Impact Of Transitioning On Transgender Mental Health

Gender identity is often complex and personal. Many factors, including personality, genetics, life experiences, and identity, can impact it.   

When the gender someone is assigned at birth does not match their gender identity, they may decide to medically or physically transition. For transgender people, the transitioning experience can vary greatly. Although it can bring relief to change one’s body or hormones, transgender individuals face discrimination, hardships, and unique obstacles. Each of these can impact their mental health negatively, making it vital to address the existing disparities. 

By recognizing and eliminating inequalities, the transgender community can hope to receive better treatment from the mental healthcare system and society. Whether you are trans or cisgender, understanding the impact of transitioning on mental health can reduce stigmas surrounding a trans identity. 

What is transitioning? 

Transitioning refers to the period during which a person aligns their life and body to match their gender identity and desire for gender expression. On a base level, it might mean transitioning from male to female or female to male, but people can also transition to experience gender euphoria as non-binary individuals. The transition process looks different for everyone. Those transitioning are often referred to as transgender or trans because their sex assigned at birth doesn’t match who they are inside and how they want to present themselves. 

The term transgender can include various gender identities, orientations, and expressions. Transgender individuals come from all backgrounds, races, and cultures and can be of any age. For many reasons, it can take years for someone to decide to transition, and the process is often expensive and physically and emotionally taxing. 

Aspects of the transitioning process

The transition process can look different for everyone. Some people make legal changes, such as changing their names, while others undergo surgical procedures to change their bodily anatomy. Some change almost every aspect of their lives to match their gender identity, while others make a few changes.  

The transition process is personal, meaning different people may be content with varying change levels. If someone makes a complete transition, they’ll have legal, social, and medical changes. These changes can be in any order, but medical changes are often the final step. Below are a few of these steps. 

Legal changes 

Transgender individuals may change their legal name, requiring them to alter their birth certificate, driver’s license, passport, and other documents. 

Social changes 

Those transitioning may take on a new name without changing it legally. Some shorten their name assigned at birth, turn it into a nickname, or change it altogether. They may also use new pronouns. For example, a trans woman might use “she” and “her” pronouns. A non-binary person might use “they” and “them” pronouns. However, pronouns don’t necessarily align similarly for each person. 

New haircuts, clothing, and grooming styles may also occur. These changes add up and allow someone to authentically present themselves to the world.  

Medical treatment

Someone transitioning may undergo surgical procedures such as breast enlargement or reduction, plastic surgery, and genital or “bottom” surgery. They may go through hair removal from the face, back, chest, or arms. 

Some trans individuals opt for hormone therapy instead of or alongside surgery. Hormones can alter one’s voice, increase the amount of hair on the body, and make masculine or feminine features more prominent. Voice therapy is commonly pursued, and puberty blockers can be used for younger trans individuals to halt the effects of puberty without side effects. 

Whether someone makes changes from each of these categories or only one of them doesn’t change their identity. Around one in four people choose gender affirmation surgery, meaning 75% do not use surgery at all. Surgery can be invasive, painful, challenging, and may cause permanent unwanted changes, so some trans people avoid it. 

Transitioning is often more about how someone feels inside and accepting themselves rather than how they choose to present themselves. However, some find that the way they present themselves to the world helps them be more accepting of themselves as they are. Every individual’s transitioning process can be different. 

How long does transitioning take?

Transitioning can be a lengthy process, but it can also be relatively short. Since everyone has unique needs, the process could take a few months to several years or more. 

The factors that could affect the length of the process include the number and type of surgeries chosen, whether hormones are used, a person’s mental and physical well-being, financial situation, support system, and legal matters. 

Transitioning and mental health 

Being a transgender person can come with unique mental health challenges, but gender transitioning can have benefits. First, it can be essential to understand the disparities transgender individuals face in daily life and how they can affect their mental health. According to research, those belonging to the transgender community are: 

• More prone to depression and other mental health disorders
• Six times more likely to develop an anxiety or mood disorder
• Prone to living in poverty—about 29% of trans individuals live in poverty. This number rises depending on one’s race.
• Often subject to discrimination—in 2019, only 62% of Americans supported trans rights.
• More likely to attempt suicide—One study found that over 40% of transgender individuals had attempted suicide at least once in their lifetime. 

