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Treating Depression and Anxiety in Teens With Gender Dysphoria

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As our society changes, so do the issues that kids and teens face. Members of Gen Z were born into a world where some of their struggles seemed unfamiliar to educators, counselors and even parents.

An example of this is the case of gender dysphoria, which is “psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity” according to the American Psychiatric Association (APA). The transgender community won the fight to stop diagnosising gender non-conformance as a psychiatric condition in 2013. However, societal acceptance is a slow process, and anxiety and depression are still quite common among marginalized communities like trans teens and stigmatized across cultures.

“Health professionals and activists have often pointed out that trans teens struggle with mental health issues more than their cisgender counterparts, but the new study provides further confirmation,” writes Donald Padget of Advocate. In fact, “roughly 20 percent of all adolescents [studied] suffered from depression at some point and that 13 percent suffered a major depressive episode in the prior 12 months.”

The study also collected data on other conditions such as anxiety, attention deficit hyperactivity disorder, PTSD, bipolar and eating disorders. Recently, access to gender-affirming care for gender dysphoria has helped individuals better manage their mental health struggles with methods like hormone replacement therapy, puberty blockers in the case of pre-pubescent patients and gender-affirming surgery. These have proven to be quite effective in easing the social and emotional burden of not identifying with one’s assigned-at-birth gender.

Additionally, learning how to recognize the early signs of gender dysphoria may be life-saving. Suicide is the leading cause of death for all youth ages 15 to 19, according to the World Health Organization (WHO), and a staggering “50% of trans youth will contemplate suicide, with risk being higher if youth are rejected by their families,” accorring to the Advocate study.

Choosing the Right Approach

Therapists and school counselors should keep in mind that when it comes to gender and transgender identities, in particular, one size does not fit all. There is immense pressure for trans youth to “pass” or present themselves as their chosen gender, but this is not the solution for everyone. Therapists and counselors must be familiar with the varying layers of gender identity and expression and encourage youth to be whoever they want to be outside of the binary constructions of gender.

Still, hormones and surgery are not magical cures for depression. Helping youth and teens manage their overall mental health is important since being transgender is only one facet of who they are, and there may be other factors at play.

In addition, parents and clinicians should offer a safe space for youth to explore their identities. From clothes and haircuts to pronouns and names, transgender individuals should feel confident that they can try out different types of expression, treatments and pronouns until they find what feels right. As a support system and leader for these individuals, this requires patience and adaptability. Telling them to “make up their mind” or to pick a silo of expression is detrimental to their growth. Asking questions, seeking affirmative representation, contacting activists and support groups and, of course, supporting their decisions are small acts that make a difference. Transitioning may make them feel like outsiders, so showing that they’re not alone is the first step to improving their mental health

The most important takeaway for patients, parents and mental health professionals alike is that being trans is not something to be cured or hidden. Instead, it’s something to be celebrated as a person’s path to finding their true self. Transgender individuals are at a heightened risk of mental health struggles and suicide, so ensuring that these individuals have a support system and feel safe is critical to their happiness.

Learn more about the University of Wisconsin-Superior’s online Master of Science in Education – Counseling Clinical Mental Health Track program.

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