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The Importance of Trans-Affirming Care

Around 240 anti-LGBTQ bills have been filed in the U.S this year alone, and the majority of these bills enforce actions that restrict the rights of trans folx. These bills have been aimed at blocking access to trans-affirming care specifically for trans youth. Trans-affirming care is essential for transgender folx, especially transgender youth. Transgender individuals face higher risks of anxiety, depression, and suicide than the general population due to stigmatization. This stigma comes from continuous misinformation about the trans community, experience, and what trans-affirming care looks like for folx who receive it.

Transgender individuals are folx whose gender identity is different from their sex assigned at birth. The opposite of this cisgender, where a person's sex assigned at birth is congruent with their gender identity. While many people are born cisgender, a 2017 study estimated that there are about one million transgender individuals in the United States alone. While a majority of those who are trans are part of the younger population, this may be due to greater awareness and acceptance of transgender folx in society compared to previous generations. Not only that, but we know for certain that trans folx have existed for many generations. Numerous cultures across the world prior to colonization accepted and even celebrated folx who didn't ascribe to the traditional Western gender binary (man and woman).

Before we go into a deep dive on trans experience, let's focus on what trans-affirming care looks like. Most people think of transitioning, or when a trans person engages in actions that align with their gender identity. Some of these include trans-affirming medical transitions like hormone therapy, gender-affirming surgery. Currently, in order for transgender folx to receive gender-affirming medical care, they have to be diagnosed with gender dysphoria by a mental health professional. Gender dysphoria, according to the DSM-V, is defined as "a marked incongruence between one's experienced/expressed gender and assigned gender." For transgender folx, this can be an incredibly complicated and stressful process.

There's another kind of transitioning, though, and that's social transitioning. Social transitioning doesn't include procedures to change one's body and instead may include things like coming out to your family, dressing in ways that feel congruent, binding, and changing legal documents to reflect one's identity. What matters with both of these types of transitions is that a trans person receives support and love from the people in their life. Social support in the general population, and especially the trans community, is a very strong buffer against mental health disorders. As trans folx navigate their life to experience euphoria instead of dysphoria,

Speaking of coming out, transgender folx often have to out themselves to their mental health professional in order to receive the care they need. And for transgender youth, they often face additional barriers like parental consent in order to receive gender-affirming care. Parental consent laws require that transgender minors have the consent of their parents or legal guardian in order to access transgender-affirming health care. Youth access to trans-affirming care has become increasingly difficult as bills have been proposed to block this access. And when trans adults or adolescents come out to therapists when seeking support or validation for distress around the many bills barring them from getting the care they need, there is the added risk of experiencing discrimination or lack of support.

All of these things, and more nuanced experiences, are part of something trans folx experience called minority stress. Minority stress is chronic stress that members of a minority group are subjected as a result of their stigmatization. As a result, transgender folx often internalize this societal stigma and discrimination they face which can lead to increased anxiety and depression. However, for transgender folx who have access to gender-affirming care experience significantly lower rates of depression, anxiety and suicidality (Tordoff et al., 2022). When anyone experiences support and affirming care, whether one is trans or not, you will see more positive health outcomes. However, it's especially important for trans folx, and trans folx of color, to have access to trans-affirming care.

There is a clear link between transgender affirming care and mental health. transgender folx who have access to transgender-affirming care experience significantly lower rates of depression, anxiety, and suicidality. For transgender folx, gender-affirming care is essential in order to live a healthy and happy life. Anti-trans laws make it difficult for transgender youth to access the care they need. It is important that we fight against these bills and advocate for transgender folx.

In case we weren't clear about the overall message of this blog: trans folx deserve love, support, and openness.

If you are trans and are looking for support (or are even beginning your journey into what your gender identity may be!), Cultured Space therapists are trained in having discussions regarding diverse identities, including trans folx. When you're ready, we're here for you.

For more resources about what trans-affirming care is, check out the links below!

UCSF's Transition Roadmap

The Trevor Project: A Guide to Being an Ally to Transgender and Non-Binary Youth

Human Rights Campaign: Understanding the Transgender Community

Planned Parenthood: What Do I Need to Know About Transitioning?

Mount Sinai: Gender-Affirming Surgery

WPATH: World Professional Association for Transgender Health


References:

Tordoff, D. M., Wanta, J. W., Collin, A., Stepney, C., Inwards-Breland, D. J., & Ahrens, K. (2022). Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Network Open, 5(2). https://doi.org/10.1001/jamanetworkopen.2022.0978