, self-identified gender, which is female. This transition typically involves a combination of social, medical, and legal steps. Here are some of the common components of an MTF transition:
- Social Transition: This may be the first step in an MTF transition, where an individual may change their name, pronouns, clothing, and appearance to align with their gender identity. They may also begin to live and present themselves as women in their social interactions.
- Hormone Therapy: Many transgender women undergo hormone replacement therapy (HRT) to develop more feminine secondary sexual characteristics. This may include taking estrogen and anti-androgen medications to promote breast development, reduce body hair, and modify fat distribution.
- Voice Training: Voice training is often a part of MTF transitions to help individuals develop a more feminine voice and speech patterns.
- Gender-Affirming Surgeries: Some transgender women choose to undergo gender-affirming surgeries, such as vaginoplasty (gender confirmation surgery), facial feminization surgery, and tracheal shave, to modify their physical characteristics to better align with their gender identity.
- Mental Health Support: Many individuals undergoing MTF transitions seek mental health support to address any emotional or psychological aspects of their transition. This can include coping with gender dysphoria and adjustment to new social roles.
- Legal Changes: Changing identification documents, such as a driver's license, passport, and birth certificate, to reflect the individual's correct name and gender marker is an important legal aspect of the transition.
- Social Support: Support from friends, family, and transgender communities can be essential in making the MTF transition process smoother and more emotionally manageable for transgender youth and adults.
What is the Fédération Internationale de Natation (FINA) decision on transgender people?
The current FINA decision on allowing transgender people is that for individuals to compete at the elite level, transgender girls or boys must complete their transition by age 12. In the policy, FINA describes how athletic performance may be altered by puberty, giving transgender athletes an unfair advantage over cisgender women. With the policy, FINA may be effectively excluding trans athletes from elite swimming as the recommended minimum age for transitioning individuals is higher than 12 making this a trans rights issue.
Can men play in the women's World Cup?
The eligibility of men playing in the women's World Cup is not allowed under FIFA (Fédération Internationale de Football Association) rules. FIFA has specific guidelines regarding the eligibility of players for its competitions, including the FIFA Women's World Cup.
The eligibility rules are based on a player's legal sex and gender identity. Generally, to participate in a women's competition, players must meet the criteria for female players as per FIFA's regulations. The criteria for joining the women’s team consist of considering a player's sex assigned at birth and any specific requirements regarding hormone levels for transgender athletes.
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