2.4 Thinking about transphobia

In 2019, the World Health Organization (WHO) declared definitively that being trans is not a mental illness, echoing the declassification of homosexuality back in 1990 (World Health Organization, 2021).

The minority stress model: Historically, it was assumed that being trans meant being mentally ill; the same thing was assumed about being gay. However, research has shown that it is not being trans that is associated with having mental health problems but rather how trans people are treated. In short, greater social stigma correlates with poorer mental health among trans people. A landmark study published in the prestigious medical journal The Lancet corroborated this understanding, prompting the WHO decision (Robles et al., 2016; see also Price et al., 2024; Drabish and Theeke, 2022).

This understanding of the mental health of trans people aligns with the ‘minority stress model’ initially developed by Meyer (2003), which understands mental health disparities for marginalised groups as being explained by the stressors caused by living in a hostile social context: experiencing bias, microaggressions, harassment, discrimination and targeted violence.

Targeted violence: Some ICTA participants reported experiencing physical threats and expressed fear about high levels of violence against trans people. Hate crimes against trans people have tripled in the past decade. (Home Office, 2024).

Stonewall reports that young trans people are particularly at risk of hate crime, with 53% having experienced hate crime in a one-year period (Stonewall, 2018), while Galop reports a significantly higher number of transfemmes (a term used to refer to trans women and feminine-presenting AMAB non-binary people) are affected by hate crime (Bradley, 2020).

Internationally, statistics for violence against trans women who also experience racism are particularly high (Human Rights Campaign Foundation, 2019).

Microaggressions: Microaggressions are everyday behaviours or terms that, intentionally or not, convey hostile or prejudicial messages based on group identity. (Sue et al., 2007). Microaggressions often reflect prevailing societal understandings of particular groups or identities; in the UK increased prejudice towards trans people is indicated by an 18% drop since 2019 (to 64%) in the number of people who describe themselves as ‘not at all prejudiced’ against people who are transgender (National Centre for Social Research, 2023).

The extensive research on microaggressions evidences their clear negative impact on the mental health of marginalised people, including trans people (e.g. Kimber et al., 2024). It is important to understand the significant impact of microaggressions as they can be:

• Insidious – often unnoticed or minimised by those unaffected.
• Systemic – rooted in broader societal bias.
• Cumulative – daily exposure makes them especially harmful to mental health.