The State of Art Education Initiative

Social Support Lacking for People with Gender Dysphoria

Reviewed by the medical professionals of the ISSM’s Communication Committee

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People with gender dysphoria may not receive the social support they need, a recent Journal of Sexual Medicine study suggests.

They are also more likely to have psychiatric disorders compared to the general population, the authors said.

Gender dysphoria refers to a distressing incongruence between a person’s gender identity and the gender they were assigned at birth. For example, a person born and raised as a male may actually feel more female, preferring activities and clothing associated with females. When that mismatch causes distress (such as feelings of frustration, depression, or anxiety), the person may be diagnosed with gender dysphoria. Many transgender people seek gender-affirming medical care, with the intention of transitioning from one gender to another.

Transgender individuals often face societal stigma, transphobia, and discrimination in their day-to-day lives. The stress can heavily impact physical and mental wellbeing, and social support is essential for coping.

In this study, researchers investigated social support in a group of 50 transgender individuals who were seeking sex reassignment at one medical center in Turkey. Another group of 50 age- and gender-matched participants served as a control group. The average age for both groups was 27 years, and 36% identified as female.

The researchers interviewed each participant about their psychiatric history. Participants also provided social and demographic information and completed the Multidimensional Scale of Perceived Social Support (MSPSS) assessment tool, which evaluates support from family, friends, and significant others.

In the transgender group, participants had shared the news of their gender dysphoria to relatives at varying rates. All had told at least one relative. About a quarter had discussed their feelings with their parents and siblings; however, 6% had opened up to just their mother and siblings. About 58% had discussed their gender identity with all of their relatives. Just over three-quarters had shared their identity with friends.

Psychiatric disorders were more common among the transgender participants. Based on interview results, about 84% met the criteria for at least one lifetime disorder, compared to 18% of the control group. Major depression was the most common disorder, affecting 78% of the transgender group and 16% of controls.

Approximately 18% of the transgender group had at least one psychiatric disorder at the time of the interview. In the control group, 4% had a current disorder. Major depression was affecting 18% of the transgender group and 2% of the control group at the time of the study. None of the transgender participants were diagnosed with anxiety disorder at that time, but 2% of the control group was.

The rate of lifetime suicide attempts was higher in the transgender group. About 32% had attempted suicide, compared to 2% of the control group.

On the MSPSS, total scores and family subscales were lower for the transgender group, indicating less social support. There were no differences between the transgender and control groups for the friend and significant other subscales.

When comparing MSPSS scores based on gender identity and assigned sex at birth, the researchers also found less social support in the transgender group.

Overall, lack of social support is “a vital public health problem,” the authors wrote.

“The present findings confirm the relative deficiency in social support, which has been shown to act as a buffer against the disruptive effects of stigmatization and discrimination in people with [gender dysphoria]” they added.

Clinicians who work with the transgender community should help their patients find and develop social support networks, they said.


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