The Mental Health of Trans, Nonbinary, and Gender-Diverse Australians: A Growing Concern

What We Did

We sourced information from Australia’s longest-running population survey of households – the Household, Income and Labour Dynamics in Australia (HILDA) Survey. This survey includes questions about mental health, which we tracked from 2001 to 2022.

Since 2022, the HILDA survey has included questions on gender identity. This allowed us to identify people who were trans (whose gender identity is not typically associated with their assigned sex at birth), nonbinary (who describe their gender outside of the female/male binary), gender-diverse (whose gender identity differs from the sex they were assigned at birth, including people who don’t identify as male or female), or cisgender (whose gender identity and expression matches the biological sex they were assigned at birth).

So, we were able to compare the mental health of Australians who identified as trans, nonbinary or gender-diverse to that of Australians who identified as cisgender.

What We Found

Across the 22-year period, trans, nonbinary, and gender-diverse Australians consistently reported worse mental health than cisgender Australians.

Between 2001 and 2010, they scored five to seven points lower on mental health, which is a clinically relevant difference. Between 2011 and 2022, the difference was even greater. Trans, nonbinary, and gender-diverse Australians scored eight to 13 points lower than cisgender Australians. We found these increasing disparities over time were even greater for young people (under 30 years old).

These trends remained even after controlling for other characteristics such as household income, education level, and living in rural areas.

What’s Behind This?

Several studies and reports indicate what could be behind these differences in mental health.

Trans, nonbinary, and gender-diverse populations are more likely to face stigma, discrimination, violence, and other human rights challenges, such as refusal of health care compared with the general population.

These experiences have profound and lasting impacts on mental health and health behaviors, such as seeking help for physical and mental health issues.

Exposure to anti-trans rhetoric and discrimination against trans, nonbinary, and gender-diverse Australians has been increasing in recent years.

Trans, nonbinary, and gender-diverse populations are more likely to experience gender dysphoria – the psychological distress that can arise when a person’s gender identity does not align with their sex assigned at birth.

Gender-affirming medical care (for instance, with puberty blockers, hormonal therapy, or surgery) can help combat gender dysphoria. However, many aspects of this care, particularly surgeries, are not currently funded in the public system in Australia. And not everyone has access to gender-affirming care, including young people who wish to start puberty blockers in Queensland’s public health system.

What Can We Do?

Improving trans, nonbinary, and gender-diverse mental health requires urgent action at multiple levels if we are to avoid the devastating consequences for these Australians and their families.

1. Reduce Stigma and Discrimination

We need to reduce stigma and discrimination against trans, nonbinary, and gender-diverse Australians. We know discrimination or stigma directed at an individual (including harassment or abuse) and broader structural discrimination (for instance, through laws and policies or broader community attitudes) impacts the mental health of minority groups.

Governments must implement policies that protect against discrimination, including banning harmful conversion practices in all states and territories. These practices, which attempt to change or suppress a person’s gender identity, have been shown to cause lasting psychological harm.

Trans, nonbinary, and gender-diverse Australians also need legal protections in education, employment, and health care to help lessen and prevent the negative mental health impacts of discrimination and social exclusion.

2. Make Services Inclusive

Trans, nonbinary, and gender-diverse community-controlled organisations should be adequately funded to provide peer support, mental health services, and training for other health workers.

Ensuring health-care providers are trained in how to deliver safe and welcoming services for trans, nonbinary, and gender-diverse people is essential in addressing health-care barriers and improving health outcomes.

3. More Gender-Affirming Care

Expanding access to gender-affirming care is also crucial to improve mental health. This includes reducing psychological distress, self-harm, and suicide attempts. There must be a concerted effort to depoliticise this area of health care and acknowledge that gender-affirming care is essential, evidence-based medical treatment.

Conclusion

The mental health of trans, nonbinary, and gender-diverse Australians is a growing concern. It is imperative that we address the stigma, discrimination, and lack of access to gender-affirming care that contributes to their poor mental health outcomes. By implementing policies that reduce stigma and discrimination, making services inclusive, and expanding access to gender-affirming care, we can work towards improving the mental health and well-being of these individuals.

FAQs

Q: What is the source of the data used in this study?

A: The data used in this study is sourced from the Household, Income and Labour Dynamics in Australia (HILDA) Survey.

Q: What is the purpose of the HILDA Survey?

A: The HILDA Survey is a long-running population survey of households that tracks various aspects of Australians’ lives, including their mental health.

Q: What is gender-affirming care?

A: Gender-affirming care refers to medical treatments that help individuals align their physical and emotional bodies with their gender identity, such as hormone therapy or surgery.

Q: How can I support the mental health of trans, nonbinary, and gender-diverse individuals?

A: You can support the mental health of trans, nonbinary, and gender-diverse individuals by promoting acceptance, reducing stigma, and advocating for their rights. You can also educate yourself on the issues they face and offer support and resources to those who are struggling.