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Trans people and mental health - a recent study

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Posts: 5219
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(@ellyd22)
Majestic Member     Norfolk, United Kingdom
Joined: 2 years ago

Hi girls

For those of you who might not have seen it, I wanted to flag an article that appeared in the Guardian newspaper in the UK yesterday (February 1st 2024).

It was reporting on a paper that was recently published in the Lancet Public Health Journal, based on research at the University of Manchester in collaboration with the Proud Trust and the LGBT Foundation. The research suggests that transgender people in England are much more likely to have a long-term mental health condition than cisgender people.

The study is a major one involving 1.5 million people aged 16 or over, with 8,000 of those identifying as transgender. Here is the link to the Guardian article:

Trans people in England more likely to have long-term poor mental health – study | Transgender | The Guardian

The key findings are that the risk of suffering from a long-term mental health condition in England is about one in 10 for cisgender men and women (8.8% and 12%) but about one in six for transgender men and women (16.4% and 15.9% respectively)  … and the frequency of mental health conditions was even higher for some gender minority groups, at almost one in two (47.2%) for non-binary transgender people.

Dr Luke Munford, a senior lecturer in health economics at Manchester and co-author of the paper, explained these findings by saying:

“Trans, non-binary and gender-diverse people across England face widespread discrimination, leading to stressful social interactions and feelings of unacceptance, increasing the risk of poor mental health. Additionally, gender dysphoria may increase the risk of poor mental health amongst some trans, non-binary, and gender-diverse people, especially when combined with very long waiting times for National Health Service (NHS) gender identity clinics.”

Alongside investigating the frequency of mental health conditions, the researchers looked at how well people’s mental health needs were being met at GP appointments. Based on the data, the conclusion is that those with a gender identity other than 'cisgender male' or 'cisgender female' were more likely to report unmet needs at their last consultation.

“Poor communication from healthcare professionals and inadequate staff-patient relationships may explain why trans, non-binary and gender-diverse patients were more likely to report that their mental health needs were not met,” said the study’s co-author, Dr Ruth Watkinson, a research fellow at the University of Manchester.

“Changes are urgently needed for the NHS to become a more supportive service to transgender, non-binary, and gender-diverse patients, including improved recording of gender across healthcare records systems and staff training to ensure that healthcare professionals meet the mental health needs of all patients, whatever their gender.”

While the report raises obvious concerns, it is at least welcome to see it receiving coverage like this in the mainstream UK media.

Hugs

Ellie x

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Managing Ambassador
(@lizk)
Joined: 5 years ago

Illustrious Member     North County San Diego, California, United States of America
Posts: 3858

@ellyd22 

This report isn't much of a surprise.  It only confirms what most trans people already know.  I would expect the US numbers to be similar.

My past is pretty standard fare for a trans person.  Suffice to say I've experienced adversity that no person should have to endure. 

With a few important exceptions, the care I've received was ineffective or did more harm than good.  When I finally figured that out, it took months to find providers that knew what they were doing.  The ones I have now.  It shouldn't be that hard. 

The medical community as a whole is seriously lacking in the skills needed to properly assess, diagnose, and treat trans patients.  Things are getting better but there's still much room for improvement.

Improving the care that trans patients receive would go a long way toward reducing mental health problems in the community.  Having ONE person that's available and can be trusted to help is more than a lot of patients have.  It's more than I had when I was in a very dark place.  ONE person....your DOCTOR....can make a huge difference when nobody else cares. 

/EA

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Posts: 152
(@steveterrill50)
Estimable Member     Weymouth, Massachusetts, United States of America
Joined: 6 years ago

I certainly suspect that the same is true here in the USA.  What a difference that social acceptance would make for girls like us!

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Posts: 2036
Baroness
(@ryanpaul)
Famed Member     Outer Eastern Suburbs Melbourne, Victoria, Australia
Joined: 7 years ago

Hi Ellie and girls,

There have been may similar studies done in Oz, I cant quote any specific ones like the above, but gthe results are the same.....

Especially with younger folk, with the social media "pressures of the day" not helping AT ALL!!

 

Caty.

She who only owns an old smart phone for her music and then only cos her I Pods died

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Posts: 1335
(@rebeccabaxter)
    Cornwall, United Kingdom
Joined: 1 year ago

It was reporting on a paper that was recently published in the Lancet Public Health Journal, based on research at the University of Manchester in collaboration with the Proud Trust and the LGBT Foundation. The research suggests that transgender people in England are much more likely to have a long-term mental health condition than cisgender people.

 

Cause or effect though? Are transgender people more likely to have mental health problems because they are transgender, or are they transgender because they have mental health problems? A difficult question to answer objectively since there will be elements of bias and ignorance on both trans and non-trans sides.

