Transgender Health and the Impact of Stigma
By Deirdre Arato, M.Ed, LPC, NCC
Transgender individuals continue to face stigma and discrimination across nearly every area of life—including education, employment, healthcare, and housing. These forms of oppression occur at structural, interpersonal, and individual levels, creating a harmful and often inescapable web of marginalization. The cumulative effects of this mistreatment are devastating: transgender people report significantly poorer physical and mental health outcomes than their cisgender peers (Garcia & Lopez, 2022; Drabish & Theeke, 2022).
This disparity is not coincidental. It is the direct result of systems that continue to devalue transgender lives. Research consistently shows that transgender individuals experience disproportionately high rates of anxiety, depression, and suicidal ideation (Bockting et al., 2013; Wilson et al., 2016). Understanding and addressing the consequences of transphobia is essential—not only to support the immediate needs of transgender communities but to confront the broader systems that perpetuate harm.
A recent study published in the American Journal of Public Health (2024) tracked self-reported mental health trends from 2014 to 2021 using a nationally representative sample. The findings revealed a growing and deeply unequal mental health crisis: in 2014, 11.4% of cisgender adults reported frequent mental distress, compared to 18.9% of transgender adults. By 2021, those figures had increased to 14.6% for cisgender adults and a staggering 32.9% for transgender adults (American Journal of Public Health, 2024).
The minority stress model, developed by Meyer (2003), offers a powerful lens to understand these disparities. The model explains how stigma, prejudice, and discrimination create hostile and chronically stressful environments for LGBTQ+ individuals, which in turn result in elevated risks for mental health issues. Rood et al. (2016) further emphasize that the expectation of rejection—or anticipated stigma—can be as psychologically damaging as actual instances of discrimination.
Anticipated stigma also creates real-world barriers to care. Many transgender people avoid seeking health services because they fear mistreatment by clinicians (Kcomt et al., 2020). Unfortunately, these fears are not unfounded. The persistent presence of discrimination in medical settings contributes to increased mental health pathology, including depression and suicidality (Bockting et al., 2013; Drabish & Theeke, 2022). When people are forced to choose between protecting their identity or risking disrespect, many understandably choose silence and avoidance.
Even in the wake of legal advances—such as the U.S. Supreme Court’s ruling in Bostock v. Clayton County (2020), which clarified that federal law prohibits discrimination against transgender workers—trans people still face widespread and persistent employment discrimination (Wilson et al., 2016). Legal protections alone are not enough when social and institutional systems continue to uphold bias and inequality.
Access to affirming, respectful, and competent care is not a privilege—it’s a human right. We must act to create inclusive, supportive environments across all sectors of society. Ending transphobia and dismantling discriminatory systems is not just a policy imperative—it is a moral one.
References
American Journal of Public Health. (2024). Mental health trends among U.S. adults by gender identity, 2014–2021. American Journal of Public Health, 114(5). https://ajph.aphapublications.org
Bockting, W. O., Miner, M. H., Swinburne Romine, R. E., Hamilton, A., & Coleman, E. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health, 103(5), 943–951. https://doi.org/10.2105/AJPH.2013.301241
Drabish, K., & Theeke, L. A. (2022). Health impact of stigma, discrimination, prejudice, and bias experienced by transgender people: A systematic review of quantitative studies. Issues in Mental Health Nursing, 43, 111–118. https://doi.org/10.1080/01612840.2021.2001959
Garcia, M., & Lopez, D. (2022). Addressing stigma in transgender health care. AMA Journal of Ethics, 24(8), E753–E761. https://doi.org/10.1001/amajethics.2022.753
Kcomt, L., Gorey, K. M., Barrett, B. J., & McCabe, S. E. (2020). Healthcare avoidance due to anticipated discrimination among transgender people: A call to create trans-affirmative environments. SSM - Population Health, 11, 100608. https://doi.org/10.1016/j.ssmph.2020.100608
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674
Rood, B. A., Reisner, S. L., Surace, F. I., Puckett, J. A., Maroney, M. R., & Pantalone, D. W. (2016). Expecting rejection: Understanding the minority stress experiences of transgender and gender-nonconforming individuals. Transgender Health, 1(1), 151–164. https://doi.org/10.1089/trgh.2016.0012
Wilson, E. C., Chen, Y. H., Arayasirikul, S., Raymond, H. F., & McFarland, W. (2016). The impact of discrimination on the mental health of trans*female youth and the protective effect of parental support. AIDS and Behavior, 20(10), 2203–2211. https://doi.org/10.1007/s10461-016-1409-7
Resources for Transgender People
Therapist: Deirdre Arato M.Ed, LPC, NCC
The Blue Lotus Garden of Healing, LLC
www.bluelotusgardenofhealing.com
Transgender people in crisis should contact the following resources:
■ The Trevor Project‘s 24/7/365 Lifeline at 866-4-U-TREVOR
(866-488-7386) or TrevorChat, their online instant messaging option,
or TrevorText, a text-based support option. If you are looking for peer
support, you can visit TrevorSpace from anywhere in the world.
