Jump to Section
Issues Transgender People Face
Transgender people, sometimes shortened to “trans,” face various issues that can significantly impact their well-being and quality of life. Some of the most common issues transgender people face include the following:1
- Discrimination: Transgender people may face discrimination in areas such as employment, housing, healthcare, and education. Despite recent legislative advancements, 27% of trans persons have experienced discrimination, including being fired, not hired, or denied a job promotion because of gender identification.2
- Harassment and violence: Transgender people are at a higher risk of experiencing harassment, assault, and violence, often due to their gender identity.
- Lack of access to healthcare: Transgender people may face barriers to accessing healthcare, including insurance coverage for necessary treatments and discrimination from healthcare providers. According to a study by the HRC Foundation, 32% of transgender persons and 22% of transgender people of color don’t have health insurance.3
- Legal issues: Transgender people may face legal obstacles related to changing their name and gender on legal documents, obtaining identification documents, and accessing legal protections.
- Mental health issues: Transgender people are at a higher risk of experiencing mental health issues such as depression, anxiety, and suicidal thoughts, often due to societal stigma and discrimination.
- Social isolation: Transgender people may face social isolation and rejection from family, friends, and community members. 1.6% of adults in the United States identify as transgender or nonbinary, with a larger percentage among those under 30.4
- Employment and economic issues: Transgender people may face discrimination in the workplace and may have limited job opportunities, leading to economic instability. About 29% of transgender adults live in poverty.5
It’s important to note that being transgender is not a mental illness. However, transgender persons confront particular difficulties that might harm their mental health. They are more susceptible to a range of mental health issues, including, but not limited to, the following:
- Gender dysphoria: Gender dysphoria involves experiencing discomfort due to a mismatch between biological sex and gender identity. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), used by mental health professionals to diagnose mental health conditions, up to 62% of transgender individuals experience gender dysphoria at some point in their lives.6
- Depression: An American Psychological Association survey found that up to 62% of transgender people experience depression.7
- Anxiety: A study published in the journal LGBT Health found that 46% of transgender men and 42% of transgender women experienced clinically significant anxiety symptoms.8
- Suicidal thoughts and behavior: A study by the National Center for Transgender Equality found that 40% of transgender respondents reported having attempted suicide in their lifetime. This is nearly nine times the rate of attempted suicide among the general US population.9
- Substance abuse: A study found that transgender individuals who experienced discrimination had higher odds of alcohol and drug use than their cisgender peers.10
Transgender Therapy Process & Goals
The process and goals for transgender therapy can vary depending on your specific needs. However, here are some general aspects of the process and its objectives:
- Exploration and self-discovery: Transgender counseling can provide a safe and supportive space to explore gender identity and expression and better understand feelings and experiences.
- Coping with gender dysphoria: Gender dysphoria is a common experience for many transgender individuals. Therapy can help you learn coping skills to manage distress and improve mental health.
- Education and support: Transgender therapy can provide education on gender identity and expression and help you develop a support network of family, friends, and community resources.
- Accessing gender-affirming care: Therapy can help you navigate the complex healthcare system to access gender-affirming care, such as hormone therapy or surgery.
- Addressing internalized transphobia and stigma: Many transgender individuals face discrimination and prejudice, both externally and internally. Gender counseling can help address internalized transphobia and develop a positive self-image.
- Building resilience and a sense of empowerment: A gender therapist can help you build strength and a sense of empowerment in the face of challenges related to gender identity.
The transgender therapy process can vary depending on each individual’s needs and goals and the therapist’s approach. However, it will typically begin with an initial evaluation whereby a qualified therapist for transgender persons will assess your needs and goals. This may include gathering information about your gender identity, history, experiences, mental health, and social support.
Next, you and your therapist will collaboratively develop a treatment plan to establish a clear set of individual therapy goals. Goals may include exploring gender identity and expression, coping with gender dysphoria, accessing gender-affirming care, building resilience through discussion and reflection, and exercises such as journaling or creative practices.
Some common types of therapy that may be used include:
- Cognitive-behavioral therapy (CBT): CBT is a type of therapy that focuses on changing negative or unhelpful thought patterns and behaviors. It can help transgender individuals manage distress related to gender dysphoria or internalized transphobia.11
- Acceptance and commitment therapy (ACT): ACT focuses on accepting and embracing complex thoughts and emotions and moving towards values-based actions. It can be helpful in building resilience and coping with challenges related to gender identity.12
- Dialectical behavior therapy (DBT): DBT is a type of therapy combining elements of CBT with mindfulness and other skills. It can help manage intense emotions and develop coping skills.13
- Family therapy: Family therapy involves working with family members to provide education and support and to help build understanding and acceptance of your gender identity and expression.
