Editing Transphobia (section)

==Consequences==
[[File:Graffiti left by angry trans people in Baltimore.jpg|thumb|alt=Graffiti on a concrete wall, in red and black. The black graffiti reads, "I'm trans & I'm pissed off". The red graffiti reads, "You should be".|Graffiti left by trans individuals in [[Baltimore]], [[Maryland]], expressing [[wikt:disillusionment|disillusionment]] with society]]

Whether intentional or not, transphobia and cissexism have severe consequences for the target of the negative attitude. Transphobia creates significant stresses for transgender people which can lead them to feel shame, low [[self-esteem]], [[social alienation|alienation]] and inadequacy. Transgender youth often try to cope with the stress by running away from home, dropping out of school, using drugs or [[Self-mutilation|self-harming]].<ref name="Handbook of" /><ref>{{Cite book|title = Disparities in Psychiatric Care: Clinical and Cross-Cultural Perspectives|last = Ruiz MD|first = Pedro|publisher = Lippincott Williams & Wilkins|year = 2009|isbn = 978-0781796392|pages = 111}}</ref> Suicide rates among transgender people are thought to be especially high, because of how they are treated by their families and by society.<ref name="Lennon-2014" />

===Childhood and adolescence===
Polyvictimization is experiencing multiple forms of abuse and victimization throughout a person's life, such as physical or sexual violence, bullying/aggression, parental neglect or abuse, experiencing crime, etc. Polyvictimization can start in childhood and has consequences for adolescent health and thus adult health.<ref>{{Cite journal|last1=Le|first1=Minh T. H.|last2=Holton|first2=Sara|last3=Romero|first3=Lorena|last4=Fisher|first4=Jane|date=26 July 2016|title=Polyvictimization Among Children and Adolescents in Low- and Lower-Middle-Income Countries: A Systematic Review and Meta-Analysis|journal=Trauma, Violence, & Abuse|volume=19|issue=3|pages=323–342|doi=10.1177/1524838016659489|pmid=27461094|s2cid=22742690|issn=1524-8380}}</ref><ref>{{Cite journal|last1=Källström|first1=Åsa|last2=Hellfeldt|first2=Karin|last3=Howell|first3=Kathryn H.|last4=Miller-Graff|first4=Laura E.|last5=Graham-Bermann|first5=Sandra A.|date=13 April 2017|title=Young Adults Victimized as Children or Adolescents: Relationships Between Perpetrator Patterns, Poly-Victimization, and Mental Health Problems|journal=Journal of Interpersonal Violence|volume=35|issue=11–12|pages=2335–2357|doi=10.1177/0886260517701452|pmid=29294710|s2cid=24904770|issn=0886-2605}}</ref> 
Transgender, [[Gender variance|gender diverse]], and [[sexual minority]] adolescents (TGSA) are more likely to experience polyvictimization when compared to their cisgender peers.<ref>{{Cite journal|last1=Sterzing|first1=Paul R.|last2=Gartner|first2=Rachel E.|last3=Goldbach|first3=Jeremy T.|last4=McGeough|first4=Briana L.|last5=Ratliff|first5=G. Allen|last6=Johnson|first6=Kelly C.|date=2019|title=Polyvictimization prevalence rates for sexual and gender minority adolescents: Breaking down the silos of victimization research.|journal=Psychology of Violence|volume=9|issue=4|pages=419–430|doi=10.1037/vio0000123|s2cid=148649307|issn=2152-081X}}</ref> Family traits more associated with polyvictimization in TGSA include: families that have higher than average levels of violence and [[adversity]] in their life, families that give their child higher than average levels of [[microaggression]]s and lower levels of [[Micro-inequity|microaffirmations]], and families that have average levels of violence and adversity, and also give their child higher levels of microaffirmations. [[Posttraumatic stress disorder]] (PTSD) symptoms reported by TGSA has shown to be a significant link between TGSA grouped by their family experiences and polyvictimization.<ref>{{Cite journal|last1=Sterzing|first1=Paul R.|last2=Fisher|first2=Aaron J.|last3=Gartner|first3=Rachel E.|date=2019|title=Familial pathways to polyvictimization for sexual and gender minority adolescents: Microaffirming, microaggressing, violent, and adverse families.|journal=Psychology of Violence|volume=9|issue=4|pages=461–470|doi=10.1037/vio0000224|s2cid=149604473|issn=2152-081X}}</ref>

