Self-Harm and the Trans* Community

An estimated 40 to 50% of GLBTIQ (Gay, Lesbian, Bisexual, Trans*, Intersex, Queer) people self-harm, or attempt suicide at least once in their lifetime.

National estimates suggest between 4 to 7% of Australian youth (aged 15 – 24 years) have engaged in self-harming behaviours. 63% of respondents of the Trans Mental Health Study 2012 (Study 2012) harmed more prior to transitioning, and only 3% after. Of these, 60% felt the reasons for self-harm related to being trans* either directly, or indirectly.

A recent Australian review of LGBTI mental health reported that 50% of trans* Australians had attempted suicide. This is almost identical to a UK study which suggested 48%. Suicidal ideation and attempts are more frequent pre-transition. One respondent said, "I feel as if I am always going to be different by the society around me, and either patronised as a ‘brave survivor’ or avoided as an incomprehensible alien artefact – never just treated as a person."

Self-harm reduces following transition for the majority of those who have a history of self-harm. "My feelings of self and worth, not to mention, my confidence has grown exponentially since coming out, and presenting male. I am not ashamed of myself anymore – it’s been a wonderful journey," said Azaria**, 31, Adelaide, SA. A respondent in the Study 2012 said, "I gained the guts to stop caring what other people thought about me. I wake up every day with a few billion people hating me just for existing, and it doesn’t matter."

The majority of trans* people feel that the way their community is represented in the media has a negative effect on their emotional wellbeing. "Tabloid stories about transpeople are often exploitative, invasive of privacy, inaccurate, irrelevant or intended to drum up transphobia." Just look at the Courier Mail reporting the death of Mayang Prastyo a couple of weeks ago. Insensitive, sensational headlines, and photos, described the trans* murder victim as ‘she-male’ and ‘lady boy’.

Transgender and gender diverse people are more likely to experience mental distress due to the social disapproval and discrimination they encounter in their daily lives. Their mental health status is disclosed by some, depending on their perceived reaction from doctors or health care professionals. According to Gender Disorder Information, ‘Some shrinks want to solve the other problems before they tackle the gender issues – but what if the gender issues are the likely source of the problem?’ Many trans* people will hide feelings of depression or self-harm in fear it will delay their transition.

Discrimination is one of the main factors influencing trans* mental health and self-harm. Abuse, discrimination and stress are all too common. Going Upstream (a framework for promoting the mental health of lesbian, gay, bisexual, transgender and intersex (LGBTI) people) suggests that 49% of LGBTI youth experience some form of abuse in childhood. The Study 2012 confirms this. ‘Once dysphoria is resolved via transition, all that remains is people’s attitudes. Once society stops discrimination against us, then it will be safe to say that being trans* is not a bad thing,’ participants said, ‘I am more comfortable with my appearance and who I am, but it also makes me very aware that others aren’t.’

From Writing Themselves in 3 2010, a national study of SSAIGD (Same Sex Attracted, Intersex, and Gender Diverse) people aged 14 – 24 years, has shown that 18% who have never been subjected to physical or verbal heterosexist abuse, had self-harmed. 31% had self-harmed after verbal abuse and 55% after physical heterosexist abuse. Data from 2013 Growing Up Queer suggests that 33% of young people have self-harmed after homophobic or transphobic abuse. ‘I was sexually abused as a child by a close relative… I was emotionally abused growing up, perhaps responsible for my self-esteem issues and confidence problems now,’ said Azaria.

According to the experience of many trans* people, healthcare services are "inadequate and staffed by uneducated workers, especially when gender issues are coupled with self-harm". Self-harm and ‘alternative’ lifestyles are still relatively taboo in our society. A high per cent of trans* people have reported feeling emotionally distressed about their mental health whilst attending a Gender Identity Clinic (GIC). 

These frustrations are just as common here in South Australia. Newly identifying trans* people are required to see Gender Clinic prior to transitioning. There is only one GIC in Adelaide, and no alternative other than travelling interstate for care. South Australian law is still abiding by the Sexual Reassignment Act, written in 1988. Obeying outdated rules and regulations in fear of archaic laws leaves no room for best professional practice and individualised care for trans* people.

I attended the ANZPATH conference, Adelaide October 4 - 6, and there the first seeds of developing a national voice for the Australian trans* community were established. This is exciting. It is a work in progress that is going to take time and commitment, but it is going to reap some fantastic steps forward for the trans* community, and the future of gender diverse people in Australia, and hopefully, the world.

**Name changed.