The risk of suicide is higher among transgender youth who do not receive the support they need, according to studies.
Transgender refers to individuals whose gender identity differs from the gender assigned to them at birth.
In a 2019 study by Bränström R & Pachankis J, transgender individuals were found to be at an increased risk of mental health conditions such as depression, anxiety, and substance abuse.
Professor Gerhard Grobler, a psychiatrist and former president of the South African Society of Psychiatrists (SASOP), highlights the importance of understanding that transgender identity is not a mental illness or disorder.
"However, gender dysphoria – a state of intense distress that can arise from the sense of a mismatch between one’s sex assigned at birth and one’s lived gender identity – is a real condition that can benefit from treatment such as gender-affirming counselling or psychotherapy," Grobler explained.
Due to stigma and the lack of acceptance, youth who identify as transgender may experience anxiety and depression, raising their risk of self-harm, according to Grobler.
These risks are greatly reduced when transgender people receive social and psychological help in "being the gender they identify with and believe is their true self," he said.
Transgender people often feel forced to hide their true identities for fear of being humiliated, threatened, or assaulted.
On Tuesday, ABC News reported that Sapir Berman, an Israeli soccer referee, has come out as a transgender woman.
Sapir realised that society would not accept her, so she lived as a man for nearly 26 years, she told ABC News.
Grobler advised parents whose children display gender non-confirming characteristics and behaviours or express a desire to change to their preferred gender that it was crucial to acknowledge and accept that this was not “just a phase.”
“Adolescents, in particular, are grappling with separation and independence, forming their own identities and autonomy. No one decides on or just chooses a gender identity overnight – appreciate that they have likely spent significant time contemplating this, and it has taken courage to share it with you,” he said.
Supporting a child or young person who identifies as transgender takes patience, understanding, and being willing to advocate on behalf of your child, Grobler said.
He highlighted some tips for parents, families, and friends of youth who identify as transgender and choose to transition:
Understand that every person’s transition and how they choose to live in their gender identity differs. The process of transitioning is complex and takes many steps. While this can include medical treatment and surgical procedures, this is not always the case and usually occurs much later in the process.
Engage with schools and other institutions to address your child’s situation and particular needs, with their consent.
Respect your child’s privacy and don’t “out” them before they are ready.
Don’t force them to act, dress, etc in a more gender-conforming way.
Seek support from a mental health professional who specialises in children and adolescents and is competent in working with gender-diverse and non-conforming young people.
Grobler warned that there was no scientific evidence to support so-called conversion or reparative “therapy” aimed at changing a person’s sexual orientation or gender identity and that the evidence showed that these discredited practices were more likely to be harmful and destructive.
“However, a transition in gender identity can be extremely stressful and psychotherapy can play a vital supporting role in helping a person come to self-fulfilling acceptance and self-actualisation, as well as developing the life skills to cope with prejudice, discrimination, and rejection,” he said.
Resources and organisations that can provide further information and support:
Groote Schuur Hospital Transgender Clinic – counselling, mental health support, gender-affirming care, info on support groups: Tel: 021 404 2151 or email GSH.PsychOPD@westerncape.gov.za
Matimba – emotional and psychological support for transgender youth and their families: https://www.matimba.org.za/page-about-us.html / Tel: 074 084 5237 or email info@matimba.org.za
OUT – counselling, health services, advocacy: https://out.org.za / Tel: 012 430 3272 or email hello@out.org.za
Gender Dynamix – trans & diverse gender resources and information portal: https://www.genderdynamix.org.za/ / Tel 021 447 4797 or email info@genderdynamix.co.za
Triangle Project – counselling, health care, support groups: https://triangle.org.za/ / Helpline 021 712 6699 or email info@triangle.org.za
American Psychological Association info & resources: https://www.apa.org/topics/lgbtq/sexual-orientation