Mental Wellbeing

Education for Mental Health Toolkit - Transgender and gender non-conforming inclusivity

Research indicates that transgender people are more likely to experience poor mental health, especially depression, anxiety, and panic attacks (2, 4), with rates higher than the general population norms (2).

Transgender and gender non-conforming inclusivity

Terms

Transgender (or trans) is an umbrella term that encompasses all individuals whose gender identity does not match the gender they were assigned at birth based on their sexual characteristics (1). Individuals who do not identify within the binary system of gender identification also fall under this umbrella. In this toolkit, we use the terms transgender to refer to gender non-conforming people, those who are non-binary, genderqueer and so on. However, the transgender and gender non-conforming community is extremely varied and there is also a relative invisibility where many trans people exist, so we acknowledge that the terminology adopted does not fully capture the diversity that the gender non-conforming population comprises (2, 3).

Education for Mental Health

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Experience

Research indicates that transgender people are more likely to experience poor mental health, especially depression, anxiety, and panic attacks (2, 4), with rates higher than the general population norms (2). Quality of life (both mental and physical) also appears to be lower for this population compared to the general cisgender (non-transgender) population (5). This is likely to be at least partly caused by the fact that transgender people are more likely to face a series of difficulties, which may include the experience of dysphoria towards their bodies, physical and social transitions, transphobia, discrimination, prejudice, and bullying (2, 4, 6-11). Undergoing these experiences can have a significant negative impact upon trans students’ wellbeing, which can negatively affect academic achievement and can lead to academic dropout (12).

These issues can, in turn, also undermine sense of belonging to the classroom environment (13), leading to alienation and isolation. As a consequence, this can affect wellbeing through negative impacts on both learning and psychological distress (14-16). Social interactions play a significant role in the mental health and wellbeing of trans people, and this is particularly important for the classroom environment and interactions between students and lecturers and students and peers. Facing difficulties, in relation to gender and identity, in the academic environment impairs trans students’ sense of belonging and inclusion as part of their class (17). Research shows that adoption and correct utilisation of the chosen name and pronouns (and thus reduction in misgendering) are linked to reduced depressive symptoms, suicidal ideation and behaviours amongst trans youth (18). Alternatively, being misgendered, misnamed or deadnamed is often a negative and painful experience (18, 19). Creating inclusive classrooms, in which trans students can be themselves, feel psychologically safe and be communicated with by their chosen names, can therefore enhance wellbeing and learning.

This is particularly important as trans people are more likely to experience difficulty with interpersonal interactions (20). This is generally due to negative past experiences such as instances of discrimination, prejudice, violence, harassment, bullying, and transphobia, which negatively impacted their social skills.

Research conducted for this project showed that both trans students and academics perceived a number of barriers to inclusivity. These barriers are mainly related to the correct utilisation of pronouns and trans-related terminology, and to a lack of education on transgender issues among the whole university community. However, participants also talked about social issues (e.g., related to discrimination, prejudice, and bullying), problems around societal, institutional, and personal bias, as well as negative attitudes perpetrated against trans students. Students also identified barriers to inclusivity in curriculum content. For instance, the lack of trans-specific examples (e.g., use of transgender cases in medicine) and theories (e.g., queer theory – 21) taught as part of the curriculum. Students also highlighted that the use of gendered language in teaching can create an environment that lacks inclusivity and that prevents students from developing a sense of belonging to the class and university settings.

This calls for a more open approach to teaching, where academics can openly talk about transgender people and create inclusive learning environments by utilising a gender-neutral language, adopting more trans-related examples within the curriculum, using students’ preferred names and pronouns and being more confident in acknowledging and discussing trans related content and issues. In turn, staff require support from universities to develop their knowledge, understanding, comfort and confidence in supporting trans students to develop a sense of cohort and disciplinary belonging, improve their learning and achievement and through this enhance their wellbeing.

