What Does Transgender Mental Health Look Like?
When I was asked to do an event on transgender mental health, it just made sense, "Yeah, of course I'll do it."
That is my knee-jerk reaction. "You want me to take up space talking about transgender people? Okay, I'll do it."
Interestingly, though, the first thing I realized is that I'm not an expert on mental health, nor am I a mental health professional. Am I, by virtue of being a trans woman, an expert on all things transgender?
I mean I've read a couple Kate Bornstein books, and made it a third of the way through Julia Serano's Excluded, heck - I even read Imogen Binnie's Nevada, but does that qualify me as an expert?
I have taken two gender and women's studies classes, and one of them was the intro course. I've taken one psychology course. How am I supposed to structure an event about transgender mental health?
I don't know any transgender professors - I'm sure they exist and they may even exist at my university - but I do not know of them as transgender. Nor, in my university's Counseling and Psychological Services center do I know of any transgender therapists. Not that you have to be transgender to be an expert on transgender mental health, but might it help?
"Well," I eventually thought to myself, "maybe I should brush up on some of the leading theories of what transgender mental health does look like to professionals and to experts."
I googled the three words, 'leading theories transgender'. The first result was a link to a University of Michigan website entitled, "What causes trannsexualism". Now, if you cringe at the use of such sterile language, if the transition narrative is already causing you to roll your eyes, I want to clarify that the five word search 'leading theories transgender mental health' returned the same first search result (and of course Google exists now to modify one's search based on their previous searches so maybe I have no one to blame but myself).
If one clicks through that first search result the first theory they will see discussed is that of John Money's. The site credits Money's work as being the , "... basis for arbitrary surgical sex reassignments of intersex infants."
It goes on to state, "Many of these kids reassigned as infants required later re-reassignments as boys when their innate gender identities became clear during childhood."
The source posits that, "Denying the existance of any inborn gender identity, behaviorists (following Money's ideas) see transsexualism as a failure of a person to properly socialize into their correct gender during childhood and adolescence, leading to "sexually deviant practices" in the adult which then brings on "mental illness" including the urge to "change sex"."
Moving on from John Money the source talks next of Dr. Ray Blanchard and his Autogynephilia theory:
"In the late 80's, certain behaviorists proposed a very specific "two-type" theory of transsexualism that has since "caught on" in psychiatric circles as "explaining the cause of transsexual mental illness". Two types of sexual urges were "intuited" and then described by behaviorists to explain MtF transsexualism: (i) extreme "effeminate homosexuality", and, more recently, (ii) obsessive "autogynephilic autosexuality". These so-called "deviant adult practices" are thought of as gradually "conditioning the transsexual" to want to "change into a woman". The theorists proclaim that these are the only causes of transsexualism, and all MtF transsexual people are of either one type or the other."
Nowhere in the entire piece does it mention or address the rates of suicide, depression, anxiety or any other mental health issues amongst transgender people, or how they are caused, or why they are higher amongst transgender people than amongst the 'general' population.
What we see instead is the sensationalizing of the transgender body and of the transgender experience.
A report by the National Center for Transgender Equality states that 41% of respondents reported having attempted suicide. This compares with 1.6% of the general population.
Amongst that same sample it was found that at highest risk for suicide were Indigenous and First Nation populations and those relegated to what the report calls the 'Street Economy'. The report goes on to say that 45% of transgender people age 18-44 were at risk for attempting suicide.
A direct quote from the report states that, "High risk cohorts include visual non-conformers (44%); those who are generally out about their transgender status (44%); and those who have only some of their identity documents in their preferred gender (46%). Those who have medically transitioned (45%) and surgically transitioned (43%) have higher rates of attempted suicide than those who have not (34% and 39% respectively)."
This statistic works against the narrative that most stress and duress ends once a transgender person is able to transition. It speaks to a larger system of transphobia that is institutional and social.
The National Center for Biotechnology Information informs us that 51.4% of transgender women and 48.3% of transgender men experience 'depressive symptoms' while 40.4% of transgender women and 47.5% of transgender men experience anxiety.
In January of 2014 The Williams Institute at UCLA released results from the National Transgender Discrimination Survey that found that, "Transgender respondents who experienced rejection by family and friends, discrimination, victimization, or violence have a higher risk of attempting suicide."
78% of respondents that have suffered physical or sexual violence at school reported suicide attempts. 65% of respondents who experienced violence at work reported suicide attempts.
What can be seen, thanks in large part to organizations such as The Williams Institute and The National Center For Transgender Equality is not only that transgender people experience mental health issues at higher rates than the 'general' population, but why this occurs. Because of discrimination, harassment, abuse, assault, dismissal and many other factors, transgender people find themselves struggling with depression and/or attempting to commit suicide.
For all of this, if there's one thing that I've found that audiences, even at a collegiate level, like less than theories, it's statistics. I sympathize - what can we do against a wall of numbers? How do we do anything?
I don't have all of the answers. I still am not sure how to address a crowd and talk about transgender mental health. My formal education recommends a plethora of ideas. As a journalist, I could simply report the facts. As an organizer I could present a specific ask. As a public speaker I could do both, while also appealing to my audiences emotions.
But what do I ask? Do I ask them to write for Jane Doe's freedom? Or Chelsea Manning's? Do I ask them to hold a vigil for Lamia Beard or Leelah Alcorn? I want my audience to remember the discriminate Chase Culpepper faced and that Sasha Fleischman had their skirt lit on fire.
Being a transgender activist is not a short time affair. Marsha P. Johnson and Sylvia Rivera did this for a long time. Kate Bornstein and Julia Serano continue to do it today, along with Laverne Cox and Janet Mock.
Transphobia lives when a kid is told that there are boys and there are girls and that all boys have penises and all girls have vaginas. Transphobia lives as long as we have boys restrooms and girls restrooms. Transphobia lives as long as teachers divide classes amongst boys and girls. Transphobia lives on Jerry Springer and Cops. Transphobia exists as long as we don't hear the names of Christine Jorgensen, Marsha P. Johnson or Sylvia Rivera in history classes. As long as science, sex education and psychology classes leave out talk about what it means to be transgender, transphobia exists.
Frankly, the issues lay out far and wide - I encourage allies and potential allies to meet their trans allyship where they are at. Address it in your classrooms, in your workplaces, in your fields of study, within your families, and with your friends.*
* I also encourage everyone to be safe and to take care of themselves. Please do not get fired if you can not afford to be unemployed. Please do not kicked out of your parent's house if you have nowhere else to go.**
** Though sometimes transgender people do not have these luxuries - they face higher rates of homelessness and unemployment than the 'general' population.
I will be facilitating a transgender mental health event on February 18 at Kennesaw State University
Sources:
http://ai.eecs.umich.edu/people/conway/TS/TScauses.html
http://transequality.org/PDFs/NTDSReportonHealth_final.pdf
http://www.ncbi.nlm.nih.gov/pubmed/23398495
http://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf
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