On the mental illness thing

Right-wing Jewish pundit Ben Shapiro spoke to Orthodox students at Yeshiva Monday.

Transgender people are unfortunately suffering from a significant mental illness that is deeply harmful and it’s not a solution to pretend that transgender people are the sex that they think they are in their head. Biology is biology; men can’t magically become women and women can’t magically become men.

Just in time for Psychology Today to elucidate on transgender mental health.

Individuals who identify as transgender tend to experience higher rates of mental health issues than the general population. While approximately 6.7 percent of the general United States population suffers from depression and 18 percent grapple with some iteration of an anxiety disorder, nearly half of all individuals who identify as transgender experience these issues. What's more, over 41 percent of trans men and women are estimated to have attempted suicide — a rate that's nearly nine times as high as the rate of cisgender Americans.

I guess it would be good to be able to assign causes:

What underlies this astonishingly elevated rate of mental health issues? According to a study published in the July 2016 edition of The Lancet offers significant evidence that the "distress and impairment, considered essential characteristics of mental disorders" among transgender individuals primarily arises in response to the discrimination, stigma, lack of acceptance, and abuse they face on an unfortunately regular basis.

In other words...the behavior of people like Ben Shapiro.

for many adults, dealing with discrimination results in a state of heightened vigilance and changes in behavior, which in itself can trigger stress responses—that is, even the anticipation of discrimination is sufficient to cause people to become stressed.

So you can imagine the amount of stress in the transgender community since Election Day.

University of California research:

Out of 91 subjects participating in an online discussion with confederates who offered them rejecting or encouraging feedback, those who were on the receiving end of rejecting feedback (i.e., "Someone's a little high on themselves" or "I can't tell where you're going with this...") were more likely to take risks in a subsequent card game with small amounts of money at stake. Rejection also led to to "greater cortisol increases, less efficient cardiac output, increased vascular resistance, and impaired memory recall — a pattern of physiological reactivity that, when experienced chronically and excessively, has been linked to accelerated 'brain aging,' cognitive decline, and early risk for Alzheimer’s disease.

Unfortunately, discrimination even by medical and mental health professionals is a common reality for many transgender individuals. A 2015 study published in the Milbank Quarterly found that out of 452 transgender people residing in Massachusetts, 65 percent reported being on the receiving end of discrimination in the context of a public accommodation (from hospitals and health centers to public transportation mechanisms and shopping centers) and 24 percent reported discrimination in a health care setting, which the researchers found to be linked with up to an "81 percent increased risk of adverse emotional and physical symptoms and a 2-fold to 3-fold increased risk of postponement of needed care when sick or injured and of preventive or routine health care."

Of course, people like Ben Shapiro couldn't care less.

At the interpersonal and community levels, transgender populations often experience high levels of both perceived and internalized social stigma, social isolation, discrimination and victimization. Extreme social exclusion and lack of acceptance of transgender populations in different settings diminishes their self-esteem and ability to participate in social events. These situations often lead to symptomatic psychological distress, depression, anxiety and other mental health difficulties among this population. Social victimization may occasionally contribute to poor sexual health and unhealthy use of alcohol among this group.

--Simran Shaikh and colleagues writing in the Journal of the International AIDS Society

The Psych Today article goes on to examine the development of self:

Rejection, discrimination, abuse, and other mistreatment of transgender individuals can impede their psychosocial and identity formation. There's a theory in Heinz Kohut's self psychology, Cathers explained to me, that you only develop a fully formed 'self' if three fundamental needs are met: Mirroring (a caregiver's accurate and consistent reflection of your emotional state), idealization (someone to look up to; a role model) and twinship (having someone who is 'like you,' that makes you feel you aren't alone in the world." Many trans people grow up lacking one or more of these crucial elements, which leaves them feeling isolated, unprotected, and much more vulnerable to life's inevitable stressors.

Trying as it may be, the more understanding each of us are when it comes to our own or another person's gender, the better the outcome will be for everyone involved in the conversation.

Around age 14 I started to experience what people would call gender dysphoria — an immeasurable and indescribable feeling, almost like I was pushing out on my own skin, trying to get out, or like an itch that I could never scratch. I didn't know where it was coming from because I’d always been very comfortable with my body. But suddenly I felt wrong. my face felt masculine but the rest of my body didn't fit. I felt like a golom stitched together.

There is no us versus them. It's, I'm experiencing something this person isn’t. And that doesn't make one person more or less acceptable.

--Von Scully, trans man

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