Transgender mental health in crisis

Transgender mental health in crisis, but support groups desperately underfunded: Australia’s transgender (trans) community is experiencing depression and thoughts of self-harm at levels never before seen, but many are not getting the help they need because they’re afraid to access mainstream services, a new study has shown.

Authored by the University of Melbourne’s Trans Health Research Group, the Trans in the Pandemic: Stories of Struggle and Resilience in the Australia Trans Community report has found 61 per cent of the 1019 people surveyed in 2020 experienced clinical depression – that’s twice the national rate and much higher than before the COVID-19 pandemic.

The team also found 49 per cent of trans people experienced thoughts of self-harm or suicide compared to 14.9 per cent for the general Australian population who reported thoughts of self-harm or suicide in the initial months of the pandemic.

The survey was carried out in May and June 2020, when there was concern the trans community may be disproportionately affected by social distancing restrictions, and healthcare and employment disruptions.

Report lead author Sav Zwickl said it was already well-established prior to the pandemic that the trans community faced numerous health disparities and was one of the most medically and socially marginalised groups in society.

“Our gender clinic saw very high levels of distress, including a suicide at the beginning of the pandemic. These experiences triggered the study as we all realised the importance of documenting how the trans community were coping during the pandemic,” Mx Zwickl said.

“As the research demonstrates, transgender mental health is in crisis. Many trans people are, however, unwilling to access mainstream services due to previous negative experiences or anticipated discrimination. Our community, therefore, relies heavily on safe LGBTIQA+ specific organisations, yet these organisations are often severely under-funded and simply cannot meet the demand.”

The authors established that 38 per cent of participants had sought support from a mental health professional compared to the national rate of eight and 19 per cent had sought out a LGBTIQA+ organisation.

“Many trans people experience social isolation and discrimination at every turn – from family rejection, to bullying in school, difficulty finding employment, and relentless street harassment and violence. More recently the political and media focus on trans issues has served to exacerbate these issues. Discrimination and stigma are key drivers behind the extremely high rates of depression and suicidality in the trans community,” Mx Zwickl said.

Fellow author, Teddy Cook from ACON – the NSW HIV and LGBTQA+ health organisation – said the demand for mental health support had reached a level never seen before in Australia.

“Trans and LGBTIQA+ organisations across Australia are facing huge demand from the trans community for inclusive and affirming mental health services and as this research has revealed, just 10.5 per cent sought the help of a mainstream health organisation so it’s little wonder our services are struggling to meet demand,” Mr Cook said.

The report, which coincides with the International Day Against Homophobia, Biphobia and Transphobia (IDAHOBIT), is calling on State and Federal governments to help improve the physical and mental health and wellbeing of trans Australians by:

• establishing and bolstering trans-affirming specialist trans and LGBTIQA+ community-controlled specific mental health services
• requiring all mainstream services, including primary, secondary, tertiary and allied health, to develop trans-affirming practice, and to ensure trans people can safely access any service without fear of discrimination
• supporting strategies to ensure the safety of trans people to live without discrimination, abuse, or violence across private and public areas of life. This includes home environments, institutions and organisations, and public spaces.

Survey participants were aged 16 to 80, with 29 the average age. Almost 40 per cent were women/trans women, 35.5 per cent were men/trans men, and 25.6 per cent were non-binary. A majority of the authors were trans or gender diverse.