Transgender Mental Health, Stigma and Internalized Transphobia

Transgender Mental Health, Stigma and Internalized Transphobia

Transgender Mental Health, Stigma and Internalized Transphobia

The discussion of transgender mental health issues is a subject that has long interested me, my personal connection to this subject comes as being a Trans woman who progressed through transition from male to female back in the 90’s.

Transgender Mental Health, Stigma and Internalized Transphobia
Transgender Mental Health

My own mental health took a heavy beating from early adolescence when it became obvious to me that I was born in the wrong body, gender dysphoria was for me the first sign that something was very wrong, I had to face the inevitable difficult questions from family and friends, their advice subsequently steered me to approaching the gender identity clinic, this was the start onto the road of my transgender transition which culminated in reassignment surgery.

Like many transgender people, I went through all the common feelings of despair, anguish, internalized transphobia, and stigma and my mental health was stretched to its limits. I do believe that having the confidence to seek early intervention by contacting your gender identity clinic is one of the most important steps in allowing yourself a more positive mental health outcome.

Discussing Transgender Mental Health:

Transgender mental health issues are commonly linked to gender dysphoria, the feeling or knowing that we have been born in the wrong body either that of MTF (Male to Female) or FTM (Female to Male) transgender people. However, there are additional general and complex mental health concerns which we face including questions that raise strong emotions and fears; how we are perceived by others, why we are different, wanting to be treated respectfully, our personal safety, relationship breakdowns, transitioning in the workplace, and long term future happiness.

Let’s take a look at the tough underlying emotions that we juggle throughout transition.

Guilt and Doubt:

It’s perfectly normal and natural to feel some guilt around the disturbance that coming out as transgender will have on our family and friends. It is often common that transition will create feelings of excessive guilt that can result from us taking on too much responsibility for others feelings and reactions. You should try and tell yourself that you are not responsible for the way others may react to you; some people may have more extreme reactions to your decisions than others.

Doubting yourself is a typical reaction to any decision where you cannot be 100% certain; nobody knows what might happen in the future and deciding on a path of transgender transition has many factors that could and will affect our lives, it throws uncertainty into the mix, and a large number of us catastrophize (thinking of the worst outcomes); common amongst people that have had traumatic experiences in their lives.

You may have conflicting thoughts about the difficulties that will lay ahead, doubt often throws up many difficult questions about making the decision to move forward with transgender transition such as the effects on relationships with family and friends. “Will I ever be able to pass? Can I afford surgery in the future? How will this affect my job or can I find a job? Am I strong enough to do this?”

Inner and outer personas start to emerge and confront each other, many of us face internal battles, perhaps you have a masculine or feminine trait that you don’t want to suppress or you may wish you rid yourself of all your old traits. This feeling of being at war with yourself creates a level of doubt at all stages of your transition. Over time you can hopefully embrace many of your old skills and activities within your new gender role; you can still love car mechanics or fishing as a woman or gardening and cooking as a man.
We all have dissimilar ‘voices’ in our heads which like to give opinions on everything we do, it can be challenging to think clearly and balance doubt against more positive emotions.

There will have been times in our trans lives when we have been ridiculed or met with disapproval from family, friends or others which plants the seeds in our mind for future shame and stigma logic.

Internalized Transphobia:

We all fear actual transphobia, others who want to cut us down to the core, but there is also an equally destructive monster inside of us that sometimes comes to the forefront of our thoughts and this is called internalized transphobia. It raises its head with awful reminders telling you, “You can’t speak like a woman” or “You are not a proper woman” or “We are faking it” it reminds you that you don’t look pretty enough or that you will never find a meaningful relationship or find love. It lets you know that the world is in fact right about you being horrible or affirms you are not accepted in society.

It is true that internalized transphobia is fueled by transphobic fears, we read and see the hateful junk posted online or media reports of trans murders and other violent crime perpetrated against somebody in the trans community and we internalize this hate within ourselves. We all too easily digest the hatred from a small minority in our society and we bury it within ourselves, it gnaws and decays deep within our subconscious mind. We find the consequences of this actually manifesting as feelings of worthlessness and loathing, also in worst case it can show as suicidal ideation.

Your outward appearance may denote a “successful” transition, passing as your true gender to others around you but it’s probable that you are besieged with inner demons. So you see internalized transphobia is one of toughest inner battles many transgender people face and it lasts beyond our transition with lingering voices that want to pop up and tell us we’re frauds, or that we should hide away from the outside world.

Transgender Mental Health Support
Transgender Support

Shame & Stigma:

Shame and stigma is familiar to trans people and to every section of the LGBTQ community (gay, lesbian, bisexual, transgender), unfortunately we still live in a transphobic and homophobic culture and we experience it in varying degrees throughout our lives. Shame however is a demon that taunts many of us and it manifests from a range of emotions including guilt, regret, remorse, embarrassment and self-consciousness. There will have been times in our trans lives when we have been ridiculed or met with disapproval from family, friends or others which plants the seeds in our mind for future shame and stigma logic.

As shame thoughts are strong negative feelings we develop techniques to guard against them thus protecting ourselves from the experiences. This could mean that we strive for perfection in everything we do which in most cases is a technique learnt from childhood in reaction to shame-based parenting. Another one is withdrawing inside ourselves and putting up barriers to shield from negative outside influences or interactions here the withdrawal technique is a reaction to both shame and stigma.


We have talked about guilt, doubt, shame, stigma, and internalized transphobia and if a few of these things start to overwhelm us then it’s despair that can follow. Despair is an ugly state of mind and it means that we nearing the point of giving up all hope, a very intense negative emotion, one that is very difficult to shake off can often lead to mental breakdown and suicidal thoughts.

If you think that you have reached despair then it is advisable to seek specialist mental health support and if that is hard for you then please talk to a family member or a trusted friend who can make contact for you.

Moving forward with Positive Emotions:

Let’s face it, transgender transition is not a smooth road, the majority of us who undertake transition face many roadblocks or potholes and we can usually get up and dust ourselves down to continue to the ultimate path to acceptance and fulfillment in our chosen gender.

I found that reading to be a great help during my own transition and there are a couple of books that stand out to me which everyone should take a look at, these include; “The Transgender Guidebook: Keys to a Successful Transition by Anne L Boedecker PhD (Availability Amazon)” and “Transgender 101: A Simple Guide to a Complex Issue by Nicholas Teich, John Malone“.

I hope you enjoyed my article and please don’t be shy to leave any comments in the box below and I will try and answer them for you.

Citations & Resources: Transgender Mental Health & Internalized Transphopbia
How to Fight Internalized Transphobia –
Internalized Transphobia, Resilience, and Mental Health –
Overcoming Internalized Transphobia –
Recommended Reading: The Transgender Guidebook: Keys to a Successful Transition by Anne L Boedecker PhD (Amazon)

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