Trans and gender-diverse young people have elevated rates of psychological distress, mental ill-health, and suicide risk when compared with their cisgender counterparts.
This has been demonstrated internationally (1, 2) as well as in Australia. The 2017 Trans Pathways study (3) surveyed 859 young Australians aged 14-25 who identified as trans. The study found that trans young people reported clinically-significant depressive symptoms at almost 10x the rate of the general Australian youth population, and anxiety disorders at 10-13x the rate of the general Australian youth population (3). Trans young people may be at higher risk of adverse mental health outcomes than older trans people, with trans youth reporting clinically significant depressive symptoms at 3x the rate of trans adults (3). The rates of suicidal ideation, suicide attempt and self-harm in trans and gender-diverse young people are also high. Surveys of Australian trans and non-binary youth have shown that between 82-92% report they have experienced suicidal thoughts at some point in their lives, 68-86% have ever self-harmed, and 35-48% have attempted suicide (3, 4). Additionally, rates of psychological distress and suicide risk in trans and gender-diverse young people may be particularly high in the context of the COVID-19 pandemic (5, 6)
The higher prevalence of mental ill-health and suicide risk in trans and gender-diverse young people is likely due to a combination of factors. Among the most significant of these relates to experiences of discrimination, abuse, bullying and harassment. Indeed, more than 70% of trans and gender-diverse Australian young people report they have experienced verbal harassment based on their gender identity (4). These experiences may have a direct impact on psychological distress and suicide risk: the Trans Pathways survey identified that young trans people who had self-harmed or attempted suicide in the past were significantly more likely than those who hadn’t to report experiences of bullying, rejection by peers, abuse by both family and non-family members, and discrimination (3).
Educational settings may be particularly impactful on the mental health and suicide risk of trans young people. Indeed, the Trans Pathways study found almost 80% of participants reported they had experienced issues with school, university or TAFE, and participants who had attempted suicide or self-harmed in the past were more likely to report these experiences than participants who had not attempted suicide or self-harmed. The Writing Themselves In 4 survey identified that trans and non-binary young people were much less likely than cis-gender, non-heterosexual young people to report feeling supported by classmates, and more than two-thirds reported feeling unsafe or uncomfortable at their educational institution (4). Feeling unsafe or uncomfortable in educational settings can directly impact school attendance: almost two-thirds of trans women, more than half of trans men, and 45% of non-binary participants reported missing day/s at their educational setting in the past 12 months for this reason.
A body of research has also examined the impact of sexuality suppression or conversion practices on mental health outcomes. A 2019 survey of Australian LGBTQA+ youth demonstrated associations between having attended practices (defined as “processes engaged in towards desired changes in gender and/or sexuality based in conversion ideology”) and being more likely to have a mental health diagnosis, report increased drug use and smoking, feel less safe at place of education, and report higher levels of truancy and unemployment (7). The study also found participants who had attended conversion practice reported increased anxiety and psychological distress, and were more than 2x as likely to think about or plan suicide and 4x as likely to attempt suicide than tose who had not attended conversion practice (7).
References
1. Connolly MD, Zervos MJ, Barone CJ, Johnson CC, Joseph CLM. The Mental Health of Transgender Youth: Advances in Understanding. Journal of Adolescent Health. 2016;59(5):489-95.
2. McDermott ES, Hughes E, Rawlings VE. Queer Future Final Report: Understanding lesbian, gay, bisexual and trans (LGBT) adolescents’ suicide, self-harm and help-seeking behaviour. United Kingdom: Lancaster University; 2016.
3. Strauss P, Cook A, Winter S, Watson V, Wright Toussaint D, Lin A. Trans Pathways: the mental health experiences and care pathways of trans young people. Summary of results. Perth, Australia: Telethon Kids Institute; 2017.
4. Hill AO, Lyons A, Jones J, McGowan I, Carman M, Parsons M, et al. Writing Themselves In 4: The health and wellbeing of LGBTQA+ young people in Australia. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University; 2021.
5. Bailey E, Boland A, Bell I, Nicholas J, La Sala L, Robinson J. The Mental Health and Social Media Use of Young Australians during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health. 2022;19(3).
6. Zwickl S, Angus LM, Qi AWF, Ginger A, Eshin K, Cook T, et al. The impact of the first three months of the COVID-19 pandemic on the Australian trans community. International Journal of Transgender Health. 2021:1-11.
7. Jones T, Power J, Hill AO, Despott N, Carman M, Jones TW, et al. Religious Conversion Practices and LGBTQA + Youth. Sexuality Research and Social Policy. 2021.