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Debunking Some of the Most Common Negative Myths About Trans Health

  • Writer: Zoë Ariel Dunning
    Zoë Ariel Dunning
  • Aug 9, 2021
  • 9 min read

Updated: Mar 28, 2024

My mental health has suffered from feeling disconnected from my body and myself, yes, but because I suffered from living in the closet.


Transmasculine Joy, from Refinery29


My dad took me out for breakfast in January a few weeks after I came out on my blog as non-binary and trans.


Midway down my dad’s list of things he needed to address with me, he told me that they (he and my mom) think that getting on T would be a bad idea because “50% of people who transition try to kill themselves”.


(That’s actually fake news; scroll to the bottom for actual studies and research about the link between mental health, transness, and transition success rates.)


I was in shock but expecting a response like this, so I replied with something along the lines of,


"You know, I know about trans healthcare, and I know the risks. But I’m doing this for my health, and I would appreciate it if you would not tell me what to do.”

He responded defensively and then moved on to the rest of his list. I sat there reeling with chaos internally but trying to appear calm and reasonable on the outside.


I went home and broke down, entering a shame- and anxiety-induced spiral of depression for weeks. The melancholy stretched into months after my mom cut off my granny and uninvited her from a trip behind my back for daring to refer to me as her grandson (among other things)...as if that term, which is truly euphoric for me to claim, is somehow shameful and wrong when applied to me.


Let's be clear: non-binary and trans identity is not just about gender; it is about being authentically you in every possible essence because fuck social and gender norms that try to change and shame you. There are no words that can adequately express the uniquely traumatic pain of your parents rejecting a central aspect of who you are and punishing others for their support and acceptance of you.


I blamed myself again for being trans before realizing that their perception and treatment of me does not define me. Only I define me.


Debunking Some Common Myths About Us


DISCLAIMER: None of the information in this post or on my blog is intended to supplement medical care or advice. I am not a doctor; I am simply a non-binary, trans person sharing MY experience and promoting trans education using peer-reviewed research by medical experts.


These are my answers now to a lot of common questions and statements that misinformed people make about trans bodies and health.


“Won’t your testosterone/estrogen levels be too high?”


People should be more concerned with the effects and safety of hormone levels in cis women and men. Most of them, after all, don't have doctors constantly monitoring their levels.

I get blood work done every 2-3 months. My doctor—who is a primary care doctor but specializes in trans care—told me that both of my labs so far have been great. I actually could raise my weekly T dose more with what my highest levels (that peak two days after my shot) are currently at. However, I decided to stay on the standard minimum dose for another three months and then re-evaluate.


“Won’t your physical health suffer if you transition?”


I‘ve been getting stronger and healthier from eating and exercising more, getting out of an abusive relationship, and starting T. As it turns out, two effects of higher testosterone levels are increased bone density and thicker, stronger muscles.


A study that ran from 2009 to 2017 studied 388 trans individuals undergoing gender-affirming hormone therapy. The researchers concluded that the treatment done "in accordance with current clinical practice guidelines is efficient and safe." (You can read an in-depth summary of most of the effects of both masculinizing and feminizing hormone therapy and some risks here and here.)


Yes, usually at around the three-month mark on T, the uterus, ovaries, and other highly estrogen-dependent organs do begin to atrophy (break down). So I will eventually get a medically-necessary hysterectomy to remove my ovaries and uterus for my health and personal reasons. As the UCSF Trans Care Guidelines say, “hysterectomy is one of the most common non-obstetrical surgical procedures.”


I can’t speak for people who were AMAB (assigned male at birth) who choose to take estrogen/progesterone/etc on their lived experiences, but research shows that many transfemmes also get an orchiectomy, or surgery to remove one or both testicles to “treat or prevent prostate cancer”. Some research indicates that prostate cancer may be less likely in trans women (who go through feminizing hormone therapy) than in cis men because their testosterone levels are lower with the presence of feminizing hormones, testosterone blockers, and/or after an orchiectomy.


“Won’t your mental health suffer if you transition? Aren’t trans people just delusional and mentally ill?”


I’ve actually experienced greater mental and emotional stability so far, which I recently wrote about: My First Three (And a Half) Months on Testosterone!


My mental health has suffered from feeling disconnected from my body and myself, yes, but not simply because I am trans and therefore delusional and mentally ill. I suffered from living in the closet and repeated attempts to force me back in over the course of my life.


People customize their hair, makeup, outfits, and bodies through beauty regimens, exercise, diet, and medical means all the time. Gender affirmation treatment and surgery are valid and oftentimes necessary, life-saving forms of care. All are valid methods to use and paths to take to express yourself authentically. If you don’t feel at home in your body and know how to correct that, do it! Life is short. ❤


I know myself better than anyone. If I’m demonized and discriminated against for how I want to live my life and for what I do to my body, then I think that’s more evident of an intolerant, uneducated society than that I’m a moral and psychological failure.


“Don’t most trans people just ‘detransition’ because it doesn’t work?”


Trans people who transition and then “detransition” are 1) rare, 2) trans people who discovered that medical transition is not for them, and/or 3) sometimes trans people who go off hormones because of financial struggles and/or societal pressure. Reasons include rejection, ostracization, fear for personal safety, lack of legal and social support, internalized shame from upbringing, and more.


A very common fear-mongering and misinformation narrative is that transitioning has a high rate of “failure”. A new study published earlier in 2021 compiled data from the 2015 U.S. Transgender Survey that heard from over 27,000 transgender Americans. 17,151 of them had undergone some manner of medical transition, and 2,242 had "detransitioned at some point in their lives", which accounts for just 7.6% of the respondents.


