Aren’t trans people mentally ill?
By: Addison Smith
Tags: LGBT Rights, Mental Health, LGBTQ, Transgender, Gender Equality

“Ask Addi” is Join the Gender Revolution’s weekly advice column for questions about gender, transitioning or general LGBTQ+ issues. Click here if you’d like to Ask Addi a question, or find them on social media, #ASKADDI. Questions are answered anonymously so provide a pseudonym if you’d like.

Why are you encouraging people who are mentally ill when they should be getting help?— Concerned in Kentucky

Dear Concerned,

Most of the time, I ignore negative or trolling questions but your note seemed to be earnest so I decided to take your question.

Transgender people are not mentally ill. This is not my opinion but the findings of research sponsored by the American Psychiatric Association, American Medical Association and the World Health Organization that has been done over the decades.

It is true that when the first psychological diagnostic manuals were written in the 20th century, both homosexuality and “transsexualism” (later “gender identity disorder”) were included in the lists of things that can go wrong with a person’s psyche.

Photo by Jonathan Simcoe on Unsplash

Then a funny thing happened. They started doing research. Note the order there. First, it was assumed that being gay or trans was pathological and placed in diagnostic manuals, then they did the research on the subjects. The point of the research was to find the underlying cause of these assumed pathologies in order to improve treatment for them. What they found though is that there is no underlying pathology.

Being part of the LGBTQ+ community does not cause significant distress or impairment of personal functioning, the hallmark of mental illness. People who are gay or trans have no problem dealing with life, relationships or work. Once they understood this, the psychiatric community was forced to accept that being gay or trans are simply normal ways that people express their humanity.

First, they had enough evidence to say that being gay isn’t a disorder and they removed homosexuality from the diagnostic manual in 1973. Then with decades-more research done, they did away with the diagnosis “gender identity disorder” in 2013. The actual research into being transgender was done back in the 1980s and 90s but since the APA’s Diagnostic and Statistical Manual (DSM) was last updated in 1994, it took a couple of decades to get it out of the manual.

The AMA actually beat the APA to the punch by recognizing gender dysphoria as a treatable medical condition in 2007. (That treatment is transitioning.) The WHO finally joined the American associations in 2018 when they removed being transgender from their diagnostic manuals after a final study in 2016.

Now, I understand that knowing that the scientific community doesn’t agree with your assertation isn’t going to change your mind. I and other trans people are all sick as far as you’re concerned. If you don’t mind, I’ll be listening to the professionals.

Photo by Sydney Sims on Unsplash

“But trans people have more depression and anxiety and commit suicide more often,” I imagine you objecting. You’d be right about that. We are more susceptible to depression, anxiety, substance abuse, and some other disorders. However, those issues do not come from being trans. They come from dealing with our society. We are constantly bombarded with the message that we are not wanted, that we shouldn’t exist. We can be refused employment so more of us live in poverty. We can be refused accommodations so more of us are homeless. We can be refused an education so more of us lack the skills we need to improve our lot in life. We’re attacked on the street for no other reason than existing. The reason so many trans people suffer from mental disorders is that they have a form of PTSD from living in our culture.

If you are really concerned about the mental health of trans people, help them. Stop accusing them of being ill, stop being part of the problem and work to get them the help they need to make it through this life.

Check out the first article in the series if you’d like to know more about Addi’s background or the Ask Addi Archive for additional columns.