Research supported by the [[National Institute of Mental Health]] (NIMH) assessed lesbian, gay, bisexual, and transgender ([[LGBT]]) adolescents and noted that those who had moderate to high, and steady or increasing rates of victimization or verbal or physical threats, were at heightened risk for developing PTSD.<ref>{{Cite journal|last1=Mustanski|first1=Brian|last2=Andrews|first2=Rebecca|last3=Puckett|first3=Jae A.|date=2016|title=The Effects of Cumulative Victimization on Mental Health Among Lesbian, Gay, Bisexual, and Transgender Adolescents and Young Adults|journal=American Journal of Public Health|volume=106|issue=3|pages=527–533|doi=10.2105/ajph.2015.302976|pmid=26794175|pmc=4815715|issn=0090-0036}}</ref> Relational and physical bullying victimization, as well as various other forms of emotional distress, are increasingly experienced by the transgender and gender diverse (TGD) adolescent population. Those who experience the most physical and relational bullying victimization and emotional distress, are [[Sex assignment|AMAB]] youth whom others perceived as very, or mostly, feminine. Moreover, regardless of assigned gender at birth, relational bullying victimization, depression, and suicidal ideation is common among adolescents that can be perceived as anything other than very, or mostly, masculine.<ref>{{Cite journal|last1=Gower|first1=Amy L.|last2=Rider|first2=G. Nicole|last3=Coleman|first3=Eli|last4=Brown|first4=Camille|last5=McMorris|first5=Barbara J.|last6=Eisenberg|first6=Marla E.|date=2018|title=Perceived Gender Presentation Among Transgender and Gender Diverse Youth: Approaches to Analysis and Associations with Bullying Victimization and Emotional Distress|journal=LGBT Health|volume=5|issue=5|pages=312–319|doi=10.1089/lgbt.2017.0176|pmid=29920146|pmc=6034394|issn=2325-8292}}</ref>

