Transgender Anxiety and Depression: The Rollercoaster Ride Continues, but on an Upswing

Depression & Anxiety 402 views
Written by Timothy Pfaff

Providing greater support for the idea of young people expressing their transgender status socially, some new research suggests a biological basis for transsexuality.

Transgender Anxiety and Depression: The Rollercoaster Ride Continues, but on an Upswing

An incalculable amount of the anxiety and depression associated with being transsexual has to do with the mounting risk of getting killed. It appears that the more popular attention transsexualism gets, the more shooters it attracts.

Clearly it’s a transnational issue, but the U.S. is currently setting the pace. Only last weekend President Trump reinstated his ban on (at least most) transsexuals serving in the U.S. military. The order was reputedly drafted by his vice president despite being opposed by the Secretary of Defense and so far seen in the courts as at odds with Constitutional law.

Existing provisions specifically for providing support and medical services to transsexuals are being revoked at the same time all topics regarding LGBTQ health are being deleted from the Health Department website. Trump’s new appointee to head the Centers for Disease Control is retired U.S. Army Lieutenant Robert Redfield, is considered by many to be homophobic and discriminatory with regards to LGBTQ and HIV issues.

That duly noted, anxiety and depression have long been known to be concomitant with gender dysphoria, whether addressed or not. With the new attention to transsexualism, there has been a proliferation of questions about when parents should accept a child’s attested transsexuality as anything but a “phase.”

Most previous studies have suggested that children and adolescents whose transsexualism is denied have higher levels of both depression and anxiety. Perhaps in response, the popular press is giving new attention to a 2017 study asserts that says the same, only in positive terms: that allowing and supporting social expression of their transsexuality is highly beneficial to those children’s mental health.

The 2017 study

That study, “Mental Health and Self-Worth in Socially Transitioned Transgender Youth,” published in the Journal of the American Academy of Child & Adolescent Psychiatry, was reported in lay language in Think Progress and elsewhere.

In brief, the study found that there was no difference in self-reported cases of anxiety and depression among children who were allowed to transition socially and their peers and siblings. The Conclusion section of the study stated this (verbatim):

“These findings are in striking contrast to previous work with gender-nonconforming children who had not socially transitioned, which found very high rates of depression and anxiety. These findings lessen concerns from previous work that parents of socially transitioned children could be systematically underreporting mental health problems.” [Emphasis ours and in Think Progress]

The report also put paid to the notion that parents underreported their trans children’s problems. As reported in Think Progress, Jack Turban, of the Child Study Center in New Haven, Connecticut, responded to another report of the study that not allowing children to transition socially can damage parent-child and therapist-child relationships.

“Because these children feel judged for being transgender,” Turban wrote, the perceived inner conflict and sense of stigma “can be dangerous and may lead to the high rates of anxiety, depression, and even suicidality that we see in these children.” In an editorial published in tandem with the study, Turban wrote, "It showed that early social transition is viable and that these children are doing quite well, with developmentally normative rates of anxiety and depression." 

Think Progress concludes its article as follows (verbatim):

“The results jibe with a variety of other studies that have found that:

  • When kids are allowed to transition, including the use of puberty blockers, it improves their mental health.
  • When parents affirm their kids’ gender identities, they have normative rates of depression and anxiety.
  • When families reject their kids’ gender identities, it increases the likelihood of their suicidality and substance abuse.
  • Transgender kids identify as completely with their gender identity as their cisgender peers.

“The Trump administration has already indicated that it is backing away from providing support and legal protection for transgender students at schools.”

Newer studies: It Gets Better

The controversial New York Magazine columnist Andrew Sullivan entitled the middle section of his March 23 blog post “Born trans.” In the middle of it, he predictably weighed in with his own opinion: “My view, and it is also provisional, is that being transgender is probably mixture of genetics, hormones, and very early environment — which is roughly what I’ve come to believe about being gay as well.” 

But above and below his view he pointed to others'. At the end of his discussion, he points to his friend Dana Beyer’s post in Huffpost, wherein Beyer states emphatically, “Trans men and women know full well who they are, and there is no flexibility involved.

“We are of one brain sex and the opposite genital sex. We identify as our brain sex, because our minds are functions of our brains, and our brains determine our gender identity. It’s not something we make up, or choose on a whim — it’s who we are.”

