Transgender and gender-diverse individuals experience depression, anxiety, suicidal thoughts and suicide attempts more often than people who are non-trans (cisgender).  

If you’re transgender, you don’t identify with the sex you were assigned at birth. If you’re gender-diverse or non-binary, you may not solely identify with the male or female sex, or with either sex.  

Transgender and gender-diverse teens and young adults are twice as likely as gay, lesbian and bisexual teens and young adults to experience depression or suicidal thoughts or to attempt suicide, according to a study published in 2020 in the Journal of Adolescent Health. 

More than 81% of transgender individuals said that they’d had suicidal thoughts at some point in their lives, with about 48% having those thoughts in the previous year, according to a 2019 report from the Williams Institute at UCLA School of Law. About 40% of transgender individuals said that they had ever attempted suicide, with about 7% making an attempt in the previous year. 

Many transgender and gender-diverse people experience depression or anxiety because of their lived experiences.  

Have you or a loved one ever: 

  • Felt distress because your physical appearance doesn’t align with your gender identity (known as body gender dysphoria)? 
  • Felt upset because your family or friends don’t understand or accept you? 
  • Felt disrespected because people didn’t use your name or pronouns when talking to you? 
  • Been acutely aware of the societal stigma that’s associated with being transgender or gender-diverse? 
  • Feared being rejected by your family, friends or peers? 
  • Coped with rejection from your family, friends or peers? 
  • Worried about being discriminated against or threatened with violence because of your gender identity? 
  • Been a victim of discrimination or violence because of your gender identity? 

How gender-affirming therapy helps 

Gender-affirming therapy helps transgender and gender-diverse people feel more deeply aligned with their gender identity. 

Our Gender Wellness Program offers gender therapy to individuals who are questioning or exploring their gender identity. We also provide gender therapy and support to transgender and gender-diverse individuals who are going through a social or medical transition.

Qualified gender therapists work with transgender and gender-diverse patients to help them manage, reduce and learn resilience related to gender dysphoria. For many patients, getting a different haircut, changing their wardrobe or learning to put on makeup feels good, because it’s gender-affirming. We may discuss different body parts that the patient is uncomfortable with, then figure out ways to make their appearance align with their gender identity. I may provide my patients with resources for gender-affirming products or accessories that help them achieve that goal. 

Gender therapists also spend a lot of time talking with patients about social transitioning. We might explore the answers to questions such as: 

  • How will you tell your boss about your gender identity? 
  • How can you be safe when you tell your family members? 
  • Do you want to tell your relatives about your gender identity individually or as a group? 
  • Do you want to tell people face-to-face? 
  • Would email be better if you’re fearful of the response? 
  • Do you have a friend to stay with if your family kicks you out or rejects you? 
  • Do you have a trusted friend to talk to when you experience stress or rejection? 
  • Do you know that helplines like The Trevor Project and Trans Lifeline’s Hotline are available if you have suicidal thoughts? 

Referrals to gender-affirming medical care 

Our Gender Wellness Program also refers patients to gender-affirming primary-care providers. These providers offer judgment-free gender-affirming care to transgender and gender-diverse patients, and they’re able to prescribe gender-affirming hormones. 

Transgender and gender-diverse people who have access to gender-affirming medical care are less likely to have suicidal thoughts and attempt suicide, according to the 2019 Williams Institute report. 

For information about resources for transgender and gender-diverse people, or for more information about ChristianaCare’s Gender Wellness Program, call 302-623-6773 or email genderwellnessprogram@christianacare.org. 

How to support transgender and gender-diverse people 

If you have a family member or friend who’s transgender or gender-diverse, the way that you interact with them may have a positive or negative impact on their mental health. 

Being supportive and accepting of the transgender or gender-diverse person in your life may help to decrease their risk of anxiety or depression. It’s a hugely powerful and positive gesture for individuals in the transgender and gender-diverse community when their families are warm and welcoming towards them after they share details about their gender identity. 

The best way to support people who are transgender or gender-diverse is to affirm their gender identity. You’ll help them feel more comfortable by: 

  • Using their pronouns. When you speak with them, or about them, refer to them with their proper pronouns. If you aren’t sure which pronouns they use, ask them. They’ll be happy to tell you. 
  • Using their proper name. Address transgender and gender-diverse people by the name that they use when they introduce themselves. They often don’t use their birth name. If you’ve known them for a long time and they have changed their name, call them by the name that they use now. It isn’t respectful to call them by their birth name, which is sometimes called “dead-naming.” 

Family members who support transgender and gender-diverse people have a powerful impact on their loved one’s mental health. When transgender and gender-diverse individuals live with people who respect their pronouns, they’re less likely to attempt suicide, according to the Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People.  

If you’re in crisis or are having suicidal thoughts and you don’t have anyone to talk to, call one of these hotlines for help:

  • The Trevor Project. A trained counselor who understands LGBTQIA+ issues will offer you confidential crisis support at any time of the day or night, 24/7. Trained counselors are available by phone (866-488-7386), text message (text “START” to 678-678) and online chat (visit https://thetrevorproject.org/get-help).  
  • Trans Lifeline’s Hotline. A transgender individual will offer you confidential peer support by phone (877-565-8860). They can talk or listen, and you don’t need to be in crisis to call. They’re available on weekdays between 1 p.m. and 9 p.m. 

Brett Herb, DSW, LCSW, is the program manager for the Gender Wellness Program. To schedule an appointment with Dr. Herb, call 302-623-7503.

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