Repeatedly, research on the effects of aggression and violence against TGD youth and young adults shows – when compared to their cisgender peers – higher rates of PTSD, depression, [[Self-harm|non-suicidal self-injury]], [[suicidal ideation]], intent, plan, and attempts, higher rates of substance use (cigarettes, alcohol, marijuana), trauma, skipping school due to safety concerns, and poorer health outcomes.<ref>{{Cite journal|last1=Newcomb|first1=Michael E.|last2=Hill|first2=Ricky|last3=Buehler|first3=Kathleen|last4=Ryan|first4=Daniel T.|last5=Whitton|first5=Sarah W.|last6=Mustanski|first6=Brian|date=14 August 2019|title=High Burden of Mental Health Problems, Substance Use, Violence, and Related Psychosocial Factors in Transgender, Non-Binary, and Gender Diverse Youth and Young Adults|journal=Archives of Sexual Behavior|doi=10.1007/s10508-019-01533-9|pmid=31485801|issn=0004-0002|volume=49|issue=2|pmc=7018588|pages=645–659}}</ref><ref>{{Cite journal|last1=Hatchel|first1=Tyler|last2=Ingram|first2=Katherine M.|last3=Mintz|first3=Sasha|last4=Hartley|first4=Chelsey|last5=Valido|first5=Alberto|last6=Espelage|first6=Dorothy L.|last7=Wyman|first7=Peter|date=22 January 2019|title=Predictors of Suicidal Ideation and Attempts among LGBTQ Adolescents: The Roles of Help-seeking Beliefs, Peer Victimization, Depressive Symptoms, and Drug Use|journal=Journal of Child and Family Studies|volume=28|issue=9|pages=2443–2455|doi=10.1007/s10826-019-01339-2|pmid=39372436 |s2cid=150838577|issn=1062-1024|pmc=11452144}}</ref><ref>{{Cite journal|last1=Taliaferro|first1=Lindsay A.|last2=McMorris|first2=Barbara J.|last3=Rider|first3=G. Nicole|last4=Eisenberg|first4=Marla E.|date=8 May 2018|title=Risk and Protective Factors for Self-Harm in a Population-Based Sample of Transgender Youth|journal=Archives of Suicide Research|volume=23|issue=2|pages=203–221|doi=10.1080/13811118.2018.1430639|pmid=29461934|pmc=6102088|issn=1381-1118}}</ref><ref>{{Cite journal|last1=Atteberry-Ash|first1=Brittanie|last2=Kattari|first2=Shanna K.|last3=Speer|first3=Stephanie Rachel|last4=Guz|first4=Samantha|last5=Kattari|first5=Leo|date=2019|title=School safety experiences of high school youth across sexual orientation and gender identity|journal=Children and Youth Services Review|volume=104|pages=104403|doi=10.1016/j.childyouth.2019.104403|s2cid=198615480|issn=0190-7409}}</ref><ref>{{Cite journal|last1=Veale|first1=Jaimie F.|author-link=Jaimie Veale|last2=Watson|first2=Ryan J.|last3=Peter|first3=Tracey|last4=Saewyc|first4=Elizabeth M.|date=2017|title=Mental Health Disparities Among Canadian Transgender Youth|journal=Journal of Adolescent Health|volume=60|issue=1|pages=44–49|doi=10.1016/j.jadohealth.2016.09.014|issn=1054-139X|pmc=5630273|pmid=28007056}}</ref><ref>{{Cite journal|last1=Reisner|first1=Sari L.|last2=Biello|first2=Katie B.|last3=White Hughto|first3=Jaclyn M.|last4=Kuhns|first4=Lisa|last5=Mayer|first5=Kenneth H.|last6=Garofalo|first6=Robert|last7=Mimiaga|first7=Matthew J.|date=1 May 2016|title=Psychiatric Diagnoses and Comorbidities in a Diverse, Multicity Cohort of Young Transgender Women|journal=JAMA Pediatrics|volume=170|issue=5|pages=481–6|doi=10.1001/jamapediatrics.2016.0067|pmid=26999485|pmc=4882090|issn=2168-6203}}</ref><ref>{{Cite journal|last1=Nahata|first1=Leena|last2=Quinn|first2=Gwendolyn P.|last3=Caltabellotta|first3=Nicole M.|last4=Tishelman|first4=Amy C.|date=2017|title=Mental Health Concerns and Insurance Denials Among Transgender Adolescents|journal=LGBT Health|volume=4|issue=3|pages=188–193|doi=10.1089/lgbt.2016.0151|pmid=28402749|issn=2325-8292}}</ref><ref>{{Cite journal|last1=Wawrzyniak|first1=Andrew J.|last2=Sabbag|first2=Samir|editor2-first=Charles R|editor2-last=Marmar|editor1-first=Charles B|editor1-last=Nemeroff|date=2018|title=PTSD in the Lesbian, Gay, Bisexual, and Transgender (LGBT) Population|journal=Oxford Medicine Online|doi=10.1093/med/9780190259440.003.0014}}</ref><ref>{{Cite journal|last1=Toomey|first1=Russell B.|last2=Syvertsen|first2=Amy K.|last3=Shramko|first3=Maura|date=11 September 2018|title=Transgender Adolescent Suicide Behavior|journal=Pediatrics|volume=142|issue=4|pages=e20174218|doi=10.1542/peds.2017-4218|pmid=30206149|issn=0031-4005|pmc=6317573}}</ref>{{Excessive citations inline|date=September 2021}}

The 2015 United States Transgender Survey, the largest such survey ever carried out (with 27,715 respondents), found that one in ten respondents suffered transphobic violence at the hands of a family member and 8% were forced to leave their homes for being transgender. The majority of those who were openly transgender or perceived as transgender at school were victims of some form of mistreatment on account of this, including verbal abuse (54%), physical attacks (24%), and sexual assault (13%). 17% experienced such severe mistreatment that they had to leave school. Support from one's community or family was correlated with more positive outcomes related to mental health and social functioning.<ref name="usts">{{cite web|url=http://www.transequality.org/sites/default/files/docs/USTS-Executive-Summary-FINAL.PDF|title=Executive Summary|work=U.S. Transgender Survey|publisher=National Center for Transgender Equality|location=Washington|access-date=9 January 2017|archive-date=1 February 2017|archive-url=https://web.archive.org/web/20170201032258/http://www.transequality.org/sites/default/files/docs/USTS-Executive-Summary-FINAL.PDF}}.</ref>

