What does transgender mean?

Transgender is an umbrella term for persons whose gender identity, gender expression, or behavior does not conform to that typically associated with the sex to which they were assigned at birth. Gender identity refers to a person’s internal sense of being male, female, or something else; gender expression refers to the way a person communicates gender identity to others through behavior, clothing, hairstyles, voice, or body characteristics. “Trans” is sometimes used as shorthand for “transgender.” While transgender is generally a good term to use, not everyone whose appearance or behavior is gender-nonconforming will identify as a transgender person. The ways that transgender people are talked about in popular culture, academia, and science are constantly changing, particularly as individuals’ awareness, knowledge, and openness about transgender people and their experiences grow.

Is being transgender a mental disorder?

A psychological state is considered a mental disorder only if it causes significant distress or disability. Many transgender people do not experience their gender as distressing or disabling, which implies that identifying as transgender does not constitute a mental disorder. For these individuals, the significant problem is finding affordable resources, such as counseling, hormone therapy, medical procedures, and the social support necessary to freely express their gender identity and minimize discrimination. Many other obstacles may lead to distress, including a lack of acceptance within society, direct or indirect experiences with discrimination, or assault. These experiences may lead many transgender people to suffer with anxiety, depression, or related disorders at higher rates than nontransgender persons.

In the United States, payment for health care treatment by insurance companies, Medicare, and Medicaid must be for a specific “disorder,” defined as a condition within the International Classification of Diseases (ICD) or the Diagnostic and Statistical Manual of Mental Disorders.

(DSM-IV). According to DSM-IV, people who experience intense, persistent gender incongruence can be given the diagnosis of gender identity disorder. This diagnosis is highly controversial among some mental health professionals and transgender communities. Some contend that the diagnosis inappropriately pathologizes gender noncongruence and should be eliminated. Others argue that it is essential to retain the diagnosis to ensure access to care.

It is important to note that the recent revision to the DSM has removed the diagnosis of Gender Identity Disorder.  The disorder  is currently termed gender dysphoria disorder, which continues to be a controversial term because not all transgender people feel gender dysphoria and this continued description in the DSM furthers the implication that this is a mental health diagnosis.  S.F.

What kinds of discrimination do transgender people face?

Anti-discrimination laws in most U.S. cities and states do not protect transgender people from discrimination based on gender identity or gender expression. Consequently, transgender people in most cities and states face discrimination in nearly every aspect of their lives. The National Center for Transgender Equality and the National Gay and Lesbian Task Force released a report in 2011 entitled Injustice at Every Turn, which confirmed the pervasive and severe discrimination faced by transgender people. Out of a sample of nearly 6,500 transgender people, the report found that transgender people experience high levels of discrimination in employment, housing, health care, education, legal systems, and even in their families. The report can be found online.

Transgender people may also have additional identities that may affect the types of discrimination they experience. Groups with such additional identities include transgender people of racial, ethnic, or religious minority backgrounds; transgender people of lower socioeconomic statuses; transgender people with disabilities; transgender youth; transgender elderly; and others. Experiencing discrimination may cause significant amounts of psychological stress, often leaving transgender individuals to wonder whether they were discriminated against because of their gender identity or gender expression, another sociocultural identity, or some combination of all of these.

According to the study, while discrimination is pervasive for the majority of transgender people, the intersection of anti-transgender bias and persistent, structural racism is especially severe. People of color in general fare worse than White transgender people, with African American transgender individuals faring far worse than all other transgender populations examined.

Many transgender people are the targets of hate crimes. They are also the victims of subtle discrimination—which includes everything from glances or glares of disapproval or discomfort to invasive questions about their body parts.

References

• American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV). Washington, DC: American Psychiatric Publishing, Inc.
• American Psychological Association. (2006). Answers to your questions about individuals with intersex conditions (PDF, 1MB). Washington, DC: Author.
• American Psychological Association. (2008). Answers to questions: For a better understanding of sexual orientation and homosexuality (En español).Washington, DC: Author.
• Harry Benjamin International Gender Dysphoria Association. (2001). The standards of care for gender identity disorders, sixth version. Minneapolis, MN: World Professional Association for Transgender Health. Retrieved from http://www.wpath.org/documents2/socv6.pdf
• National Center for Transgender Equality and the National Gay and Lesbian Task Force. (2011). Injustice at every turn. Washington, DC: Author.
• World Health Organization. (1992). ICD-10: International classification of diseases and related health problems. Washington, DC: American Psychiatric Publishing, Inc.