"The most common reason cited for detransition was pressure from a parent (35.5%), pressure from their community or societal stigma (32.5%), or trouble finding a job (26.8%). Other reasons included pressure from medical health professionals (5.6%) or religious leaders (5.3%) ... Only 2.4% of transgender people who reported past detransition attributed this to doubt about their gender identity, while only 10.4% attributed their past detransition to fluctuations in gender identity or desire."

Furthermore, "[d]etransition was significantly associated with male sex assigned at birth, nonbinary gender identity, or bisexual sexual orientation" due to lower rates of acceptance.


A study out of the Netherlands that ran from 1972-2015 and was published in 2018 found that “only 0.6% of transwomen and 0.3% of transmen” regretted undergoing gonadectomy (surgical removal of the ovaries or testes).

Another study done at Essen University Hospital reported that out of 119 patients who underwent male-to-female (feminizing) gender affirmation surgery,


“90.2% said their expectations for life as a woman were fulfilled [5 years] postoperatively. 85.4% saw themselves as women. 61.2% were satisfied, and 26.2% very satisfied, with their outward appearance as a woman; 37.6% were satisfied, and 34.4% very satisfied, with the functional outcome. 65.7% said they were satisfied with their life as it is now.”

“But most trans people try to kill themselves when they transition!”


Yes and no. This is one of those "correlation does not equal causation" discussions. I can tell you from experience―and from every other trans person I’ve talked to―that my suicidal thoughts that are specifically related to my gender have entirely to do with internalized shame, rejection from my family, and pervasive, systemic discrimination.


A study published in 2016 with data drawn from the National Transgender Discrimination Survey identifies the following as “the major risk factors that influence the suicidal behavior” of trans people:


“Gender-based victimization, discrimination, bullying, violence, being rejected by the family, friends, and community; harassment by intimate partner, family members, police and public; discrimination and ill treatment [in] health-care system...”

The suicide attempt rate for trans people varies across countries―from 32 to 50%―and is heavily dependent on social acceptance and support.


The 2015 U.S. Transgender Survey found that trans people who "experienced discrimination or were a victim of violence were more likely to report suicide thoughts and attempts, who experienced family rejection were also more likely to report attempting suicide, [and that] access to gender-affirming medical care is associated with a lower prevalence of suicide thoughts and attempts."


The major data points of the Survey are as follows:

98% of respondents who had experienced four instances of discrimination and violence in the past year thought about suicide that year.
51% of them attempted suicide in that year.
13% of respondents who had been denied equal treatment because they are transgender reported suicide attempts in the past year.
6% of those who had not experienced such treatment reported past-year attempts.
11% of respondents who had been rejected from their families reported past-year suicide attempts.
5% of those who had not experienced such rejection reported attempts in the past year.
30% of respondents who were physically attacked in a public place reported attempting suicide in the past year.
7% of those who were not similarly attacked reported past-year attempts.
9% of respondents who wanted but did not receive gender-affirming care reported past-year suicide attempts.
5% of those who wanted and received gender-affirming care reported attempts in the past year.

Last but certainly not least, the 2015 National Transgender Discrimination Survey again identified family rejection as a significant predictor of suicide attempts and substance abuse by trans people.


"Overall, 42.3% ... reported a suicide attempt and 26.3% reported misusing drugs or alcohol to cope with transgender-related discrimination. After controlling for age, race/ethnicity, sex assigned at birth, binary gender identity, income, education, and employment status, family rejection was associated with increased odds of both behaviors. Odds increased significantly with increasing levels of family rejection."

All of the studies form similar conclusions: that trans people are unfairly assumed to be mentally ill because they are trans. The researchers suggest that the transgender community needs more support, not pathologization and rejection.


The Mount Sinai Adolescent Health Center suggests a multi-layer treatment/support plan for trans adults and youth, including "gender-affirming dialectical behavioral therapy [DBT], cognitive behavioral therapy [CBT], family therapy, and support group interventions."


“Well, your body just isn’t ‘meant' to be like that because you were born a girl/boy.”


Oh really? Are you a doctor or another medical/psychological professional educated about transgender healthcare? Because I can guarantee you that I know more about trans care as a trans person than the majority of people (doctors included, because most of them are woefully un/misinformed and I have to explain seemingly basic concepts of my care to them).


I was assigned female at birth (AFAB), but a lot has changed since then. I’m no longer 6 lbs 6 oz, for starters. “Female” was a label given to me solely based on the appearance of my genitalia, and the role of “girl/woman” was assigned to me as a result. I don’t fit into and reject that gender category. Additionally, reducing someone―whether they’re an infant, child, or adult―to just their genitals is creepy, uninformed, and inaccurate. (Intersex people exist and are actively erased, but most of y'all aren't ready for that conversation yet.)


In Conclusion


Stop using phony science to justify transphobia. Transgender healthcare is so complex and requires a curious, compassionate approach, not an exclusionary one intended to ignore and erase us. No objective right/wrong, healthy/unhealthy standard exists for all bodies. The sex and gender binary is a gross, dangerous oversimplification of the natural biodiversity that all creatures—including humans—exhibit. The medical model for health that we currently have is created by and for cisgender, heterosexual people, and any deviations are deemed wrong and defective. Sound familiar at this point? (Eugenics.)


I personally find sacrificing some of my internal reproductive organs―that I have no use for anyway―well worth the transformation and synchronization of my mind and body so that I can be at peace in my soul. I want to live a life full of self-love and authenticity.


If you learned something or just appreciate my writing, you can tip me at paypal.me/zoeadunning or cash.app/$zoeadunnin.


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