Transphobia is a form of oppression and discrimination against those who identify as transgender. This can affect their mental and physical health.

The LGBTQIA Resource Center state that people who are transgender have a gender identity or expression that is different from the cultural or conventional expectations based on the sex a doctor assigns them at birth.

The term “transgender” is an umbrella term that can describe those who identify as non-binary, genderfluid, and genderqueer. It can also refer to those who have no gender, multiple genders, or other gender identities.

In this article, we will be replacing the term “transphobia” with “cissexism.” This is because the term “transphobia” inaccurately focuses on an individual’s irrational fears as opposed to the oppressive systems that can affect a person’s health.

This article explores what cissexism is, how it affects a person’s health, where to find support if a person is experiencing cissexism, and how to be an ally.

An image of an Indigenous transgender woman who has experienced transphobia.Share on Pinterest
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Cissexism is a form of oppression and discrimination by those who fear, disbelieve, or severely dislike people who are gender non-conforming.

Cissexism can be both obvious and subtle, with some people denying jobs, housing, healthcare, and more, to someone who is transgender.

People can have cissexist tendencies or behaviors due to several reasons. For example, a person may grow up in a family or community that encourages stereotypes or negative views of people who are transgender.

Additionally, an individual’s family or community may also have strict gender roles and look down on those who do not conform.

Other people may exhibit cissexist attitudes or behaviors because they do not know or understand the issues that the trans community faces.

Some examples of cissexist beliefs and behaviors include:

  • having a negative attitude towards people who are transgender
  • prejudice and aversion to those in the trans community
  • fearing and misunderstanding the trans community
  • not believing and refusing to use preferred pronouns or a person’s gender identity
  • using offensive slurs
  • physical, verbal, and psychological abuse and violence

Experiencing cissexism can lead to mental health conditions.

In a 2018 systematic review, researchers used a minority stress model to investigate the stressors that a minority group experiences.

These stressors include:

  • discrimination and violence
  • the energy that a minority group has to expend to protect themselves against this discrimination and violence
  • a minority group’s internalization of negative stereotypes

These all contribute toward mental health conditions. A combination of these stressors may overwhelm a person’s ability to cope.

The review looked at several studies through the minority stress model to investigate the effect of cissexism on a person’s mental health.

People who are a part of the trans community and experience cissexism are likely to experience:

  • depressive symptoms
  • anxiety symptoms
  • posttraumatic stress symptoms
  • general psychological distress

Cissexism can directly and indirectly affect a person’s health in multiple ways.

Insurance

A 2015 critical review notes that many people who are transgender do not have health insurance. One factor that could explain this is that those who are transgender are more likely to be unemployed, which may stem from employers discriminating against transgender candidates.

This lack of insurance may mean that transgender people have to pay out of pocket for gender-affirming procedures, such as hormones and surgery.

The cost of these procedures may be too high for some, and they may resort to cheaper hormones that they buy from friends or online.

Buying hormones online comes with health risks. People may take too much, or the syringes could harbor fluid containing HIV. As hormones available for sale online are often unregulated, they may also contain dangerous substances.

Access to healthcare

The 2015 critical review also notes that if a medical school does not teach an adequate LGBTQIA+ curriculum, healthcare providers may lack the ability to provide competent and sensitive care to transgender people.

This may lead to those in the trans community traveling further to receive competent care, paying out of pocket for a healthcare provider their insurance does not cover, or not receiving care at all.

Some individuals in the trans community may also experience harassment or violence in medical settings, or even encounter a healthcare professional who refuses to give them care.

Aside from these overt instances of cissexism, some people may experience their healthcare provider using outdated or incorrect language, which contributes to a feeling of unease, discomfort, or even hostility.

People who are transgender and conceal this fact from healthcare providers after transitioning due to a fear of cissexism may also prevent themselves from receiving appropriate care. For example, a transgender male may still need a pap smear, while a transgender female may need prostate exams.

Appearance and coming out as transgender

If a person comes out as transgender, they are more at risk of cissexism involving physical and sexual assault.

The 2015 U.S. Transgender Survey found that 13% of those surveyed were sexually assaulted in a school setting because others perceived them to be transgender, or they were openly transgender.

Additionally, 15% of the respondents experienced verbal, physical, or sexual harassment at work, while approximately half experienced sexual assault at one point in their life.

The appearance of people who are transgender may affect the level of direct cissexism they experience.

Individuals who do not conform to stereotypical physical gender norms may experience more discrimination and worse healthcare outcomes than those who do conform.

Even if a person has high visual conformity, they may experience stress. People who have high visual conformity may choose not to disclose that they are transgender to try to avoid cissexism.

However, concealing this part of their identity may lead to extreme stress, as they may still feel anxious about who may find out that they are transgender, and how people will react to it.

Violence and abuse

Violence against those who are transgender often comes from people they are close to, such as friends and family.

Some families reject people who are transgender, and this rejection can include physical confrontations.

It can also come in the form of:

  • refusing to use gender-affirming language
  • denying access to medical procedures
  • cutting off financial support
  • refusing access to the home

This can all cause feelings of isolation, low self-esteem, depression, and other adverse mental health outcomes.

Direct health effects

The 2015 critical review states that all of the above stressors can have immediate health effects on the body, including:

  • an impact on a person’s diastolic blood pressure
  • an increased chance of a cardiovascular event, such as stroke or heart attack
  • elevated cortisol levels, which can affect a person’s physical and psychological health

The prolonged effects of chronic stress can lead to:

There are several ways a person can get support if they are experiencing cissexism.

If they are a part of a supportive community of other people who are transgender or allies, speaking to them may help.

Additionally, several national organizations can help provide support and advocacy for those experiencing cissexism.

These organizations include:

Learn more about mental health resources available here.

There are several ways to be an ally and play a part in stopping cissexism.

These include:

  • never using cissexist slurs
  • not asking personal questions about a person’s genitals, surgery, or sex life
  • avoiding giving insults that sound like compliments, such as saying, “you look like a real girl”
  • not making assumptions or believing in stereotypes of people who are transgender
  • people educating themselves about the issues the trans community faces
  • respecting people’s decisions on when and where they come out as transgender
  • asking for and using a person’s preferred pronouns
  • using gender-neutral language, such as “they”
  • if it is safe to do so, speaking up and educating other people who are displaying cissexist tendencies or behaviors

Planned Parenthood note that if a person decides to speak up and educate others who are engaging in cissexist attitudes and behaviors, it is important to make sure they remain safe while doing so.

In some situations, it may be safer to remain quiet and walk away rather than addressing cissexism.

It is also important to remain calm and ask questions, as some people may not be aware that the language they are using is cissexist.

People can experience many forms of cissexism from their friends and family, the wider community, and even in healthcare settings.

This can lead to multiple adverse healthcare outcomes as well as mental health conditions such as depression, posttraumatic stress disorder, and anxiety.

Several organizations can provide support and advocacy to the trans community. Allies can use affirming language and educating others about the problems and issues the trans community faces.