What do the statistics say about transgender mental health?

Michael Cook
October 23, 2015
Reproduced with Permission

In the sudden avalanche of publicity for transgender issues since Bruce Jenner announced that he had become Caitlin Jenner, it is often said that transitioning from one sex to the other is a positive experience.

Some even claim that there is no evidence that sex reassignment surgery is psychologically harmful and that criticism is due only to prejudice and "transphobia". As one activist has written , "gender dysphoria as a psychological disturbance has been consigned to the wastebasket of medical history, much like hysteria, lunacy, and the disease view of homosexuality".

This is simply not true. Any discussion of transgender issues, particularly for adolescents or young adults, must bear in mind the lessons from the following peer-reviewed articles in major journals.

A study from Boston published earlier this year in the Journal of Adolescent Health , reported that 180 transsexual youth (106 female-to-male; 74 male-to-female) had a two-fold to three-fold increased risk of psychiatric disorders, including depression, anxiety disorder, suicidal ideation, suicide attempt, self-harm without lethal intent, and both inpatient and outpatient mental health treatment compared to a control group of youth.

Although the authors were sympathetic they still commented that "a significantly higher proportion of transgender adolescent and emerging adult patients were burdened by mental health concerns than cisgender youth".

A study published in PLoS One in 2011 of over 300 people who had undergone sex reassignment surgery in Sweden over the past 30 years reached a very sombre conclusion:

"Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group."

That study also complained that "there is a dearth of long term, follow-up studies after sex reassignment". Hence it is much too early to assert that the transgender experience is largely positive.

A review written last year about research into suicide and transgender population found "an unparalleled level of suicidal behavior among transgender adults". This was compiled by the Williams Institute, at the UCLA School of Law, an LGBT think tank, and the American Foundation for Suicide Prevention. Their conclusions are also quite sobering:

"The prevalence of suicide attempts among respondents to the National Transgender Discrimination Survey (NTDS), conducted by the National Gay and Lesbian Task Force and National Center for Transgender Equality, is 41 percent, which vastly exceeds the 4.6 percent of the overall U.S. population who report a lifetime suicide attempt, and is also higher than the 10-20 percent of lesbian, gay and bisexual adults who report ever attempting suicide."

None of these sad statistics is news. The risks have been widely studied for years. For instance, a 2001 study in the American Journal of Public Health of 392 male-to-female and 123 female-to-male transgender persons revealed that 62 percent of the male-to-female and 55 percent of the female-to-male transgender persons were depressed; 32 percent of each population had attempted suicide.

"The prevalence of suicide attempts among male-to-female and female-to-male transgender persons in our study was much higher than that found in US household probability samples and a population-based sample of adult men reporting same-sex partners. This finding supports a previous study of male-to-female transgender persons in the Netherlands, which found that the number of suicides among male to-female transgender persons was much higher than the expected mortality for the Dutch male population."

Too often it is glibly asserted that troubled youths can deal with their psychological conflicts by transitioning to a different gender. They are either deceiving themselves or being deceived. The facts are there for anyone, especially those considering sexual reassignment surgery, to see: for many people life as a transgender is full of psychological pain.