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====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=101β104}}</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=143β157|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=505β509|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=24β38|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=21β29|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"/>
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