- Group therapy: Support groups involve working with other transgender individuals in a supportive and affirming environment and may include education, validation, and skill-building.
Medications can be an important part of transgender therapy, as well. However, medication should always be used with therapy and closely monitored by a medical professional. The decision to use medication as part of transgender therapy should be made on a case-by-case basis, considering the individual’s needs, goals, and potential risks and benefits.
Hormone therapy and puberty blockers often help transition to an affirmed gender. This type of medication involves using hormones, such as testosterone or estrogen, to bring about physical changes that align with the individual’s gender identity. Additionally, puberty blockers are medications that can delay puberty, allowing individuals time to explore their gender identity and expression before undergoing irreversible physical changes.
In addition to hormone therapy and puberty blockers, some transgender individuals may also benefit from medications to treat co-occurring mental health conditions, such as depression or anxiety.
Signs It May Be Time for Therapy
There is no one “right” time to seek transgender therapy. If you are questioning your gender identity or experiencing distress related to your gender, it may be helpful to talk to a gender therapist who specializes in transgender issues. They can provide support, validation, and guidance as you navigate your gender identity and expression.
However, here are some signs that it may be time for transgender therapy:14
- Persistent discomfort or distress related to gender identity: If you feel like your gender assigned at birth does not align with who you are or you feel uncomfortable with your body, it may be a sign that transgender therapy could be helpful.
- Difficulty coping with gender dysphoria: Gender dysphoria is a term used to describe the distress some transgender individuals experience related to their gender identity. Suppose you are experiencing difficulty coping with gender dysphoria, such as feeling depressed or anxious. In that case, it may be a sign that transgender counseling could be helpful.
- Struggles with social or family support: If you are experiencing challenges with social or family support, it may be a sign that transgender counseling could be beneficial. A therapist can provide support and validation and help you navigate relationships with others who may not understand or accept your gender identity.
- Desire to explore gender identity and expression: If you are curious about exploring your gender identity and expression or are considering transitioning, it may be a sign that transgender therapy could be valuable. A gender therapist can provide education and support and help you explore your gender identity and expression.
- Co-occurring mental health conditions: If you’re experiencing co-occurring mental health issues related to your gender identity, it may be a sign that therapy could be helpful. A therapist can help you develop coping skills and strategies to manage these conditions while also addressing the challenges related to your gender identity.
Insurance may be able to help cover the cost of therapy. Find out if your insurance provider can help with the costs by filling in our confidential insurance verification form below.
Transgender Therapy Treatment Costs & Insurance Coverage
The cost of transgender therapy treatment can vary depending on several factors, including the type of therapy, the length of treatment, and the therapist’s location. Some therapists may offer sliding scale fees based on income, while others may accept insurance.
Sometimes, transgender counseling may be covered by Medicaid, the government-funded healthcare program for low-income individuals and families. However, coverage can vary depending on the state, so it’s essential to check with Tennessee’s Medicaid program to verify what services are covered.
In terms of insurance coverage, many insurance plans now cover transgender-related health care, including transgender counseling. However, the extent of coverage can vary depending on several factors, including your particular policy and the insurance provider. Therefore, it’s important to understand what services are covered and what out-of-pocket costs you may be responsible for.
In some cases, you may be required to obtain prior authorization or a referral, and some insurance companies may limit the number of therapy sessions provided. In addition, each carrier will have different limitations and exclusions. However, therapy typically costs between $100 and $200 out-of-pocket per session.15
Athena Care is in-network with most major insurance plans. Filling out our free, no-obligation online insurance verification form is the simplest, most efficient method to determine if your insurance covers transgender therapy.
Our highly skilled care coordinators at our multiple mental health treatment clinics will handle the challenges of contacting your insurance carrier for more information about transgender counseling in Tennessee. After you’ve completed the no-obligation form, a care coordinator will review your policy and thoroughly explain your options. Any information provided and discussed is confidential.
Transgender Therapy Treatment Success & Outlook
There is limited research on the success rates of transgender counseling, as success can be difficult to define and measure. However, below are a few positive statistics on transgender therapy treatment:
- A recent review of more than 25 years of research on transgender mental health found a strong consensus that transgender people’s well-being can be enhanced by gender transition.16
- It was also found that transgender individuals who received therapy reported lower levels of depression and anxiety and improved quality of life than those who did not receive treatment.
