Mind the Gap: PTSD in trans versus cisgender people.

Transgender people face plights that cisgender people will never come across. Fear of using the restroom that matches their gender. Fear of wearing clothes that align with their gender. Fear of correcting the use of a deadname.

Things that seem normal to cisgender people are political, social, and personal statements to trans people.

Imagine living in a world where everything that is obvious to everyone else is ambiguous and controversial to you.

It would feel as though you are living in a world inside-out.

Living in that kind of world would most certainly cause you stress, sadness, and fear (to say the very least). 

That is why being transgender can also mean living with conditions such as anxiety, depression, and, as is a center topic today, Post Traumatic Stress Disorder (PTSD). 

Trans people have a “1.6 and 3.9 times greater risk of probable PTSD” than cisgender people, according to the AJPH. 

Discrimination and violence are common reasons why the transgender community is at a higher risk for developing PTSD. 

Despite this higher risk, we have less research, resources, treatment options, and coverage on PTSD in the trans community. 

I am not claiming trans people with PTSD deserve more attention. 

I am claiming that the community deserves more attention than has been provided. 

Many activists are demanding that the gap in attention get addressed swiftly. The current situation is causing many trans people to become alienated from treatment. 

So, despite the textbook presentations, PTSD goes untreated and underreported, further reinforcing stigmas. It is a vicious cycle that we can break with knowledge. 

Speaking of spreading knowledge, I would like to discuss this gap. 

What does it mean? 

Why is it there? 

How do we close it?

What is the Gap?

First, let’s get you up-to-speed with what PTSD is at its core. 

The four markers of PTSD, according to a journal in PMC, are as follows (directly quoted): 

1) Persistent intrusive thoughts. 

2) Avoidance of stimuli associated with the event.

3) Negative cognitions...such as emotional numbing and detachment.

4) Hypervigilance, irritability, exaggerated startle response, or self-destructive reckless behavior.

In layman’s terms, PTSD traits include flashbacks of the experience, avoidance of things that remind them of it, and negative emotional responses that cause harm to themselves.

It is a response to trauma. 

Both cisgender and transgender people can experience trauma and PTSD. It is the cause of the experience that creates the gap. 

For example, transphobia is a common cause of PTSD in transgender individuals.

Meanwhile, cisgender people would not develop PTSD as a direct result of transphobia. 

Here is where separation in the disorder presentation shows itself. The gap refers to the differences in what causes the disorder. It also included how different causes factor into treatment. 

Since the causes are different, PTSD in transgender people must be treated (medically) differently. 

For instance, you would not counsel a cisgender person on how their gender identity is not to blame for their trauma. You may have to address this issue with a transgender person. 

In addition, PTSD can get caused by unconventional reasons in trans people. These reasons are incomparable to those that might affect cisgender people.

According to a journal published in the American Psychiatric Association, “anti-transgender bias and non-affirmation experiences [can be] potentially traumatic themselves.”

To summarize, general societal rejection of transgender people can be traumatic on its face. 

To develop PTSD based on a global transphobic environment is not something anyone who is not trans would likely experience.

It is unique to trans people and their PTSD. 

Such shows that transgender mental health comes with certain circumstances that must get considered. 

To disregard them is to ignore the treatment nuances that the community requires to recover. 

We also ignore something vital: individualized treatment.

Addressing PTSD in the trans community requires individualized treatment with LGBTQ+ informed practitioners and standards.

Interestingly, individualized treatment is commonplace in 2021...for cisgender-heterosexuals.

For anyone else, you would have to do some hard searching for professionals who specialize in your circumstances or identity. 

Cisgender people who have PTSD can go to just about any professional for treatment and receive informed help. The story is different for transgender people. 

Per recent studies, trans people face medical discrimination at extremely high rates. 

Additionally, a run-of-the-mill psychiatrist is not well informed of the transgender experience (general experience, of course).

That makes it hard to treat trans patients beyond surface-level, often inaccessible, medication. 

Why is this the case? Do doctors not care? 

Not necessarily. It is more complex than that.

Let’s open that can of worms real quick. 

Why is it there?

This question deserves a blog site altogether. Therefore, I will summarize. 

For starters, there is a lack of transgender representation in government.

Why?

I recommend Googling American History + Transgender as I do not have the space to dive into that.

A little side Google never hurt anyone. 

Secondly, there is a lack of research to support new and humane treatments. That is due to funding issues, lack of transgender study participants, and too little demand.

To build off the “too little demand” comment, I mean to say there is not enough push. The LGBTQ+ community and allies must band together to make our voices heard. 

We cannot sit on this information. We must act. There are many ways to advocate for transgender health care and human rights.

Find some ideas here. 

Closing the Gap

That leads us to how we can close it:

Solve all that. 

Tall order. But an order to be filled nonetheless.

It is an urgent matter, a rush order if you will. 

Transgender individuals are at high risk for PTSD and suicide (which increases with PTSD).

Lives are on the line. 

One main obstacle is changing the way we talk about mental health care.

Think about it. 

We do not discuss cisgender healthcare. That sentence was even odd to type because those terms are otherwise known as “healthcare." 

Why? Because singling out cisgender people and saying they deserve to be healthy would get this response: 

Duh.

There is that gap again. Not only does it exist in cause and treatment, but it is also in our everyday conversations.

To change our mindsets, we must change the way we speak. 

We can also help by donating to support organizations, voting NO on anti-LGBTQ+ health care policies, petitioning for inclusive treatment, and volunteering at transgender advocacy centers. Even speaking out and sharing your experiences helps by raising awareness. 

So what are you waiting on? Get involved today.

Resources: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981566/

https://psycnet.apa.org/record/2021-80260-001

https://transequality.org/health-care-action-center

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395766/