BRANDON CHEW
Transgender people suffer from debilitating mental illnesses like depression and anxiety at much higher rates than the general public and therapists need to do more to help them, experts say.
Over 72.2% of transgender and gender diverse Michigan residents have been diagnosed with depression in their lifetime and 73% have been diagnosed with anxiety, according to data from the 2018 Michigan Trans Health Survey.
The survey, which was produced by Transcend the Binary, a community health center in Ferndale, analyzed physical and mental health concerns of 659 trans and gender diverse people. It recommended that counselors, therapists and other social workers provide more mental health services to trans people.
“One of the biggest challenges that we have with doing trans research anywhere in the U.S. is that we don’t have representative data on what the trans population looks like,” said Shanna Kattari, an assistant professor at the University of Michigan’s Department of Women and Gender Studies and the lead author of the study.
There is limited data on this group’s health concerns, in part because it may be difficult for them to come out as trans, especially in rural areas, Kattari said.
Data shows that trans people harm themselves and attempt suicide at far higher rates than the general public.
“Depending on the gender (of those surveyed), between about 6% and 10.5% of people had attempted suicide in the past year,” Kattari said. “Which is a really horrific number. Nationally, it’s usually a lifetime rate of 1.4%. So we’re already much higher.”
“But, when we look at the state in general, about a third, 32.8%, had attempted suicide,” in their lifetime, Kattari said.
Trans people have higher rates of depression and anxiety, in part due to experiencing transphobia in their day-to-day life, Kattari said, and heterosexuals can help a trans person’s mental health simply by using their chosen name and pronouns.
Other experts also emphasized the importance of using preferred pronouns when addressing trans people.
That can be comforting for trans people who’ve dealt with trans-phobic rhetoric and jokes, said Brodie Lobb, a therapist at Southfield Mental Health Associates who works mainly with trans clients.
Lobb has used dialectical behavioral therapy with his clients to “invite folks to look at the things that are causing them distress and find a way to accept that as part of their reality.”
Dialectical behavioral therapy tries to identify and change negative thinking patterns.
That could include, but is not limited to, issues such as body dysphoria which trans people can struggle with as they figure out how best to express their identity.
Body dysphoria refers to an obsessive focus on perceived physical flaws in appearance.
“Speaking a little bit from personal experience, managing dysphoria is not a fun time — it’s really uncomfortable,” Lobb said. “There’s sometimes where I want to just completely forget and push away the dysphoria so that I don’t have to deal with it or acknowledge it. That just makes it worse.”
Lobb emphasized the importance of trans people having a supportive community around them that accept them for who they are.
The COVID-19 pandemic has forced therapists to move sessions with clients online, a switch that presents opportunities and challenges.
Online therapy allows some people without access to nearby services an opportunity to reach out to therapists, said Jennifer Schwartz, a therapist at Health Emergency Lifeline Programs (HELP), based in Detroit.
“The ability to see a provider online for some people has made therapy accessible,” she said. “Just being able to hop online is a huge step-up for a lot of people.”
However, online therapy also presents challenges, especially for individuals who may have difficulty affording co-pays or having reliable access to the internet in rural areas, Schwartz said.
“There is something intangible in the process of therapy about being in a room with another person that we can’t capture via teletherapy, and for some people that’s a really big loss,” she said.
Therapists have also seen an increase in clients as a result of the pandemic, according to Dalton Connally, the owner of Connally Counseling, a mental health clinic in Ann Arbor.
“Every therapist I know is full as a result of the pandemic,” she said. “I think we have a waiting list of 30 individuals that are trying to get in and see our therapists.”
While offering online therapy may provide help for people who otherwise would not have access, most prefer in-person sessions, Connally said.
Online therapy “is not ideal for the practitioner or for the client. Most people prefer to connect on such an intimate level in-person, but that’s not the world that we’re living in right now.”
The pandemic may increase feelings of isolation for trans people, therapists said.
“A lot of times what can help a trans person’s journey is whether the people in their life support them,” Lobb said. “That substantially impacts rates of depression, rates of anxiety, rates of suicide, rates of self-harm.”
He said relatives, friends, partners and co-workers should give them “pace to navigate their own identity and accommodate them as much as possible.”