What Does It Mean to Be Transgender?

Transgender is a term used to identify a person who experiences incongruence between their experienced gender and the sex they were assigned at birth. Those who are transgender or who experience gender dysphoria may feel distressed when they are forced to conform to the gender they were assigned at birth. They feel that they are their true selves when they live and experience their chosen gender and gender norms. Transitioning is a common practice and people who transition are still whole people who get to experience life the way they choose. 

Gender and Gender Dysphoria

A person’s gender can be different from a person’s biological sex. Sex is often assigned at birth, based on a person’s external anatomy, and is often confused with gender. Gender identity, however, is a person’s internal sense of their gender. 

Gender expression, on the other hand, refers to how a person presents themselves to the world in a gendered way (e.g., wearing a dress is often considered “feminine” whereas wearing a suit is considered “masculine”). It is also important to note that gender identity is different and separate from sexual orientation, which describes a person’s physical, romantic, and/or emotional attraction to another person (i.e., straight, gay, lesbian, bisexual, etc.)

For many people, their gender identity matches up with their biological sex (i.e., male or female), and this is known as being “cisgender.” For transgender people, however, the sex they are assigned at birth does not match their gender identity. This discrepancy between a person’s biological sex and internal gender identity is known as gender dysphoria.

According to a study on gender dysphoria, “People who experience this turmoil cannot correlate to their gender expression when identifying themselves within the traditional, rigid societal binary male or female roles, which may cause cultural stigmatization. This can further result in relationship difficulties with family, peers, friends and lead to interpersonal conflicts, rejection from society, symptoms of depression and anxiety, substance use disorders, a negative sense of well-being and poor self-esteem, and an increased risk of self-harm and suicidality.”  

This study also includes an overview of diagnostic criteria for gender dysphoria in children, adolescents, and adults.

Gender Dysphoria and Gender Affirmation

Gender dysphoria often begins in childhood, although some people may experience it during puberty or much later. In order to combat some of the psychological distress that comes with gender dysphoria, those who are transgender may pursue different kinds of gender affirmation, including:

• Social affirmation: Changing one’s name and pronouns (i.e., he/she/they)
• Legal affirmation: Changing gender markers on official government documents
• Medical affirmation: Using pubertal suppression or gender-affirming hormones
• Surgical affirmation: Procedures such as vaginoplasty, facial feminization surgery, breast augmentation, masculine chest reconstruction, etc.

It is important to note that not all transgender persons desire to pursue all–or any–avenues of gender affirmation. Some may choose to “transition” from one gender to another through hormone therapy and other medical procedures, but not every transgender person chooses to do so. These are highly personal and individual decisions, and they should be respected as such.

Challenges Faced by Transgender People

Transgender people are often discriminated against and experience high levels of poverty and violence. According to the Transgender FAQ page from GLAAD.org, a “2015 U.S. Trans Survey” report by the National Center for Transgender Equality found that:

• 9% of transgender people live in poverty, compared to 14% of the general population
• 30% of transgender people report being homeless at some point in their lives
• Transgender people experience unemployment at 3 times the rate of the general population (with 4 times the rate for people of color)
• 30% of transgender people report being fired, denied a promotion, or experiencing mistreatment in the workplace due to their gender identity
• 31% of transgender people experienced mistreatment in the past year in a place of public accommodation, including 14% who were denied equal service, 24% who were verbally harassed, and 2% who were physically attacked because they were transgender
• 40% of respondents reported attempting suicide in their lifetime, nearly 9 times the attempted suicide rate in the U.S. (4.6%)

Transgender people also face shockingly high rates of murder, homelessness, and incarceration, often just because they are “different” by society. Unfortunately, many states do not provide any legal protections in housing, employment, health care, and other areas where they face discrimination based on their gender identity and expression.

Substance Use and Mental Health in the Transgender Community

Children and adults who suffer negative mental health effects from gender dysmorphia may do so due to confusion, stigma, or trauma. Those in the transgender community have some of the highest rates of substance abuse, mental health disorders like anxiety or depression, and suicide. To learn more, read the CDC’s comprehensive guide to transgender health and resources. If you are transgender and struggling with substance use disorder (SUD) or any co-occurring mental health issues, do not hesitate to reach out–gender-affirming help is available.

Approximately 1.4 million individuals identify as transgender. Transgender people often suffer from gender dysphoria, as well as experiencing high rates of discrimination, poverty, and violence. Unfortunately, this has lead to extremely high rates of substance abuse, mental health disorders, and suicide among the transgender community. If you are struggling with addiction or any co-occurring mental health challenges, it is vital that you reach out for help. At RECO Intensive, we understand that there are extra, unique challenges for transgender individuals. Our professional staff and experienced alumni can create a treatment plan according to your individual needs. We offer gender-affirming care using talk therapy and alternative therapeutic modalities to help you overcome addiction and address any mental health struggles as well. At RECO Intensive, we want to support you in your journey and help you recover from addiction. Call us today at (561) 464-6533. Let’s get back to a brighter future.