The mental health struggles associated with being a trans man are often dismissed in already frail discussions on men’s mental health. As a trans man living in the U.S., it’s become abundantly clear to me that we need to reframe how we talk about men’s mental health to make progress.
Discovery is part of the journey
When I was thirteen, I finally began seeing a therapist; it was a long overdue change in my life after my grandmother, who acted as a second parent alongside my mom, passed away the year prior. As one might expect, this sudden loss sent me into a depressive spiral. I was diagnosed with depression, anxiety, and obsessive-compulsive disorder (OCD). Although therapy and medication helped, I continued to struggle, especially with nagging issues related to my self-image — issues I had never been able to put into words during most of my childhood.
When I was fourteen, I had the chance to meet one of my long-standing Internet friends in real life; she and I had been talking online for around a year. Our friendship quickly grew from long nights chatting on the forums to calls from our house phones, then FaceTime and texting.
Spending several nights with me let her see a side of me that few others saw; I owned girls’ clothes, but they never left my bureau in favor of ripped jeans and graphic tees. I wore mens’ deodorant and tilted my head up in the mirror from time to time to see if I could create the illusion of a bobbing Adam’s apple if I swallowed the right way. Early one morning, we had a frank conversation: she asked me if I felt like a girl, or something else.
The wall I had built around myself for the past fourteen years crumbled around me. I tearfully told her what I knew to be the truth — that I was a boy, or at least, I wanted to be a boy. To her credit, she took it in stride. “That makes sense,” she said. “What would you like me to call you?” Today, 9 years later, the girl who helped me finally break down my self-imposed walls is my wife. I am lucky to have had her support through the years, but I cannot say the same for many people I know who haven’t had the blessing of even a single person’s support to count on during their transitions.
What I was surprised to find was that, after I came out, my once supportive and safe environment surrounding mental health care became critical of my every move. My mom and I "agreed to disagree" after I came out. After limiting discussions of my gender issues, we mutually hoped my therapist would help us find common ground. I hoped he would help me to communicate what I was struggling with — that this seemingly irrational development, out of left field to some in my life, had been my reality for as long as I could remember.
“Are you sure you’re not genderfluid?” My therapist asked, perhaps ill-informed instead of ill-intentioned. “It would be easier for your mom to accept that you’re still her daughter if some part of you was still the girl she recognizes.” But I wasn’t, and I never had been.
The spaces that had been intended to help me work through my unrelated mental issues became focused on picking apart the source of my transness, which seemed to be regarded as the biggest illness of all.
Gender Dysphoria: The persistent ‘sickness’ that may not exist
I experienced some of the lowest points of my life during high school. Many believe the mental health struggles of transgender kids are inherent; that is, they accompany being transgender, or from a more sinister standpoint, mental health issues are deserved if you have committed the crime of being trans.
I was elated when in 2019, at 18 years old, the World Health Organisation declassified ‘gender dysphoria’, which I had been previously diagnosed with, as being a mental illness. The condition I lived with was not a sickness, nor was it treatable; it was how I had been born, and the healthiest way for me to move forward was to go with the flow instead of fighting the current.
Trans people aren’t mentally ill by default — but how can trans people thrive today?
Many people have tried to spark debates with me about how transness and mental illness intersect. Some may bring up alarming statistics: for example, a 2022 U.S. survey found that 1 in 5 transgender and nonbinary youth had attempted suicide. Others, including many far-right politicians, purport the idea of a transgender "cult" acting in sinister ways. Of course, this idea is not based in reality, but its ability to scare the uninformed is, without question, effective. This has led to widespread beliefs that trans people are inherently bad. Many believe that transness is in itself a mental illness, and that treating trans people poorly is some kind of karmic justice for the crime of being born trans.
What I have to ask others, though, is this: wouldn’t you be depressed? If you woke up and discovered you had to live your life as the opposite gender and nobody believed you when you professed your internal sense of self? Instead, what if they suddenly began accusing you of pedophilia or menacing women in the bathroom? Would you not struggle to get a hold of your mental health? The weight of being trans is somehow often omitted from discussions on trans mental health.
Of course so many trans folks are struggling — those who are rejected by society often do.
Trans men aren’t the problem — the stigma around men’s mental health is.
There is very little space for trans men in men’s mental health discussions. I would go out on a limb and say that the perceptions of men’s mental health hurting trans men are hurting cis men, too. Trans men may avoid appropriate mental health care because they feel getting that help makes them appear weak, or effeminate; the same pervasive idea of ‘therapy is for sissies’ that has permeated the culture of today’s masculinity. These perceptions push down struggling cis men and may bar trans men from seeking appropriate treatment for fear of misstepping. There are high expectations from society on how to be a man correctly, and many trans men walk on eggshells for fear that showing emotions or admitting when things are tough will prove to others that their masculinity is not to be believed.
To uplift not only trans men, but all men, we need societal change. Mental health issues are not shameful — they’re a part of life. A diagnosis does not change your values or your experiences, nor does it determine your inner strength. To find acceptance for all, we need open, honest conversations - and new perspectives on how gender determines our lives.