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7.

Since trans people are more likely to face discrimination than the general population, they are at a higher risk of mental illness. Other disparities that put them at risk of developing a mental illness include lack of healthcare coverage, stigma, poor financial situations, lack of resources, and violence. Within the mental healthcare system, they may have difficulty finding a provider who understands and supports them without discrimination. 

Gender transitioning and mental health

Gender transitioning may alleviate some of the mental health struggles faced by trans people as they step into their identity. For example, research shows that transitioning can have the following positive outcomes on an individual’s mental health: 

• Higher self-esteem
• More resiliency
• Greater relationship satisfaction
• More confidence 
• Fewer mental health conditions
• Greater career satisfaction
• Less substance use 
• A more positive mindset
• Decreased anxiety and depression
• An overall more significant quality of life

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Those who choose gender-affirming surgery have better mental health outcomes in the long run. Their odds of needing support for a mental health condition decline by 8% yearly after getting gender-affirming surgery. In addition, people who can receive gender-affirming hormone therapy may have improved mental health.

Should I transition? 

Whether you’ve been considering transitioning for a long time or it’s an idea that recently came to mind, recognize how you feel as an individual. You may work on understanding your emotions before considering how others feel about your gender. Others might persuade you, whether their opinions are positive or negative. 

While it can be beneficial to consider what others say, especially if they care for you, set boundaries, and make the best decision for you. Finding adequate support from your loved ones can be difficult, but leaning into the people who accept you can help. At the end of the day, what may matter most is whether you accept yourself.  

What to do if you decide to transition 

Gender transition is a unique and individualized experience. To begin transitioning, you can choose any number of paths. First, explore your gender identity alone and with trusted friends and family. Seeking help from a mental health professional may also be beneficial, especially if they have experience working with trans individuals. During this time, you might decide to come out to your community.

You can continue making minor changes and working up to significant ones, such as surgery. After going through a medical transition, transgender individuals may experience various emotions. However, realize that this response may happen at any point in the transition process.

After deciding to transition, you can alter how you present yourself. For example, you might start dressing differently, change your pronouns, or ask to be called by a different name. Try not to be pressured to do anything you’re uncomfortable with. Transitioning is all about you, and moving at your own pace can be essential. 

Becoming the person you are can take months or years, and no one moves at the same speed. Leaning on your support system, staying true to yourself, and meeting regularly with a mental health professional can keep you committed to your goals and aligned with your truth. 

Ways to care for your mental health as a trans individual

Transitioning can be an emotional process of highs and lows. It may be valuable to prioritize your physical and mental well-being during this process. While seeing a professional can be wise if possible, it can also be helpful to develop healthy habits you can incorporate into your daily life, including the following. 

Unplug and unwind

The world can be overwhelming between the news, social media, and notifications on your phone. Putting your devices on ‘do not disturb,’ turning off the TV, and logging out for the day may significantly benefit your mental health. 

Take your time off social media for a hobby or enjoyable activity. You may receive much more satisfaction from partaking in a relaxing activity rather than scrolling, listening to opposing news segments, or comparing yourself to people online. 

Pick up healthy habits 

Healthy habits include eating well, exercising regularly, and getting enough sleep at night. Since your physical and mental health are intricately connected, look after both. It can be healthy to start with minor changes, as these can add up and develop into permanent habits that benefit your health for years.

Find a support system

Finding people who support and accept you as you are can be vital. Having people in your corner who emotionally support you can be beneficial, especially during difficult moments. Transitioning can be physically and mentally challenging, but not having the right people by your side can make the process more difficult. Close friends can reduce stress, decrease loneliness, and help you accept yourself. 

Talk to a professional 

Whether you or a loved one is considering or already transitioning, you might benefit from talking to a therapist. If you face barriers to in-person treatment, such as cost, distance, or another factor, you can also try online therapy through a platform like BetterHelp.

Online platforms can match qualified mental health professionals with those needing support. In addition, you can attend your therapy sessions from the comfort of your couch. These platforms often offer the option of phone, video, or live chat sessions, and you can specify that you want an LGBT-affirming therapist when you sign up.  

Research shows that online therapy is effective for various conditions, including social anxiety disorder, panic disorder, generalized anxiety disorder, and depression, and it can significantly reduce the impact of stress.