A Complex and Perplexing Problem

This week brings the Transgender Day of Remembrance, so I return to the subject I have written about often. Last summer an op-ed piece in the New York Times addressed the issue of malleability in gender. Richard Friedman, a psychiatrist at Weil Cornell Medical College, spoke of two studies that have shed light on the transgender experience.

The first was conducted by Dr. Georg Kranz at the Medical University of Vienna and published in the Journal of Neuroscience. A specialized MRI was utilized to study the functioning brains of four different groups, natal males and females, male to female transsexuals, and female to male transsexuals. All of the trans participants had not yet begun hormone therapy, since it is known that brain structure changes with cross-sex hormones.

The findings supported the hypothesis that gender dysphoria is neural in its origins. The MRIs of both groups were about halfway between the natal males and females. What accounts for the findings? It is known that biological sex develops in the first trimester of gestation, while the brain’s sexual wiring does not develop until the second half of pregnancy. The study makes the educated assumption some kind of glitch occurs when the brain is wired with its gender identity, leaving a brain not in sync with its corresponding body.

The second study was completed by the Karolinska Institute in Sweden. They followed 324 transgender individuals for 10 years post-transition and found the incidence of suicide 19 times higher than the population at large. Friedman did not mention that the study was of people who transitioned before 1989, a time when virtually no society was welcoming toward transgender individuals.

Dr. Friedman does not believe the Karolinska study shows that transitioning is unwarranted. To the contrary, he acknowledges that transitioning resolves gender dysphoria. His question, which remained unanswered in the article, is why does transitioning not make for a better life? Fortunately there are more recent studies that answer that question.

A study of 1229 transgender individuals published in August of this year showed 35 percent of the participants had seriously considered suicide. But the additional findings of the study shed considerable light on the reasons for that suicidal ideation.

First, transgender people who had the support of their families had an 82 percent lower rate of suicide than those who did not have family support. The study also showed that transgender people who were not a part of a racial/ethnic minority and had a higher level of education had far lower rates of suicide. Additionally, transgender people who “passed” in public reported a quality of life not statistically different from the population at large. In other words, if you are like me, white and educated with a supportive family, and you can live in your new gender without people on the street staring at you, your chances for having a satisfying life are pretty good. If you don’t have all of those things, it is a different story.

The study showed those who had been discriminated against in employment and housing had a higher rate of suicide, as did those who were subject to physical violence and those who did not have the means to complete the legal name and gender change process. Alarmingly, another study showed that transgender youth whose parents were not supportive had a 13 times greater chance of suicide than those whose parents were.

The biggest indicators of difficulty in transition are alienation from family, friends, and co-workers, and the accompanying deep sense of shame. If the trans person internalizes transphobia, their adjustment to their new life becomes monumentally difficult.

Some have used the suicide rate to attack the transgender community, suggesting these suicides occur because of multiple mental disorders, when the reality is the suicide rate is not high because of psychiatric comorbidities. It is high because of societal issues. When trans people have the kind of support received by the population at large, they report a quality of life in line with the population at large. The problem is that a lot of trans people are not supported at all, but face rejection everywhere they turn. That is the main reason they internalize transphobia.

The debacle in Houston is a prime example. Millions of dollars were spent to create a threat where none exists. There is not a single record anywhere of a trans person attacking anyone in a restroom. But that did not stop the misguided zealots from their shame-inducing smear campaign. The tragedy is that this vilification of the trans community does not happen in a vacuum. Real live struggling trans people in Houston were subjected to a barrage of attacks that for those who do not have the support they need, result in the internalization of shame and transphobia. The hate pedaled in the name of decency will lead, with great certainty, to the suicides of vulnerable trans people. It also perpetuates the global hate that leads to one transgender person being murdered every 29 hours.

We live in a world in which hate abounds, minorities are vilified, and innocent people are slaughtered, often in the name of religion. The solution to all of the hatred is not complicated.

On his last day of public ministry, in answer to the last question he was ever asked by the population at large, Jesus said the greatest laws were to love God and love your neighbor. Everything else was based on those two. Matthew tells us his audience didn’t like the answer and Jesus was greeted with dead silence. Matthew goes on to say from that day on no one dared to ask Jesus any more questions. He made clear what he wanted people to do. They just decided not to do it. And 2000 years later, not much has changed.

And so it goes.