Understanding Transgender Health: Definitions, Challenges, and Paths to Thriving

As a clinical psychologist, I aim to provide affirming, clear information about gender diversity and the unique mental health needs of transgender and nonbinary (TGNB) individuals. I follow the guidelines of the World Professional Association for Transgender Health (WPATH) Standards of Care, version 8 (SOC8), which provides evidence-based guidelines for supporting trans clients’ health and transition needs.

What does transgender mean?

Transgender describes people whose gender identity differs from the sex they were assigned at birth. For example, a person assigned female at birth who identifies as a man is a transgender man. Research (Coolidge et al., 2002; Polderman et al., 2018) shows that biological factors - like genetics and prenatal hormones - play a role in gender identity development, highlighting that being trans is not a “choice.”

What is Gender Dysphoria?

Gender dysphoria refers to the distress some people feel when their gender identity doesn’t match their assigned sex at birth. While not all trans people experience dysphoria, about 0.6% of the U.S. population is affected.

Mental health and suicide risk

Alarmingly, 41% of LGBTQ youth seriously considered suicide in the past year (CDC, 2024), and rates are even higher among those without an accepting adult (The Trevor Project, 2023). Acceptance matters: LGBTQ youth with supportive adults are about 40% less likely to attempt suicide (The Trevor Project, 2023). Having just one accepting adult (parent, teacher, or doctor) can dramatically lower the risk of suicide and hopelessness among trans and LGBTQ youth. People who are trans face higher rates of depression (50-67%, Chang et al., 2018), anxiety (26%; Chang et al., 2018), and eating disorders (16%; NEDA, 2025) compared to cisgender peers. The interpersonal theory of suicide (Van Orden et al., 2010) suggests that suicide risk rises when someone feels both a lack of belonging and that they are a burden. These feelings are intensified for people who are trans and facing rejection or discrimination. When someone is misgendered or called by the wrong pronouns, it can lead to feelings of disrespect, invalidation, embarrassment, invisibility, alienation, or dysphoria (APA, 2021). Research shows that using a transgender youth’s chosen name can reduce suicidal behavior by more than half (Russell et al., 2018). People who are trans often experience “minority stress,” chronic stress from discrimination, stigma, and lack of acceptance, which can negatively impact their mental and physical health; this makes even small problems and stressors more difficult to cope with.

Ways to transition

Transitioning is unique for each person and may include:

• Social transition: Changing name, pronouns, clothes, or hairstyle.
• Medical transition: Using hormones or surgery to align the body with gender identity.
• Legal transition: Updating legal documents to reflect true name and gender.

Despite what many worry about, regret after gender-affirming surgeries is very rare; only 0.3% of trans men and 0.6% of trans women report regret, with an average of 11 years of monitoring for regret (NIH, 2023). We have higher odds at regretting knee surgery!

How to thrive in your trans identity

Despite facing multi-level challenges, many people who are trans thrive with support, community, and affirming care. Evidence-based treatments include gender-affirming mental health treatment and access to medical transition if desired. Acceptance, safe environments, and connection with affirming communities are key to well-being and resilience. Know that thriving is possible.

Here are some ways to work toward thriving in therapy:

Find joy and affirmation in your gender journey: As you explore your gender, it’s important to focus on your hopes, dreams, and the strengths that make you who you are. With your therapist, you can talk about your goals for the future and what brings you joy and meaning.

Explore how you want to embody your gender: Discuss how you’d like to express and embody your gender, whether that’s through your appearance, mannerisms, or other aspects of presentation. For some people, how they show their gender to the world (“passing” or not) is more important than specific labels or identities, and that’s okay. Your goals are unique to you.

Understand gender euphoria and congruence: Focus on moments when you feel most at ease, joyful, or affirmed in your gender; these are moments of gender euphoria. Talk with your therapist about what gender congruence means for you, whether that’s alignment between your body, your identity, or your expression.

Build your affirmation plan: Make a plan to help you experience more of these positive moments. This might include:

• Noticing when and with whom you feel affirmed and supported
• Finding community or support networks
• Identifying triggers for dysphoria and creating coping strategies

Remember, your journey is your own. Your therapist’s role is to support you in finding what feels right for you, celebrating your strengths, and helping you navigate any challenges along the way.

If you or someone you love is navigating gender identity, reach out to affirming professionals for guidance, support, and care. Acceptance saves lives, and you and your loved ones deserve to be seen and supported.