On Wednesday, Florida Gov. Ron DeSantis (R) signed four different measures to attack LGBT rights. One is to prevent minors from receiving gender confirmation care, to prevent health insurance from covering such care for adults, and to prevent trans people from changing the gender indicated on their birth certificates. Another says adults can face criminal charges if they don’t use the bathroom corresponding to the gender they were assigned at birth.
It’s no wonder that in the current landscape, and at a time when teens face unprecedented mental health challenges, transgender youth in particular are at risk. A 2022 survey of nearly 34,000 LGBTQ youth ages 13-24, conducted by The Trevor Project, found that nearly two-thirds of trans and non-binary youth reported symptoms of depression in the past year, and about 1 in 5 of Trans and non-binary youth have attempted suicide in the past year. The rates were higher for young people of color.
Not every mental health issue that transgender teens face is necessarily related to their gender identity. However, as the data above shows, trans teens are disproportionately affected by depression and thoughts of suicide. To be clear, it is not being trans that puts these young men in such disturbing danger. Instead, it’s the discrimination and transphobia they face. In addition to the usual ups and downs of adolescence, trans teens often face outright hostility in their communities, schools, and even in their homes.
While some may need specific help with gender-related issues, such as gender dysphoria [identifying as a gender other than your assigned sex]Others may seek help for depression, anxiety, or other mental health issues, Caroline Finkel, a trained social worker who oversees programming at Charlie Health, a provider of teen mental health care, told HuffPost.
Finkel cites a study recently published in the Journal of the American Medical Association showing that gender confirmation care — that is, helping children transition socially and/or medically (using puberty blockers or hormones) — “was associated with 60% lower odds of moderate or severe depression and 73% lower odds of lower risk of suicide at 12-month follow-up” in 104 transgender or nonbinary youth ages 13-20.
Meeting children where they are with their gender identity, and supporting their transition in a way that seems appropriate to them, appears to mitigate some of the mental health risks they face.
HuffPost spoke to trans youth, and the mental health professionals who work with them, about what trans people need when it comes to their mental health, and ways to provide that support.
Passion Childs is a 22-year-old who lives in Detroit and identifies as a non-binary woman. She became depressed while working full time after high school.
“It got to the point where it was very scary, because I really wanted to be happy. But I just can’t be happy,” Childs told HuffPost.
One day, Childs came across a video of a woman talking about her transition and was shocked at how well it worked.
“I started questioning myself,” Childs said. She had a boyfriend in high school who didn’t approve of her wearing makeup or playing up her femininity in other ways. When Childs confided to him that she wanted a vagina, “he was looking at me like crazy. And I was so serious. But it was always in the back of my head because I felt like it was never going to happen.”
Far from rushing, Childs’ decision was preceded by years of longing and another month of internal questioning after she finally made her wish known.
“I’ve been thinking about it for a long time, and I really feel like this is who I am,” she explained. Characteristics like the way she walks and gestures with her hands make sense in this new context. Childs decided, “I don’t want to live with any regrets.”
She told her brother, who is also known as a stranger, and he accepted. For her birthday, her brother and his friend buy her a wig and makeup. “Honestly, it was the best birthday ever.”
“I started the social transition and it was the best decision I’ve made in my life to this day,” said Childs.
Although she felt sure that she was becoming a truer version of herself, the transition wasn’t exactly an easy experience.
“I was walking to my door and my neighbors were taking my pictures and they were calling me names, [saying] They know I have a wig, and they call me a bitch. After that, I fell into a deep depression. “I started hurting myself again,” said Childs, who had periods of having her arms cut off before moving on.
Looking back, she thinks she was cutting “because I didn’t really feel. I felt like I didn’t care. I felt—I don’t know. It was a low point in my life and through my transition.”
Her grandmother, who was living with her at the time, did not understand what she was going through and was not helpful.
Childs ended up in hospital in a psychiatric ward. She says it was among the other patients there – “a very diverse, open-minded and receptive group” – that she found the support she needed to get through this difficult period.
I have now been taking hormones for a year and a half, and recently underwent surgery. She is happy with these physical elements of her transition, but still faces roadblocks, such as being entangled in gender in the workplace. “It’s really messing around mentally,” Childs said.
“I fight with confidence and my self-respect,” she continued. “I’m just afraid to let anyone see me without makeup.”
These days, she has a small group of trans friends who she feels close to and can turn to for support. She went to therapy in conjunction with her hormone therapy, and participates in art therapy at the Ruth Ellis Center, a Detroit organization that provides trauma-informed services to LGBTQ+ youth.