 

Key Lessons

  • Transgender students face many challenges, which negatively affect their interpersonal interactions, social skills, physical and mental health. Issues with social interactions are often the result of having undergone negative social experiences (such as discrimination, bullying and transphobia).
  • Negative experiences in academic environments have negative repercussions upon academic attainment and can lead to dropout.
  • There is a strong need to make both curriculum and practice more inclusive in order to improve students' sense of belonging and reduce feelings of alienation. An increased sense of belonging and psychological safety can have a positive impact upon learning and academic achievement.
  • Critical barriers to inclusivity are related to the use of gender-neutral language in teaching and to inclusion of trans-related examples, materials and theories as part of the curriculum.

 

Top Tips

  • When introducing yourself at the beginning of the course, also introduce your pronouns. Add your own pronouns to your email signature and on Zoom/Teams (online software).
  • Do not assume students' names, pronouns and/or gender identity. Use gender-neutral terminology and language where possible.
  • Tell students that if you make mistakes, you are not doing it on purpose, you are open to being corrected – this can help establish a classroom environment in which mistakes are seen as opportunities to learn and develop more generally.
  • Talk about trans-related issues in class and add well-evidenced and up-to-date cases of transgender people to curriculum and teaching when possible and appropriate. This is particularly important in subjects such as medicine and law, where transgender people are often excluded or negatively portrayed.

 

Resources
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References
  1. Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J, Fraser L, Green J, Knudson G, Meyer WJ, Monstrey S. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. International journal of transgenderism. 2012 Aug 1;13(4):165-232.
  2. Bouman WP, Arcelus J. The transgender handbook: A guide for transgender people, their families and professionals. New York: Nova Science Publishers, Inc.; 2017.
  3. Meier SC, Labuski CM. The demographics of the transgender population. In: International handbook on the demography of sexuality 2013 (p. 289-327). Springer, Dordrecht.
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  8. Reynolds HM, Goldstein ZG. Social transition. Trans bodies, trans selves: A resource for the transgender community. 2014 May 12:124-54.
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  11. Goldberg AE. Transgender Students in Higher Education. UCLA: The Williams Institute. 2018. Available from: https://escholarship.org/uc/item/4p22m3kx
  12. Mckendry S, Lawrence M. TransEdu Scotland: researching the experience of trans and gender diverse applicants, students and staff in Scotland's colleges and universities [internet]. 2017. Available from: https://strathprints.strath.ac.uk/62107/1/Mckendry_Lawrence_TransEDU_2017_TransEdu_Scotland_Researching_the_experience_of_trans_and_gender.pdf
  13. Cemalcilar Z. Schools as socialisation contexts: Understanding the impact of school climate factors on students’ sense of school belonging. Applied psychology. 2010 Apr;59(2):243-72.
  14. Hascher T. Wellbeing. In: Peterson P, Baker E, McGaw B, editors. International Encyclopedia of Education. Oxford: Elsevier, 2010. (p.732-8). Available from: doi: 10.1016/B978-0-08-044894-7.00633-3
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  16. Ifeagwazi CM, Chukwuorji JC, Zacchaeus EA. Alienation and psychological wellbeing: Moderation by resilience. Social Indicators Research. 2015 Jan 1;120(2):525-44.
  17. Locks AM, Hurtado S, Bowman NA, Oseguera L. Extending notions of campus climate and diversity to students' transition to college. The Review of Higher Education. 2008;31(3):257-85.
  18. Russell ST, Pollitt AM, Li G, Grossman AH. Chosen name use is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth. Journal of Adolescent Health. 2018 Oct 1;63(4):503-5.
  19. Howansky K, Wittlin N, Bonagura D, Cole S. Him, her, them, or neither: Misgendering and degendering of transgender individuals. Psychology & Sexuality. 2021 Sep 9.
  20. Davey A, Bouman WP, Meyer C, Arcelus J. Interpersonal functioning among treatment‐seeking trans individuals. Journal of clinical psychology. 2015 Dec;71(12):1173-85.
  21. Jagose A, Genschel C. Queer theory. Melbourne: Melbourne University Press; 1996 Jan.