- Receiving gender-affirming therapy, such as puberty blockers and sex hormones, was linked to 60% lower chances of moderate or severe depression and 73% lower odds of suicidality in transgender nonbinary youths (TNB) aged 13 to 20 years.17
While there are still challenges and obstacles to overcome, the outlook for transgender people and therapy is increasingly positive, with greater recognition and acceptance of transgender experiences. As a result, the significance of providing gender-affirming care is becoming increasingly clear.
While there are still challenges in accessing quality transgender therapy and healthcare, many medical professionals are becoming more knowledgeable and skilled in providing gender-affirming medical treatments, including hormone therapy and surgeries.
Additionally, the mental health profession has become more aware of the unique challenges transgender individuals face. As a result, a growing number of therapists specialize in working with transgender clients. These therapists can provide support and guidance to help individuals navigate the complex issues related to gender identity, gender roles, and transition.
The duration of transgender therapy can vary depending on your needs and goals. Treatment can involve a range of interventions, including transgender counseling, hormone therapy, and gender-affirming surgeries.
Counseling or psychotherapy sessions may last anywhere from a few months to several years, depending on your progress and the complexity of your needs. For example, some individuals may need ongoing support and counseling to manage the challenges of living as a transgender person. In contrast, others may only need a few sessions to achieve their goals.
Hormone treatment is typically a long-term intervention lasting several years or even a lifetime. However, the duration of hormone therapy depends on the individual’s goals, the type of hormone therapy prescribed, and overall health and well-being.
Gender-affirming surgeries can also vary regarding the recovery period and follow-up care duration. Some surgeries, such as breast augmentation or facial feminization, may have shorter recovery times and require less follow-up care. Other surgeries, such as genital reconstruction, may have longer recovery times and require more extensive follow-up care.
The success of transgender therapy may look different for each individual. What matters most is that you feel comfortable, supported, and empowered to live authentically with your gender identity. With that said, here are a few signs that transgender counseling may be working:
- Reduction in Gender Dysphoria: Reduction in the intensity or frequency of gender dysphoria is a positive sign that therapy is helping.
- Improved Mental Health: Reducing symptoms that lead to improved mental health may indicate that therapy is working.
- Positive Changes in Relationships: Improvement in familial and social relationships, such as increased understanding or support, can signify that therapy is helping.
- Greater Comfort in Gender Expression: Greater comfort and confidence in expressing one’s gender identity is a positive sign that therapy works.
Other Resources for Transgender People
There are many advocacy and support organizations for transgender individuals and their families, which can provide information, resources, and community support. These organizations can help you find competent and supportive therapists, connect with other transgender individuals, and advocate for your rights and access to healthcare.
- National Center for Transgender Equality (NCTE): The NCTE is a social justice organization dedicated to advancing the rights of transgender people. The organization provides policy advocacy, public education, and support for transgender individuals and their families.
- The Trevor Project: The Trevor Project offers assistance for crisis intervention and suicide prevention for LGBTQ+ youth. The organization provides a 24/7 hotline, text, chat services, and resources and support for transgender youth.
- Trans Lifeline: Trans Lifeline is a peer support and crisis hotline run by and for transgender people. The hotline is staffed by volunteers who are transgender and provides support for individuals in crisis or who need someone to talk to.
- GLAAD: GLAAD is a media advocacy organization dedicated to promoting the positive representation of LGBTQ+ people in the media. The organization provides resources and support for transgender individuals and their families, including a transgender media program that works to ensure accurate and positive portrayals of transgender people in the media.
- Transgender Legal Defense & Education Fund (TLDEF): TLDEF is a nonprofit organization providing legal representation and advocacy for transgender individuals. The organization offers free legal services, including name change assistance and help with employment discrimination.
- PFLAG: PFLAG is a national organization that provides support and resources for LGBTQ individuals and their families. The organization offers local chapters, support groups, educational resources, and advocacy efforts.
- Gender Spectrum: Gender Spectrum is an organization that provides support and resources for transgender and non-binary youth and their families. The organization offers online resources, training programs for schools and organizations, and a support hotline.
- Transgender American Veterans Association (TAVA): TAVA is an organization that advocates for transgender veterans and active-duty service members. The organization offers resources and support for transgender individuals who have served in the military.
- Trans Student Educational Resources (TSER): TSER is a youth-led organization that provides resources and support for transgender and gender-nonconforming students. The organization offers educational resources, advocacy efforts, and support for transgender students and their allies.
- World Professional Association for Transgender Health (WPATH): WPATH is a professional organization promoting evidence-based care for transgender people. The organization provides guidelines for healthcare providers who work with transgender patients and maintains a directory of healthcare providers who specialize in transgender care.