===Adulthood===
In adulthood, the effects of aggression and violence against various groups of transgender people has also been documented in domains such as mental and physical health, and safety and discrimination in the military. Transgender related bias, or discrimination, victimization, and rejection, affects transgender adults and the severity of PTSD symptoms they report. A systematic review completed in 2018 examined 77 studies that reported mental health [[Disparities in mental health care|disparities]] and [[social stress]] felt by TGD adults. The analysis found associations between TGD identity and anxiety, depression, PTSD, substance use, and [[suicidality]], as well as added social stress factors such as violence, discrimination, and exclusion.<ref>{{Cite journal|last1=Valentine|first1=Sarah E.|last2=Shipherd|first2=Jillian C.|date=2018|title=A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States|journal=Clinical Psychology Review|volume=66|pages=24–38|doi=10.1016/j.cpr.2018.03.003|pmid=29627104|pmc=6663089|issn=0272-7358}}</ref> When examining posttraumatic stress disorder and substance use in transgender adult communities, records indicated that transgender adults who have PTSD are more likely to be diagnosed with a [[substance use disorder]] within their lifetime.<ref>{{Cite journal|last1=Keuroghlian|first1=Alex S.|last2=Reisner|first2=Sari L.|last3=White|first3=Jaclyn M.|last4=Weiss|first4=Roger D.|date=1 July 2015|title=Substance Use and Treatment of Substance Use Disorders in a Community Sample of Transgender Adults|journal=Drug and Alcohol Dependence|volume=152|pages=139–146|doi=10.1016/j.drugalcdep.2015.04.008|issn=0376-8716|pmc=4458188|pmid=25953644}}</ref> A [[National Institutes of Health|National Institute of Health]] (NIH) analysis conducted with data collected at a [[Community health centers in the United States|community health center]] in the United States compared transgender and cisgender adult [[patient]]s on various possible health disparities. Their research showed that within their lifetime, transgender patients experienced more violence, childhood abuse, discrimination, and suicidal thoughts or suicide attempts when compared to their cisgender counterparts who had a similar age, education, ethnicity/race, and income.<ref>{{Cite journal|last1=Reisner|first1=Sari L.|last2=White|first2=Jaclyn M.|last3=Bradford|first3=Judith B.|last4=Mimiaga|first4=Matthew J.|date=2014|title=Transgender Health Disparities: Comparing Full Cohort and Nested Matched-Pair Study Designs in a Community Health Center|journal=LGBT Health|volume=1|issue=3|pages=177–184|doi=10.1089/lgbt.2014.0009|pmid=25379511|pmc=4219512|issn=2325-8292}}</ref>

===United States military===
Strong associations between [[military sexual assault]] (MSA) and PTSD have been documented in both men and women.<ref>{{Cite journal|title=Military sexual trauma|last1=Hyun|first1=J.K.|last2=Kimerling|first2=R.|date=2009|journal=Research Quarterly}}</ref> A nationwide survey of military personnel in 2015 found that 17.2% of transgender [[veteran]]s reported experiencing MSA, and nearly two times more [[Trans man|transgender men]] (30%) had a MSA experience when compared to [[Trans woman|transgender women]] (15.2%). Links have been found between MSA experienced by transgender veterans and increased depression symptom severity, drug use, and PTSD symptom severity.<ref>{{Cite journal|last1=Beckman|first1=Kerry|last2=Shipherd|first2=Jillian|last3=Simpson|first3=Tracy|last4=Lehavot|first4=Keren|date=30 March 2018|title=Military Sexual Assault in Transgender Veterans: Results From a Nationwide Survey|journal=Journal of Traumatic Stress|volume=31|issue=2|pages=181–190|doi=10.1002/jts.22280|pmid=29603392|pmc=6709681|issn=0894-9867}}</ref>

Posttraumatic stress disorder has also been associated with suicidality and substance use among adults.<ref>{{Cite journal|last1=Blanco|first1=Carlos|last2=Xu|first2=Yang|last3=Brady|first3=Kathleen|last4=Pérez-Fuentes|first4=Gabriela|last5=Okuda|first5=Mayumi|last6=Wang|first6=Shuai|date=2013|title=Comorbidity of posttraumatic stress disorder with alcohol dependence among US adults: Results from National Epidemiological Survey on Alcohol and Related Conditions|journal=Drug and Alcohol Dependence|volume=132|issue=3|pages=630–638|doi=10.1016/j.drugalcdep.2013.04.016|pmid=23702490|pmc=3770804|issn=0376-8716}}</ref> For instance, records reflect that veterans who identify as transgender increasingly experience PTSD and [[Suicidal ideation|suicide ideation]], plans, and attempts. Further, transgender specific stigma experienced while in the military and PTSD have been associated with deaths by suicide.<ref>{{Cite journal|last1=Lehavot|first1=Keren|last2=Simpson|first2=Tracy L.|last3=Shipherd|first3=Jillian C.|date=15 February 2016|title=Factors Associated with Suicidality Among a National Sample of Transgender Veterans|journal=Suicide and Life-Threatening Behavior|volume=46|issue=5|pages=507–524|doi=10.1111/sltb.12233|pmid=26878597|issn=0363-0234}}</ref>

