Transgender men face a number of unique mental health concerns. Working past personal and societal stigmas may help them access care and find the help they need.
Some mental health conditions are more common in transgender men. Treatments, including hormone therapy, may help alleviate symptoms of mental health issues, though not everyone wants these.
As a close friend or family member of a transgender man, there are some ways to support their transition and mental health. This can include holding space for them or offering support to find quality mental health care.
Keep reading to learn more about mental health in transgender men, from common issues, the unique difficulties transgender men may face, and how to help and support them.
A study in the American Journal of Preventative Medicine notes the difference between markers of mental health in cisgender people of college age and gender minority people. In this context, gender minority means those who identify with a gender other than they were assigned at birth.
In general, gender minority people seem to have a significantly higher prevalence of mental health symptoms.
According to this study, gender minority people are more than four times as likely to have at least one mental health problem compared with their cisgender counterparts.
Possible mental health disorders include:
- eating disorders
- suicidal thoughts or tendencies
A similar study in BMC Public Health also found that transgender people were more likely to experience reduced life satisfaction and increased signs of loneliness.
There are a number of reasons why this may be the case.
There are many contributing factors why transgender men and transgender people may face more mental health conditions than other groups.
Overall, transgender people may have increased stressors throughout their lives than their cisgender peers when it comes to sexual orientation and gender identity.
These stressors may include:
- rejection from family
- rejection by loved ones
- low self-esteem
- poor coping skills
- body image issues
- poor sexual satisfaction
- avoidant behaviors
The effect of these stressors throughout life may contribute to lower mental health.
Loneliness may also play a role in mental health issues.
A study in the Journal of Clinical Medicine notes that social loneliness was the main predictor of poor mental health in transgender people.
In transgender men, specifically, romantic loneliness appears to be the strongest factor. The study associated higher levels of loneliness with lower levels of mental health.
As loneliness may be more likely in transgender people, its effects may manifest as poor mental health.
Societal expectations may also play a role. Social attitudes to gender expression can vary greatly from one place to the next.
Because of this, transgender men may face discrimination throughout their lives. They may experience:
- possible violence
- personal prejudices
- social stigma
These factors can influence the negative mental health aspects that transgender people sometimes experience.
The stigma surrounding both mental health and gender minority identities may also keep people from reaching out or seeking help.
This silence itself may reduce the access a person has to support and may promote a cycle of needing help, feeling bad for needing help, and feeling even worse because of this trap.
Leaving these issues untreated may lead to worsened mental health and, in extreme cases, to deep depression or suicide.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.
Mental health issues may affect transgender men differently than their cisgender peers, especially if the person does not have access to gender-affirming treatments.
Treatments that affirm gender identity may help ease symptoms, while treatments that deny someone’s identity may not.
Mental health issues may also affect transgender men differently than cisgender people if they do not have access to a proper support system.
Whether from their peer group, family, or general population, acceptance of a person’s gender identity may be a big step toward improving their mental health.
Gender-affirming hormone therapy (GAHT) involves giving a person with gender dysphoria safe doses of hormones to help them transition to their true gender identity.
A review in Current Psychiatry Reports notes that overall, GAHT has positive psychological impacts on both adolescents and adults.
GAHT reduces symptoms of mental health issues, such as anxiety and depression, reduces markers of social stress, and improves quality of life and self-esteem.
Hormone therapy is often an integral part of alleviating gender dysphoria and may be key to treating underlying mental health issues.
It is important to note that while many transgender people choose GAHT to help affirm their gender identity, not all transgender people will opt for or even desire this treatment.
As a friend or family member of a transgender man, it may be difficult to imagine what they are going through during transition. A cisgender person may never completely understand the process or difficulty a transgender person faces during these times.
Crucially, friends and family members of a transgender man can aim to be supportive.
Creating a gender-affirming environment in a familial or social setting may help ease gender dysphoria. It may also make it easier to facilitate treatment for underlying mental health conditions.
As part of this supportive role, it may help to:
- become educated about transgender issues and solutions
- use the person’s favored pronouns and name
- keep the lines of communication open
- listen without being judgemental
- avoid making assumptions about someone’s sexual preferences, gender roles, or desire for treatment
- advocate for transgender rights
It can take time to adjust to a person’s identity as they transition, and the change may produce reactions, judgments, or confusion.
Mental health professionals and support groups may offer tools and resources, not just for the transgender person undergoing the transition, but for those close to them, as well.
As the National LGBT Health Education Center note, the mental illness and mental health of a transgender person are entirely separate from the fact that they are transgender. Proper treatment will reflect this.
Gender dysphoria, or the feeling or stress of a person not having the same gender identity as the sex they were assigned at birth, is a mental health disorder, according to the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5).
While many transgender people may struggle with gender dysphoria, and seek treatment for it, having a transgender identity is not the same thing. It is not in the DSM-5, as it is not a form of psychopathy.
For most people, affirming their gender identity through gender-affirming health practices and treatments can treat their feelings of gender dysphoria.
Some people will need hormone therapy and surgery to fully alleviate their gender dysphoria, while others may not need either.
In many cases treating gender dysphoria may reduce signs of mental health issues, such as depression and anxiety.
Properly treating gender dysphoria can reduce the stressors on a transgender person and help them focus on any underlying issues.
While focusing on gender-affirming treatments, mental health specialists can also diagnose and treat any other underlying mental health issues, such as depression, anxiety, or eating disorders.
Treatment for individual mental health issues can vary greatly. Therapies may include a combination of prescription medications and various forms of psychotherapy.
It is essential that these treatments also integrate gender-affirming environments and therapies that support favorable outcomes in transgender people.
Transgender men face unique mental health issues, and working towards a solution is a delicate process.
Some drugs and hormone therapy may alleviate stressful symptoms, though not every transgender man will choose these options.
It is important to support someone through their transition and as they seek mental health care when they need it.