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Managing Ambassador
(@ellyd22)
Joined: 2 years ago

Majestic Member     Norfolk, United Kingdom
Posts: 5219

@rebeccabaxter 

...or are they transgender because they have mental health problems?

No.

Whereas: 'Are transgender people more likely to have mental health problems because they are transgender?'.

Yes.

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Managing Ambassador
(@lizk)
Joined: 5 years ago

Illustrious Member     North County San Diego, California, United States of America
Posts: 3858

@rebeccabaxter 

Posted by: @rebeccabaxter

Cause or effect though? Are transgender people more likely to have mental health problems because they are transgender, or are they transgender because they have mental health problems? A difficult question to answer objectively since there will be elements of bias and ignorance on both trans and non-trans sides.

Every transgender person I know will tell you it's the former.  If it were the latter, why isn't the incidence of transgenderism higher?  According to the World Health Organization, 1 in 8 people worldwide suffer from mental illness.  That's roughly 1 billion people.  Surely there would be far more trans people if this were the case.  And would it not be possible to "cure" transgenderism by prescribing medication?  There's no documented evidence that psychiatric medication relieves or reverses transgenderism.

No, I don't think this question is difficult to answer objectively.  It was settled by the medical community years ago.  

/EA

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Posts: 1335
(@rebeccabaxter)
    Cornwall, United Kingdom
Joined: 1 year ago

I'm not coming down on either side, what I'm getting at is that for any reduction in mental health problems to occur, society has to become more accepting of people 'outside the norm' as it is seen BY that society. Also, one has to take into account, when saying that mental health in transgender people is more prevalent, that society now takes more notice of the trans group and as such will be more obvious now. It is much the same as the gay community before, say, the 1980s, wherein being gay was seen as a sin against 'god' and an abomination -- it is still seen that way by many people. However, being gay is much more accepted by society now and perhaps other societal diversifications may also become more accepted and this, as much as anything, may go a long way to helping the mental health of transgender folk.

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Managing Ambassador
(@lizk)
Joined: 5 years ago

Illustrious Member     North County San Diego, California, United States of America
Posts: 3858

@rebeccabaxter I agree.

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Posts: 5
Lady
(@pwyllie)
Active Member     Oregon, United States of America
Joined: 1 year ago

Hello girls-if i may put 2 cents in...in the US-the DSM IV-diagnostic and Statistical Manual for Mental Disorders--is constantly adding everything possible --as a disorder--and if one accepts a diagnosis--then one owns it.There Are issues--for sure--doubts, shame, fear etc.--having a mentor or friend-or community like this can help assuage much. My recent journey(6 yrs) has been aided by living near an LGBTQ etc community gathering place where all stripes show up. Realizing i am not alone--has been huge.

Accepting where we are and who we are is also huge. Walt Whitman-an American poet wrote-" I never knew why i loved anyone or any thing" He was considered either gay or bi-sexual. This is all easy to say,

it is a journey--one step at a time.

 

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Managing Ambassador
(@lizk)
Joined: 5 years ago

Illustrious Member     North County San Diego, California, United States of America
Posts: 3858

@pwyllie 

Clarifications Per Wikipedia:

DSM Edition

  • The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association (APA). In 2022, a revised version (DSM-5-TR) was published. In the United States, the DSM serves as the principal authority for psychiatric diagnoses.

Regarding Gender

  • DSM-IV's gender identity disorder is similar to, but not the same as, gender dysphoria in DSM-5. Separate criteria for children, adolescents and adults that are appropriate for varying developmental states are added.
  • Subtypes of gender identity disorder based on sexual orientation were deleted.
  • Among other wording changes, criterion A and criterion B (cross-gender identification, and aversion toward one's gender) were combined. Along with these changes comes the creation of a separate gender dysphoria in children as well as one for adults and adolescents. The grouping has been moved out of the sexual disorders category and into its own. The name change was made in part due to stigmatization of the term "disorder" and the relatively common use of "gender dysphoria" in the GID literature and among specialists in the area. The creation of a specific diagnosis for children reflects the lesser ability of children to have insight into what they are experiencing and ability to express it in the event that they have insight.
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Lady
(@pwyllie)
Joined: 1 year ago

Active Member     Oregon, United States of America
Posts: 5

@emilyalt  Thank you for all of that!! Each is on their own journey and hopefully get support ..  I do not like boxes, pigeon holes or categories to define who i am. This is where society is today.

Blessings

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Posts: 3442
Hostess
(@ab123)
Illustrious Member     Surrey, United Kingdom
Joined: 5 years ago

It was an interesting article but leaves a lot of questions. Although it stated 'Trans' it mentioned other genders so are the 8000 actually trans or all of the genders?  It has always been known that those in minority groups tend to have higher mental health issues and, as we know from the past trans was considered a mental health issue, that thought train has changed, fortunately.

