There is no doubt that mental health is important for everyone. Furthermore, there are additional considerations for transgender persons as they navigate their internal struggles along with the external stigma from friends, neighbours, co-workers and strangers. Transgender individuals face additional burdens that remain unresolved for an extended period of time due to the unavailability of mental health providers who have the capacity to address these issues.
Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
Source: World Health Organization
There are two major issues that are specific to the transgender community when it comes to mental health – gender dysphoria and the transitioning experience. Let us first discuss gender dysphoria.
Gender dysphoria is the significant discomfort and dissatisfaction with the biological sex one is born with. For transgender persons, this is normally the root cause of depression, anxiety and other symptoms of mental illness.
Imagine looking in the mirror and hating what you see. The image reflecting back at you does not match up with the way you see yourself. There are many people who face this problem with regards to insecurities but gender dysphoria is different in that a transgender person hates their body so much that they want parts of it removed permanently. They desire a drastic change that goes beyond biological and physical. The inability to align one’s biological sex with their gender identity and gender expression is a cause for great despair for many transgender persons and is something some transgender individuals deal with throughout their childhood into adulthood. Many transgender individuals experience suicidal thoughts or attempts at suicide.
In order to alleviate and eventually eliminate gender dysphoria, many transgender persons proceed with transitioning as the solution. The transitioning experience is another major cause of mental discomfort within the transgender community. While this process might be something that a transgender person has been looking forward to for their entire lifetime, it is still a scary, anxiety causing process that can result in disappointment for the individual.
While the decision to transition can be exhilarating, there are some issues that can cause great concern for the transgender person – such as anxiety about hormone therapy and surgery. There are additional frustrations such as attempting to update one’s legal documents to reflect your new gender assignment or even fears that one can be identified as transgender and hence face discrimination. After the transitioning is completed, the transsexual is faced with coming to terms with their new bodies and the realigning what they thought they would look like with their actual physical reality. Sometimes, there is disappointment with the transitioning as the changes seen might not reflect the image the transgender person had prior to their transition.
The process or decision to transition, ideally starts when the individual gets counselling from a mental health provider. This is key so that the transgender individual can receive therapy to navigate their feelings and to receive information and guidance that will help them through the transitioning process. Therapy is an integral part of the process, regardless of the transgender person’s ultimate decision to transition or not. Many health care providers in Jamaica are not equipped with enough knowledge about the issues affecting transgender persons and thus might not know best how to support or treat the transgender person. Also significant is the fact that trans-sexual health is not a part of the medical curriculum in Jamaica and as such medical professionals are not equipped with the tools or skills to provide treatment specific to the transgender community.
These hurdles are significant to the transgender community and are cause for concern as they try to navigate their own feelings while attempting to improve their quality of life. Certainly there is much need for change to the healthcare policy in Jamaica so that it is more inclusive and supportive of the transgender community. A policy change is needed so that transgender Jamaicans can update their legal documents such as their driver’s license and/or passport. In addition, healthcare providers need more training in order to address the needs of their patients who are transgender so that the mental health support needed can be met.