Partial Transition and Mental Health: Barriers to a Full Transition

Introduction Transgender and non-binary (TNB) individuals are at severe risk of adverse mental health outcomes. Transitioning is associated with marked improvements in mental health. Unfortunately, a significant proportion of TNB individuals experience challenges to fully transitioning. In this paper, we examine the mental health status of TNB individuals who have partially transitioned and have expressed a desire to live fully in a gender different from the one assigned at birth and the barriers deterring them from doing so. Methods Using the 2015 US Transgender Survey, we estimated generalized ordered logistic models to predict psychological distress using barriers to transitioning as main predictors and accounting for relevant covariates for a subsample of 9242 TNB adults. Results Individuals that list structural barriers to transition such as fearing not receiving needed medical care, becoming homeless, and facing violence were significantly more likely to be in moderate and severe, and severe distress compared to individuals who did not report those barriers. Conclusions These findings demonstrate the structural nature of barriers to fully transitioning for transgender adults. Although some interpersonal fears were significant, the majority of concerns associated with psychological distress are structural in nature and speak to the institutional barriers TNB people face during the transition process. Policy Implications These structural barriers could be ameliorated through social policy in which transgender individuals could access services and are afforded protections to allow for a transition without the fear of negative consequences.