■ The National Suicide Prevention Lifeline at 800-273-TALK (8255)
■ Trans Lifeline at 877-565-8860
■ Do you live outside the United States? If so, check out The Trevor
Project’s list of international resources here.
Transgender Organizations
■ National Center for Transgender Equality (NCTE) (advocacy)
■ Transgender Legal Defense and Education Fund (TLDEF) (legal
services)
■ Transgender Law Center (TLC) (legal services and advocacy)
■ Sylvia Rivera Law Project (SRLP) (legal services)
■ Trans People of Color Coalition (TPOCC) (advocacy)
■ Trans Women of Color Collective (TWOCC) (advocacy)
■ Black Trans Advocacy (advocacy)
■ Trans Latina Coalition (advocacy)
■ Gender Spectrum (support for families, trans youth, and educators)
■ Gender Diversity and TransFamilies (support for families, trans youth,
and educators)
■ Trans Youth Equality Federation (support for families and trans
youth)
■ TransTech Social Enterprises (economic empowerment)
■ SPART*A (advocacy for trans military service members)
■ Transgender American Veterans Association (advocacy for trans
veterans)
■ TransAthlete.com (info about trans athletes)
■ Massachusetts Transgender Political Coalition (MTPC) (advocacy)
■ TransLife Center at Chicago House (support services)
■ Trans Doe Task Force (legal services)
Transgender Programs at LGBT Organizations
■ GLAAD’s Transgender Media Program (media advocacy)
■ Freedom for All Americans (policy and legislative advocacy)
■ PFLAG Our Trans Loved Ones (support for families of people who
are trans)
■ PFLAG Transgender Resources (resources for trans people and their
families)
■ PFLAG’s Transgender Ally campaign (advocacy)
■ COLAGE Kids of Trans Community (support for kids of trans
parents)
■ The Task Force’s Transgender Civil Rights Project (advocacy)
■ HRC’s transgender resources (advocacy)
■ Gender Identity Project at the NYC LGBT Center (support services)
■ American Civil Liberties Union (ACLU) (legal services)
■ Gay & Lesbian Advocates & Defenders (GLAD) Transgender Rights
Project (legal services)
■ National Center for Lesbian Rights – Transgender Law (legal
services)
■ L.A. LGBT Center’s Transgender Economic Empowerment Project
(economic empowerment)
■ SF Transgender Economic Empowerment Initiative (economic
empowerment)
■ TransJustice at the Audre Lorde Project (advocacy)
General Information and Resources
■ The 2015 U.S. Trans Survey is the largest survery of transgender people ever conducted. The data has also been broken down by race, ethnicity, and geography. The survey’s results detail the extent of the poverty, discrimination, and violence faced by transgender people. The results are also available in Spanish.
■ Transgender Lives: Your Stories is an interactive campaign created by The New York Times to allow transgender people to tell their own stories in their own words..