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Affirming Transgender Adult and Youth Identity

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Written by Kyle Cleary, BA

Kyle is currently an intern and under the supervision of Kayce Bragg, LPCS (# 8061), LAC #369

Kyle is an intern attending the University of the Southwest’s online CACREP accredited program. He is obtaining a master of science in Clinical Mental Health Counseling. He obtained a Bachelor of Arts in psychology at the City University of New York’s Senior college, Hunter College. Kyle is most passionate for LGBTQIA+ issues as well as treatment for anxiety disorders, personality disorders and trauma of all kinds.

Kyle’s therapeutic approach is to meet every client exactly where they are in life with warmth, nonjudgment, empathy and stellar listening skills to facilitate a trusting client-counselor relationship. He is interested in a myriad of theories to help clients. Some of which are Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), person-centered approaches, Acceptance and Commitment Therapy (ACT) and Rational Emotive Behavioral Therapy (REBT).

Affirming Transgender Adult and Youth Identity


Transgender individuals face a unique mental health risk due to their identity. Comprehensible and unvarying data indicates a heightened risk of mood and anxiety disorders among transgender individuals. Emerging evidence also suggests elevated rates of bipolar disorder, post-traumatic stress disorder (PTSD), and substance use disorders in this population. This is based on a small body of research published, but something must be done to alleviate the genuine mental health concerns related to people who are transgender. Furthermore, transgender youth confront mental health risks as well. Transgender youth exhibit a discrepancy in adverse mental health outcomes when compared to cisgender youth, with a similarly high burden observed in both female-to-male (FTM) and male-to-female (MTF) youth. Recognizing gender identity differences in clinical settings and offering relevant services and support are crucial measures in addressing this imbalance.

How can anyone help transgender people facing mental health struggles?

  • Counselors and people interacting with these individuals should avoid committing microaggressions towards them. This starts with cultural awareness, training, and workshops to learn information about this identity group. 
  • Therapists and individuals in transgender people’s lives should avoid misgendering these individuals, “dead naming,” or calling these individuals by the wrong names, and asking invasive questions about their bodies.
  • Ask the individual what their preferred name and pronouns are. If the individual does not want to be called by their chosen name or their “dead name,” or new pronouns, respect their wish.
  • Accountability: If a mistake is made in learning to respect these individuals, apologize sincerely, correct the error, and move on. 
  • Supporting them and listening to their stories and concerns are of utmost importance. Often, lack of familial and social support leads to the onset of other mental health concerns in trans individuals. 

Transgender Individual’s mental health concerns


Counselors and other mental health professionals often encounter common concerns when working with transgender individuals. These concerns may manifest in symptoms related to gender dysphoria, including depression, anxiety, and suicidal ideation. 

If a client or your transgender child comes to you with thoughts of suicidal ideation or self-harm, don’t panic! This should be discussed between you and the person openly and honestly. Ensure that the individual can express their detailed thoughts on the issue, and you can work together to ensure the individual is safe and protected. 

Higher rates of eating disorders are also standard in trans individuals. Gender dysphoria and body dysmorphia are common risk factors for eating disorders. These individuals experience controlling their body weight and shape through disordered eating. 

Counselors may also work with transgender individuals on traumatic experiences as well as Indications of minority stress, which are linked to experiences of discrimination, stigmatization, and harassment. With this, it is particularly distressing to these individuals to note that in many states within the U.S., their rights are up for debate. Certain legation and lawmakers believe that they are in control of their identities. The stress of these mental health and individual experiences have real-life implications. According to the Williams Institute at UCLA School of Law, research indicates that 81% of transgender adults in the U.S. have contemplated suicide, with 42% having attempted it and 56% reporting instances of non-suicidal self-injury throughout their lifetimes.


Gender and body dysphoria


While being transgender is in no way a mental illness, A significant number of transgender individuals undergo periods of dysphoria at different stages in their lives. Dysphoria is a state of unease or general dissatisfaction with aspects of life. Experiencing dysphoria, transgender individuals often find themselves living in a body and adopting social roles that do not align with their internal sense of self, particularly within a societal context marked by misunderstanding and discrimination. Counselors and support systems in transgender people’s lives have a critical job of helping the clients by supporting them through the emotional challenges of depression, anxiety, fear, guilt, low self-esteem, shame, and self-hatred. Our responsibility as mental health professionals and support systems in trans lives is to address and treat the dysphoria and its associated symptoms, focusing on the wellbeing of the individual rather than attempting to alter their gender identity. 

Gender identity and recognition typically commence between the ages of 2 and 4 years. Children who eventually develop gender dysphoria may exhibit gender-crossing behaviors between the ages of 2 and 4 years. Some individuals may not experience gender dysphoria until the onset of puberty. Among teens, gender dysphoria can manifest quickly during the puberty.

Risks associated with gender dysphoria are suicide, suicidal ideation, self-harming behaviors, and substance use and abuse. Individuals with gender dysphoria face a significantly higher rate of suicide compared to the general population, with a staggering 32–50% attempting suicide. This elevated rate is believed to be influenced by social stigma, rejection, discrimination, bullying, and violence. Approximately 26.3% of individuals with gender dysphoria resort to substance abuse as a coping mechanism for the stress and oppression associated with their diagnosis. Researchers posit that this elevated rate of substance use is linked to three minority-theory experiences: enacted, internalized, and social stigma. 

Conclusion: Caring for Transgender and Transgender Youth’s Mental Welfare


Whether you are a counselor, a parent, or a friend of a transgender individual, acceptance and understanding are at the core of upholding the well-being of their mental health. Often these individuals do not feel seen or heard; they feel ostracized by a heteronormative and cisgender society or are having internal struggles with their own body and gender image. These are delicate issues, yet there is an attainable resolution. It starts with support from the outside. Making sure they feel safe to be who they are, however they may look on a day, is paramount to obtaining positive mental health outcomes in their lives. 


If you, or know of someone who could use some online counseling to feel heard and learn ways to cope, please connect with one of our therapists today for a free consultation.


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