- 988 Suicide and Crisis Lifeline: Free, confidential assistance to those in need 24 hours a day.
- HRC Foundation. “Understanding the Transgender Community.” Human Rights Campaign, www.hrc.org/resources/understanding-the-transgender-community. Accessed 10 Apr. 2023.
- Singh, Sejal, and Laura E. Durso. “Widespread Discrimination Continues to Shape LGBT People’s Lives in Both Subtle and Significant Ways – Center for American Progress.” Center for American Progress, 22 Mar. 2023, www.americanprogress.org/article/widespread-discrimination-continues-shape-lgbt-peoples-lives-subtle-significant-ways.
- PSB Research. “THE ECONOMIC IMPACT OF COVID-19 INTENSIFIES FOR TRANSGENDER AND LGBTQ COMMUNITIES OF COLOR.” Human Rights Campaign Foundation, 2020, assets2.hrc.org/files/assets/resources/COVID19-EconImpact-Trans-POC-061520.pdf?_ga=2.46166372.253234460.1681153132-435357331.1680191130.
- Brown, Anna. “About 5% of Young Adults in the U.S. Say Their Gender Is Different From Their Sex Assigned at Birth.” Pew Research Center, 7 June 2022, www.pewresearch.org/fact-tank/2022/06/07/about-5-of-young-adults-in-the-u-s-say-their-gender-is-different-from-their-sex-assigned-at-birth.
- Badgett, M. V. Lee, et al. “LGBT POVERTY IN THE UNITED STATES: A Study of Differences Between Sexual Orientation and Gender Identity Groups.” Williams Institute of UCLA, Oct. 2019, williamsinstitute.law.ucla.edu/wp-content/uploads/National-LGBT-Poverty-Oct-2019.pdf.
- “Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).” American Psychiatric Association, www.psychiatry.org/psychiatrists/practice/dsm. Accessed 10 Apr. 2023.
- “Guidelines for Psychological Practice With Transgender and Gender Nonconforming People.” American Psychologist, vol. 70, no. 9, American Psychological Association, Dec. 2015, pp. 832–64. https://doi.org/10.1037/a0039906.
- Xiao, Fulong, et al. “A Case Report of REM Sleep Behavior Disorder, Behcet’s Disease, Sjogren’s Syndrome and Cognitive Dysfunction.” BMC Rheumatology, Springer Science+Business Media, July 2018, https://doi.org/10.1186/s41927-018-0022-y.
- S. E., James, et al. “The Report of the 2015 U.S. Transgender Survey.” National Center for Transgender Equality, 2016, transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf.
- Hughto, Jaclyn M. White, et al. “Prevalence and Co-occurrence of Alcohol, Nicotine, and Other Substance Use Disorder Diagnoses Among US Transgender and Cisgender Adults.” JAMA Network Open, vol. 4, no. 2, American Medical Association, Feb. 2021, p. e2036512. https://doi.org/10.1001/jamanetworkopen.2020.36512.
- “Cognitive Behavioral Therapy Overview.” Mayo Clinic, 16 Mar. 2019, www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610.
- “Psychotherapy Overview.” Mayo Clinic, 17 Mar. 2016, www.mayoclinic.org/tests-procedures/psychotherapy/about/pac-20384616.
- Behavioral Research & Therapy Clinics — University of Washington. “Dialectical Behavior Therapy | Behavioral Research and Therapy Clinics.” University of Washington Center for Behavioral Technology, depts.washington.edu/uwbrtc/about-us/dialectical-behavior-therapy. Accessed 10 Apr. 2023.
- “Understanding Transgender People, Gender Identity and Gender Expression.” American Psychological Association, 9 Mar. 2023, www.apa.org/topics/lgbtq/transgender-people-gender-identity-gender-expression.
- Lauretta, Ashley. “How Much Does Therapy Cost?” Forbes Health, 27 June 2022, www.forbes.com/health/mind/how-much-does-therapy-cost.
- The What We Know Project. “What Does the Scholarly Research Say About the Effect of Gender Transition on Transgender Well-being? | What We Know.” What We Know, 11 Aug. 2021, whatweknow.inequality.cornell.edu/topics/lgbt-equality/%20what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people%20.
- Tordoff, Diana M., et al. “Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care.” JAMA Network Open, vol. 5, no. 2, American Medical Association, Feb. 2022, p. e220978. https://doi.org/10.1001/jamanetworkopen.2022.0978.
If you suspect that you or someone you love suffers from mental health disorders, contact Athena Care today.
One of our friendly associates will help you get the help you need. Take this first step to feel better and take control.