This could be worsened by racial health disparities that exist within the [[United States Department of Veterans Affairs]] (VA) Healthcare System.<ref>{{Cite journal|last1=Carter|first1=Andrea|last2=Borrero|first2=Sonya|last3=Wessel|first3=Charles|last4=Washington|first4=Donna L.|last5=Bean-Mayberry|first5=Bevanne|last6=Corbelli|first6=Jennifer|last7=Batch|first7=Bryan C.|last8=Breland|first8=Jessica Y.|last9=DiLeone|first9=Brooke|last10=Foynes|first10=Melissa Ming|last11=Keene|first11=Robin|date=2016|title=Racial and Ethnic Health Care Disparities Among Women in the Veterans Affairs Healthcare System: A Systematic Review|journal=Women's Health Issues|volume=26|issue=4|pages=401–409|doi=10.1016/j.whi.2016.03.009|pmid=27138241|issn=1049-3867}}</ref> Particularly, racial health disparities between non-Hispanic Black transgender veterans (BTV) and non-Hispanic White transgender veterans (WTV) have been acknowledged. Non-Hispanic Black transgender veterans are at increased odds of having an array of physical health issues/diseases, serious mental illnesses, alcohol use, tobacco use, homelessness, and previous [[Imprisonment|incarceration]] when compared to the WTV. Non-Hispanic White transgender veterans had increased odds of depression, obesity, and [[hypercholesterolemia]] when compared to BTV.<ref>{{Cite journal|last1=Brown|first1=George R.|last2=Jones|first2=Kenneth T.|date=16 July 2014|title=Racial Health Disparities in a Cohort of 5,135 Transgender Veterans|journal=Journal of Racial and Ethnic Health Disparities|volume=1|issue=4|pages=257–266|doi=10.1007/s40615-014-0032-4|issn=2197-3792|doi-access=free}}</ref> Previous incarceration plays a larger role in the PTSD and homelessness that transgender veterans may experience. Specifically, transgender veterans that have a history of previous incarceration are more likely to have PTSD or to experience homelessness when compared to previously incarcerated veterans who are not transgender.<ref>{{Cite journal|last1=Brown|first1=George R.|last2=Jones|first2=Kenneth T.|date=2015|title=Health Correlates of Criminal Justice Involvement in 4,793 Transgender Veterans|journal=LGBT Health|volume=2|issue=4|pages=297–305|doi=10.1089/lgbt.2015.0052|pmid=26788770|issn=2325-8292}}</ref>

===Poverty and homelessness===
Nearly one third of U.S. transgender people responding to the 2015 U.S. Transgender Survey lived in poverty, compared to 14% of the population. During the 12 months prior to the survey, 30% of employed transgender people were either fired or mistreated for being transgender, from verbal abuse to sexual violence. 30% had been homeless at some point in their life, and 12% had been homeless during the previous year. Family and community support were correlated with significantly lower rates of homelessness and poverty.<ref name="usts"/>

===Violence and harassment===
During the year prior to the 2015 U.S. survey, 46% of respondents had been verbally harassed and 9% had been physically attacked for being transgender. 10% had been sexually assaulted during the previous year, and 47% had been sexually assaulted at some point in their life.<ref name="usts"/>

Evidence collected by the Transgender Day of Remembrance and National Coalition of Anti-Violence Programs on the homicide rates of transgender individuals suggests that the homicide rates of young trans women who are Black or Latina are "almost certainly higher" than those of cisgender women of the same race.<ref name="Dinno-2017">{{Cite journal|last=Dinno|first=Alexis|date=Sep 2017|title=Homicide Rates of Transgender Individuals in the United States: 2010–2014|url=|journal=American Journal of Public Health|volume=107|issue=9|pages=1441–1447|doi=10.2105/AJPH.2017.303878|pmid=28727530|pmc=5551594}}</ref>