Trans is now multi layered and has strayed away from what trans means or what I believed it to mean, the need to be a woman. Naturally there are stresses in coming out whatever gender you may say you are and also frustrations. Under the meaning if it affects you psychologically or your wellbeing then it is mental health. It would seem that there are flaws in the mental health system for any one suffering but such is the way society is at the moment more and more people are suffering some mental health issues. The mental health system is overstretched as are the G.P's and A&E. The latter two do have protocols but they have to prioritise cases and the actual mental health service is in a precarious state, I know from personal work experience in dealing with mental health. It may, even has made me more exasperated when trying to get help for serious cases when the demand keeps growing due to the load and expectations, hence it is easy to say in the survey that they didn't get what they expected but then what did they expect? The survey doesn't state so we can only surmise and what about CIS gendered how did they feel after a consultation, were their needs met.

It is also easy to say, Are transgender people more likely to have mental health problems because they are transgender?'. Then is someone more likely to have mental health issues if they are bullied at school/work' the answer to both is yes. 

 'Changes are urgently needed for the NHS to become a more supportive service to transgender, non-binary, and gender-diverse patients, including improved recording of gender across healthcare records systems and staff training to ensure that healthcare professionals meet the mental health needs of all patients, whatever their gender.” 

Mental health is assessed and recorded to find causes, treatment which is individual to the needs of a patient regardless of what gender they are. Is the survey saying transgender should get special treatment above others? The issue of recording genders is a bit of a hot potato at the moment as the list grows every year. If it is part of the issue then it will be recorded where is the urgency as mental health is across the board. Statements like that are quite negative to a service that is for all suggesting they are failing the gender diverse community and as if they need more admin.

Trans, non-binary and gender-diverse people across England face widespread discrimination, leading to stressful social interactions and feelings of unacceptance, increasing the risk of poor mental health. Additionally, gender dysphoria may increase the risk of poor mental health amongst some trans, non-binary, and gender-diverse people, especially when combined with very long waiting times for National Health Service (NHS) gender identity clinics.”

Is it actually true, widespread discrimination across England? I think we are a very accepting country and the laws and protocols have been a boon to trans people. I am not disagreeing there can be negative incidents but widespread? Some people do have difficulties understanding but is this discrimination. I see more gender diverse in the workplace in the last few years than I have ever seen and also out and about freely expressing themselves so it doesn't fit with the beginning of the statement. Naturally gender dysphoria may increase the likelyhood of mental health issues but then there are many other things that will do that. Naturally the wait once being referred to the G.I.C. clinic is long but there are doctors that can and will prescribe hormones and offer support. It is a bit of a lottery but is getting better as the service is being regionalised and more doctors are being trained in care for transgender. Is this self identity adding to the demand and expectations not being satisfied I wonder. It was once a referral from the G.P and then at least a two year process before any progress to surgery. Are the expectations realistic.

I may seem negative but ....

To me it matters not your gender or anything else, mental health is an issue and if your circumstances are getting out of control, you can't sleep for example, you are becoming angry or your work is suffering then seek help. Do not be embarrassed to admit it to your friends, family, partners or even work. Look up a helpline if you can't talk to anyone else and  do let your doctor know. It maybe that talking will help you through a bad patch and come up with solutions. It maybe just one issue but it maybe a number of issues that you didn't realise was part of the cause. Do not ignore it- get help, the earlier the better.

 

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Posts: 305
Duchess
(@2bmadeline)
Reputable Member     Walla Walla, Washington, United States of America
Joined: 2 years ago

Ellie,

Thanks for bringing the article to our attention. I look forward to reading it, thoroughly.

Madeline

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Posts: 1335
(@rebeccabaxter)
    Cornwall, United Kingdom
Joined: 1 year ago

It is perceived by the general [cis] public that non-binary, transgender and/or gay people are 'not quite right'. Even I, as a very open-minded cross-dresser with a gay son find the concept of someone calling themselves 'they' and 'them' just a bit weird, and it doesn't help their case when they try to get cis people to adopt their mannerisms as normal, because they just won't see it that way. Start with the 'they and them' thing and society will just change that to 'it', which is hardly complimentary. I'm not saying that non-binary folk need to hide just to fit in but by some of their words and actions and sense of 'entitlement', they make it too hard for general society to accept them. The response they get from cis people is generally unfriendly and suspicious and their reaction is likely to exacerbate any mental problems that the non-binary person may already be experiencing. Transgender people differ somewhat in this respect, IMHO, because they are trying very hard to 'be' the sex they feel they are and it's a shame that society doesn't really accept this. We all -- non-binary, transgender, cross-dressers, et al. -- have to tread a fine line between acceptance and alienation, push it too far and society will push back, and they are bigger than we are. 

 

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Posts: 5
Lady
(@pwyllie)
Active Member     Oregon, United States of America
Joined: 1 year ago

Thanks, Rebecca.!!!

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