Last week, she says, she made a “dream box.”
“I put the things I want out of life inside of it,” Childs said, including getting married one day and having a pet. “I just want the life I deserve.”
Lee, 18, is another young trans who has found support at the Ruth Ellis Center. He told HuffPost he remembers feeling like something was different about him at maybe 4 or 6 years old, but didn’t come out to his parents until he was 12 or 13.
While his mother was supportive, neither was his father, to begin with, nor other members of the family.
“My mental health was not the best at the time,” he told me, “because I was mostly denied what I needed.” He said that the inability to access species confirmation care “made my mental state worse.”
He told me he is doing better now thanks to the support of his mother and the Ruth Ellis Center. “They have been a huge help and made a huge impact on my life,” he said. “My mental health needs are being met.”
He says he wishes parents understood that having a trans child “doesn’t mean you lost your son — they just found themselves in a way that shows who they are.”
He told me that trans teens need support more than discrimination. We hope people will realize it without backlash.”
How parents can provide support
Katie Horton is a Registered Trainee Mental Health Counselor working towards her license. She has been in practice for two years in Florida. After earning her master’s degree on the West Coast, Horton, who is trans, said,[I] I wanted to open my clinic here, because that’s where I came from.”
Many of its clients are trans too, and given the onslaught of anti-LGBT legislation, Florida is perhaps the most hostile place in the US for trans people right now. This hostility and lack of acceptance causes stress for trans teens. Without support, they’re more likely to resort to behaviors like drug use and cutting, something Horton says isn’t uncommon among the young people she works with.
It’s a “coping mechanism,” she explained, “when you feel a lot and something makes you feel numb, then it becomes addictive and it becomes hard to stop.”
She continued, “When you don’t have an outlet for support, when you don’t have an outlet and an understanding of the resources that are available so you can connect with others and not feel lonely — it makes sense. It makes sense for people to go to those places and get stuck there.”
The statistics on self-harm and suicidal thoughts in trans teens are alarming, but the good news is that parents can make a difference by showing their support and providing their children with some resources. Horton says she’s noticed patients’ depression and anxiety improve when they find a safe place, whether it’s in therapy or elsewhere.
“This is not an experience that many parents have, and there are no expectations that they should know how to deal with it,” Horton said. But she explained, “Being able to sit with your child during [therapy] Sitting down and asking these questions, getting that connection and that equality in the parent-child relationship,” it shows that you’re in this with them.
Horton says finding community, whether it’s support groups specifically for transgender youth or a “Dungeons & Dragons” group that’s a safe space for gender-nonconforming teens, is also important. Online communities like Discord are another place where she’s seen teens online find a sense of belonging.
In addition to helping teens find those safe places, Horton says the biggest thing parents can do to show their support is to listen to their child. Letting your child direct the conversation, Horton recommends.
“Ask them,” I suggested, “what does it mean to be an ally?” “You may be the only person in his life who takes his gender identity and expression seriously.”
This doesn’t mean you have to become an expert on trans issues overnight, but try to show that you’re open to learning and making an effort. There are plenty of organizations with helpful resources, including PFLAG, the Family Acceptance and Gender Spectrum Project. You can also check out “The Transgender Teen,” “A Handbook for Parents and Professionals.”
Helping your teen get his hair cut or styled, or helping him find and buy clothes he feels comfortable in are other ways to appear to your child.
You also need to “admit mistakes,” Horton said. “If you made a mistake, admit it [it]Be willing to correct yourself, go ahead and practice.”
If you’re misunderstanding your teen, for example, correct yourself and move on without making too much of it. If you’re too apologetic, you may make them feel like they need to care about your emotional reaction instead of testing their own.
Horton also notes that parents receive opposition from their children for “sharing someone else’s story”. For example, you don’t want your social media blowing up with the news that your child is changing their name and pronouns if your child isn’t ready to make that information public.
“It’s about letting your kids tell their story,” Horton explained. Let them know you understand that “sex is complicated and can take time.”
The words they use to identify and describe themselves may evolve and change as they grow in their individual identity, and you want them to feel safe sharing any new developments or understandings with you. Your role is not to provide all the answers, but to ensure that your child feels heard.
If you or someone you know needs help, call 988 or call 1-800-273-8255 to The National Suicide Prevention Lifeline. You can also get support via text messages by visiting suicidepreventionlifeline.org/chat. Plus, you can find local mental health and crisis resources at dontcallthepolice.com. Outside the United States, please visit International Association for Suicide Prevention.