====In public restrooms====
During the year prior to the 2015 U.S. survey, 12% of respondents reported being verbally harassed in a public restroom. 1% reported being sexually assaulted in a public restroom for being transgender, and 1% reported being otherwise physically assaulted for being transgender. 9% reported being denied the right to use a public restroom consistent with their gender.<ref name="usts"/>

===Health===
During the year prior to the 2015 U.S. survey, 59% of respondents reported avoiding using a public restroom out of fear of violence or harassment. 32% limited the amount they ate or drank in order to avoid using a public restroom. 8% reported suffering a urinary tract infection, kidney infection, or other kidney problem as a result of avoiding public restrooms.<ref name="usts"/>

33% reported having negative experiences with a healthcare professional related to being transgender, such as verbal harassment or denial of treatment. 23% reported that they did not seek treatment for a condition out of fear of being mistreated, while 33% did not seek treatment because they were unable to afford it.<ref name="usts"/>

During the month prior to the survey, 39% of American transgender people experienced major psychological distress, compared to 5% of the general population of the United States. 40% had attempted suicide at some point in their life, compared to 4.6 percent of the American population. Family and community support were correlated with far lower rates of suicide attempts and of major psychological distress.<ref name="usts"/>

A study conducted on transgender women of color in San Francisco has shown a higher correlation between transphobia and risk of transgender women engaging in HIV risk behavior. The study shows that the transgender youth face social discrimination, and they may not have a social role model. The young adults in this group have shown a higher risk of engaging in unprotected receptive anal intercourse when the exposure to transphobia is high. Therefore, as per the study shows a correlation between transphobia and high risk of HIV.<ref>{{Cite journal|last1=Sugano|first1=Eiko|last2=Nemoto|first2=Tooru|last3=Operario|first3=Don|date=2006|title=The Impact of Exposure to Transphobia on HIV Risk Behavior in a Sample of Transgendered Women of Color in San Francisco|journal=AIDS and Behavior|volume=10|issue = 2|pages=217–225|doi=10.1007/s10461-005-9040-z|pmid=16362237|citeseerx=10.1.1.554.5857|s2cid=6642842}}</ref>

====Mental health====
People who are transgender are more likely to experience some type of psychological distress because of the harassment and discrimination that comes with transphobia. Student Affairs Administrators in Higher Education conducted a nationwide survey on college campuses examining the psychological effects on transgender people, with a sample size of 86. Out of these 86 participants, 54% stated they have attended psychological counseling before and 10% had been hospitalized for reasons related to mental health. The final results of the study show that over twice as many participants who considered themselves transgender (43%) had engaged in self-injurious behavior, versus those who considered themselves male or female (16%).<ref>{{Cite journal|last=Hayes|first=J.|title=The Center for Collegiate Mental Health: Practice and research working together |journal=Journal of College Counseling|pages=101–104}}</ref><ref>{{Cite journal|last1=Effrig|first1=Jessica C.|last2=Bieschke|first2=Kathleen J.|last3=Locke|first3=Benjamin D.|date=1 September 2011|title=Examining Victimization and Psychological Distress in Transgender College Students|journal=Journal of College Counseling|volume=14|issue=2|pages=143–157|doi=10.1002/j.2161-1882.2011.tb00269.x|issn=2161-1882}}</ref>

According to Virupaksha, Muralidhar, and Ramakrishna, suicide attempts among transgender people globally range from 32% to 50%. In India, 31% to 50% of transgender people have tried to commit [[suicide]] before age 20. 50% of transgender people in Australia and 45% of those in England have attempted suicide at least once.<ref name="Suicide">{{Cite journal|last1=Virupaksha|first1=H. G.|last2=Muralidhar|first2=Daliboyina|last3=Ramakrishna|first3=Jayashree|date=2016|title=Suicide and Suicidal Behavior among Transgender Persons|journal=Indian Journal of Psychological Medicine|volume=38|issue=6|pages=505–509|doi=10.4103/0253-7176.194908|issn=0253-7176|pmc=5178031|pmid=28031583 |doi-access=free }}</ref> In the United States, suicide attempts reported by transgender and gender nonconforming adults exceed the rate of the general population: 41% versus 4.6 percent.<ref>{{cite tech report |first=Ann H. |last=Haas |author2=Philip Rodgers |title=Suicide Attempts Among Transgender and Gender Non-Conforming Adults |institution=American Foundation for Suicide Prevention and Williams Institute, UCLA School of Law |year=2014 | url = http://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf}}</ref> In San Francisco alone, the suicide attempt rate among transgender people is 32% overall, and for those under age 25 it is 50%.<ref name="Suicide"/>

