Is being trans a mental illness?

No.

The myth that being trans is some form of illness comes from a long history of misunderstanding and miscategorisation.

Society has long believed people who are different to be sick or ill, and modern human rights movements have fought to correct these myths, such as in 1973, when homosexuality was removed as an illness from the DSM1.

However, the myth that being trans is an illness has been more difficult to debunk because many trans people rely on the support of medical professionals for gender affirmation, which in the past has relied upon a diagnosis of a mental condition or disorder.

This was in part due to miscategorisation by doctors, but also because statistics do show that trans and gender diverse people suffer other mental health concerns and symptoms at higher rates, including depression, anxiety, and suicidality, which we’ll talk more about below.

The most recent update of the ICD (11) has finally removed “gender identity disorder“, which was in the mental disorders section, and instead included “gender incongruence’ under the sexual health section2, reflecting that for trans people who want to medically affirm their gender, it is an aspect of their health and wellbeing, and not in order to fix a disorder or mental illness.

As this update is reflected in research and practice in the future, we look forward to a time when trans people are trusted to access care and affirmation without needing to seek a diagnosis, but simply because they want or need to affirm their gender.

Research shows that a disproportionate number of trans people experience worse mental health than the general population, including higher rates of suicidality (12 times more likely), diagnosis with a mental disorder (3 times more likely), and experiences of psychological distress3.

We also have found that this is not because these problems are innate for trans people, but because of what we call social determinants of health4, which use the conditions in which people live to understand their health experiences, among others.

Distress and impairment, considered essential characteristics of mental disorders among transgender individuals primarily arises in response to the discrimination, stigma, lack of acceptance, and abuse they face on an unfortunately regular basis.

Psychology Today5

These can include:

• discrimination, such as refusal of service

• not being treated the same or given the same opportunities as cis people

• misuse of language

• assuming that someone’s gender is the cause of their mental or physical health issues

• the intersection of trans identity with other identities/experiences such as race, class, sexuality

• and more

Many trans people also experience dysphoria, which is not itself a mental health condition, but can contribute to or exacerbate negative mental health outcomes.

If you are living with a mental illness, gender affirmation may help, but many people find it helpful to engage in both gender affirmation and mental health support at the same time.

Some people find that affirming their gender, in whatever way works for them, does indeed relieve a lot of their mental and physical distress, but others may need some more support. There’s nothing wrong with needing support or treatment for mental health issues, and people of all genders do so in order to feel healthier and happier.

It’s important to not place all your hopes on gender affirmation as the solution to any mental health issues you’re dealing with. Gender affirmation can be a difficult and intense time for many people, and having the tools to seek support and to support yourself is a great way of looking after not only your mental health, but every part of you.

If you are seeking mental health support, check out our Mental Health page or Crisis Support page for more information and links to services.