How We are Failing the Transgender Community

Suicide, depression, discrimination, violence, substance abuse and inadequate access to health care are dangerous issues facing the transgender community.


shutterstock_79104379Transgender individuals have an extremely high suicide risk. According to one survey, 41% of transgender individuals have tried to commit suicide. Compare this to the general population where only about 1.6% of the population attempt suicide.

Suicide risk is especially high in those between the ages of 18 and 44 years.



Harassment and discrimination are constant pressures faced by transgender individuals. A 2010 research study found that 78% of male-to-female individuals were psychologically abused, and 50% were physically abused, only because of their gender orientation.

This high level of physical and psychological discrimination and abuse is a public health problem. Harassment rates are also high in the female-to-male population.


Substance abuse, alcoholism and smoking are common. Many times these substances are used to cope with the effects of physical and psychological abuse.shutterstock_275984108

Many “safe spaces” for transgender individuals are found in clubs, restaurants and bars where smoking and drinking are acceptable and popular. In 2008, the American Journal of Public Health reported on the aggressive marketing campaigns by cigarette and alcohol corporations, targeting the gay and transgender communities.


shutterstock_214547947Living in a hostile environment with a high risk of harassment interferes with education and employment. This in turn affects the ability to earn an income and receive adequate medical coverage.

A quality of life research study found a staggering 97% of transgender individuals experienced discrimination on the job.

Next Steps

Everyone is responsible for providing a safe and accepting environment for the transgender community:

Health Care Providers: In a world of few allies, every health care practitioner must provide a safe environment for counseling and medical care. Depression, suicide risk, substance abuse and other health concerns need to be addressed openly at every visit.

Businesses: A Zero tolerance policy for discrimination must be in effect. Education about gender-identity in the workplace and steps to provide an inclusive environment need to be offered regularly.

Schools: A Zero tolerance policy for discrimination must be in effect. Gender-identity education that starts early can socialize broader communities and develop awareness and inclusivity.

The Transgender Community: Collaborating with medical and mental health professionals to develop substance abuse counseling and health screenings starts the dialogue and involves leaders across the communities.

First Responders: Identifying and addressing discrimination and harassment in the community is essential. Training programs for police to understand transgender challenges and enforce anti-discrimination laws can help.

Citizens: Report harassment, and provide support to transgender individuals. Become educated on gender role identity and how to ensure harassment and violence against transgender people does not occur, or is immediately stopped.

According to the Institute of Medicine, there is currently not enough research on how medical providers can meet the needs of transgender patients. Many primary care providers do not have adequate training on the medical, social and psychological needs of this population.

As with individuals of all types of backgrounds, the health care community must provide care to this population with empathy, understanding and acceptance.

The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed medical professional. It is essential that you discuss with your primary care provider any symptoms or medical problems that you may be experiencing.


Carmel TC, Erickson-Schroth L. Transgender Mental Health. Paper presented at: Philadelphia Trans Health Conference; May 30–June 2, 2012; Philadelphia, PA

Human Rights Campaign. Corporate Equality Index 2015. Available at Last accessed 2015

Institute of Medicine. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington, DC: The National Academies Press; 2011

Newfield E, Hart S, Dibble S, Kohler L. Female-to-male transgender quality of life. Qual Life Res. 2006;15(9):1447-1457

Nuttbrock L, Hwahng S, Bockting W, et al. Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. J Sex Res. 2010;47(1):12-23

Ray N, National Gay and Lesbian Task Force Policy Institute. Lesbian, Gay, Bisexual and Transgender Youth: An Epidemic of Homelessness. Available at Last accessed 2015

Smith EA, Thomson K, Offen N, Malone RE. “If you know you exist, it’s just marketing poison:” meanings of tobacco industry targeting in the lesbian, gay, bisexual, and transgender community. Am J Public Health. 2008;98(6):996-1003

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