But he begins his discussion by citing some new research reported in Medical Daily in an article of March 16 of this year. Its headline is "Transgender People's Brain Structures Are Different from Cisgender Folks, Study Suggests."

The report itself, published in Scientific Reports section of the highly respected journal Nature on January 15, 2018, is entitled “Grey and white matter volumes either in treatment-naïve or hormone-treated transgender women: a voxel-based morphometry study.” 

In that study, a team of researchers from the Medical School of the University of Sao Paolo, Brazil studied 80 participants between the ages of 18 and 49 in four equal groups: cisgender women, cisgender men, transgender women who had never used hormones, and transgender women who had used hormones for at least a year.

“MRI scans were then used to look for differences in gray and white matter volume of the brains,” writes Sadhana Bharanidharan in Medical Daily. “It was revealed that both groups of transgender women had variations in the volume of the insula in both hemispheres. The insula is a region of the brain that reads the physiological state of the body, thus being responsible for body image and self-awareness.”

Professor Geraldo Bussatto, a researcher on the study, was quote thus in Medical Daily: "It would be simplistic to make a direct link with transgender, but the detection of a difference in the insula is relevant since trans people have many issues relating to their perception of their own body because they don't identify with the sex assigned at birth."

The report was picked up by the popular press, particularly in the UK with some headlines many specialists considered inflated. In a post entitled “20 Gene Variants and Transgender Identity; What Does it Mean?” in DNA Science Blog, geneticist Ricki Lewis replied to the press’ “conclusion” that transgender identity is genetic in a section called “How Hype Is Born.”

Lewis in turn quotes from an abstract of a study J. Graham Theisen, MD, of the Medical College of Georgia at Augusta University, “Understanding the Genetic Basis of Transgender Identity,” presented at the Society for Reproductive Investigation’s annual meeting in San Diego March 6-10.

In that study, Theisen told Lewis, “We identified genetic variants in 20 genes that may play a role in transgender identity.” But it is still a powerful statement, for it lends justification to the idea that identifying as transgender is neither a mental illness nor a lifestyle choice – it is a variation on the theme of being human, as we all are in one way or another.”

He added, “Our research is still preliminary in nature, and we are a very long way from knowing what (if any) significance our findings have. The DNA of any randomly chosen individual will contain unique variants, and as a result, identifying variants alone is not sufficient to make any claims regarding causation of, or even relation to, a given phenotype. Therefore, we have not yet identified any particular genes or genetic variants that we know to be involved in the development of transgender identity, though that is the eventual goal of our research.”

What does this signify?

As usual, the only thing upon which all are in agreement is that further study is needed. But as Sullivan points out, the science is important in significant part to counter the unscientific attitude of the far right, namely, that transsexualism is a form of mental illness.

“There are, mercifully, some transgender activists who have taken up the biological argument,” Sullivan writes in the final paragraph of his discussion. He calls the formulation of Beyer, quoted above, “brilliant.

“It doesn’t overturn the vast majority’s sense of their own sex and gender; it bases its compassion in a scientific discourse, not an ideological one; and it may even have the virtue of being true. Here’s hoping it will play a greater role in deepening our understanding, even though so many transgender people (not ideologues) have been telling this story about themselves forever.”

Here’s hoping indeed.

Sources/Reading:

http://nymag.com/daily/intelligencer/2018/03/america-takes-the-next-step-toward-tyranny.html (middle section)

https://www.nature.com/articles/s41598-017-17563-z

http://www.medicaldaily.com/transgender-peoples-brain-structures-are-different-cisgender-folks-study-423107

http://blogs.plos.org/dnascience/2018/03/22/20-gene-variants-and-transgender-identity-what-does-it-mean/

https://www.huffingtonpost.com/dana-beyer/musings-on-wpath----the-w_b_10777292.html

http://www.jaacap.com/article/S0890-8567%2816%2931941-4/fulltext

https://thinkprogress.org/trans-kids-socially-transition-study-529f34c1bb3b/

https://www.medscape.com/viewarticle/875569#vp_2

https://thebodyisnotanapology.com/magazine/9-strategies-for-dealing-with-body-dysphoria-for-gender-queer-and-trans-folks/

Bonus reading:

https://www.theatlantic.com/science/archive/2018/01/remembering-the-transgender-scientist-who-changed-our-understanding-of-the-brain/549458/

 

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