According to the study ''Transphobia Among Transgenders of Color'' by the [[University of California, San Francisco]], transphobia affects the psychological vulnerability of transgender people of color as compared to those of other ethnicities. Acts of transphobia such as undue denial of services, unfair dismissal from work places or stigmatization have far-reaching effects on the subjects such as low self-esteem, under-performance, stress, withdrawal or even depression. When it comes to the minorities, who are already proven to be undergoing various forms of discrimination, the consequences are even more exaggerated. Transgender people of color are more significantly associated with depression than their white counterparts.<ref>{{cite web|url=https://prevention.ucsf.edu/uploads/pubs/presentations/pdf/APHA_Nemoto.pdf|title=Transphobia Among Transgenders of Color|work=Center for AIDS Prevention Studies, University of California, San Francisco|date=November 2004|access-date=15 November 2017|archive-date=16 November 2017|archive-url=https://web.archive.org/web/20171116021212/https://prevention.ucsf.edu/uploads/pubs/presentations/pdf/APHA_Nemoto.pdf|url-status=dead}}</ref>

Information regarding the effects of transphobia with respect to minority identities has not been well documented. In a 2018 review of mental health research regarding transgender individuals, only 4 out of 77 studies that were reviewed examined the intersectionality of transgender and racial identities. There were other studies that included disproportionately high amounts of transgender individuals who are in multiple minority groups, but the authors note that it is difficult to tell if these studies generalize to the transgender/ gender nonconforming community as a whole due to lack of extensive study.<ref>{{Cite journal|last1=Valentine|first1=Sarah E|last2=Shipherd|first2=Jillian C|date=March 2018|title=A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States|url=|journal=Clinical Psychology Review|volume=66 December 2018|pages=24–38|doi=10.1016/j.cpr.2018.03.003|pmid=29627104|pmc=6663089}}</ref>

To help transgender people work through traumatic experiences, minority stress, and internalized transphobia, mental health practitioners have begun integrating the gender-affirmative model into [[cognitive behavioral therapy]],<ref>{{Cite journal|last1=Austin|first1=Ashley|last2=Craig|first2=Shelley L.|date=2015|title=Transgender Affirmative Cognitive Behavioral Therapy: Clinical Considerations and Applications |journal=Professional Psychology: Research and Practice|volume=46|issue=1|pages=21–29|doi=10.1037/a0038642 }}</ref> [[person-centered therapy]],<ref>{{Cite book|title=Person-Centered Counselling for Trans and Gender Diverse People |last=Hope|first=Sam|date=2020|publisher=Jessica Kingsley Publishers|isbn=978-1785925429|location=London}}</ref> and [[acceptance and commitment therapy]].<ref name="Stitt"/>

====Pregnancy issues====

Many transgender people transition without undergoing surgery to remove reproductive organs or to reconstruct genitals, thus transition does not necessarily remove the ability or the desire to reproduce. While the same-sex issues surrounding the birth and parenting of children have gained a degree of acceptance, trans practices of parenting have received much less attention and acceptance.<ref>{{cite web |title=Trans Pregnancy |url=https://transpregnancy.leeds.ac.uk/about/ |website=University of Leeds |access-date=5 November 2022 |archive-date=1 November 2022 |archive-url=https://web.archive.org/web/20221101140701/https://transpregnancy.leeds.ac.uk/about/ |url-status=dead }}</ref> In 2007 a transgender man, [[Thomas Beatie]], became pregnant because his wife was infertile. His pregnancy drew world-wide attention. He commented:

<blockquote>Doctors have discriminated against us, turning us away due to their religious beliefs. Health care professionals have refused to call me by a male pronoun or recognize Nancy as my wife. Receptionists have laughed at us. Friends and family have been unsupportive; most of Nancy's family doesn't even know I'm transgender.<ref>{{cite web |title='Pregnant Man' Thomas Beatie Splits From Wife Nancy: Why The Break-Up After 9 Years [PHOTOS] |url=https://www.ibtimes.com/pregnant-man-thomas-beatie-splits-wife-nancy-why-break-after-9-years-photos-555171 |date=2012-04-21 |website=International Business Times |access-date=November 5, 2022}}</ref></blockquote>