Yes, words can harm young trans people: What we can do to help

All children and adolescents have the right to live free from discrimination. However, the public debate last week around the proposed religious discrimination bill threatened this right.

While the bill has been shelved, the debate is a continuation of a discussion in which the existence, rights, and lives of trans children and adolescents have been called into question both in Australia and overseas.

These young people have endured intensified stigma and discrimination that negatively impacts their health and well-being.

Poorer health outcomes

Trans people make up between 2.3% to 3.7% of Australia's youth population.

Although many trans people live healthy, fulfilled lives, research from overseas shows a disproportionate number have poorer mental health than their peers.

Recent Australian studies paint a similar picture. One study found:

• 90% of trans young people experienced high or very high psychological distress in the previous four weeks
• 54% had self-harmed
• 71% reported suicidal ideation
• 14% had attempted suicide in the preceding 12 months
• 38% reported having attempted suicide at some point in their life.

Another study found trans young people in Australia were 15 times more likely to attempt suicide than the general population.

Minority stress

Minority stress arises from the social, psychological and structural discrimination associated with belonging to a stigmatized minority group.

Negative media commentary can directly contribute to minority stress among trans people, as can legislation and policies that seek to exclude trans individuals from schools and workplaces.

Negative representations of trans children and adolescents in the media shape public attitudes and practices. This can not only stoke fear and mistrust that further marginalizes trans young people, but also lead to violence against them.

In Australia, one study found 89% of trans young people had experienced peer rejection. Some 74% had experienced bullying, while 69% had experienced discrimination.

Another study found 68% of trans young people in Australia had felt uncomfortable or unsafe in their educational setting because of their gender or sexuality diversity.

A third study found young trans Australians were four times more likely to have experienced sexual violence or coercion.

Public debate about trans young people also impacts their families. For instance, a recent study reported parents of trans children and adolescents in the United States experienced significant stress as a result of legislation introduced to prevent young trans people accessing medical and surgical gender affirmation.

Not surprisingly, parents viewed these bills as increasing stigma towards their child and the broader trans community.

Health harms of public debate

Apart from fostering stigma and discrimination, public debate about trans people can also negatively impact their health.

Physical activity in adolescence is important for long-term health. Trans young people already experience multiple barriers to participating in sport and physical activity. Public commentary questioning involvement of trans people in sport acts as a further obstacle.

Negative press coverage about affirmative health care for trans young people has also been associated with reduced referral rates to specialist pediatric gender clinics overseas, and highlights the role public debate is likely to play in reducing access to such care.

Finally, trans young people report exposure to negative news stories adversely affects their mental health by provoking experiences of depression, anxiety, and/or fear.

So what can we do to help?

Strikingly, previous research has shown when trans young people are supported and their gender is affirmed, they have similar mental health outcomes to their cisgender peers.

While parental support no doubt plays a key role, emerging evidence indicates having safe and supportive schools is critical too.

School safety and connectedness, for example, are protective factors against depression, self-harm, and suicide.

Similarly, peer and school support provide a buffer against the negative impact of gender-related victimization on mental health.

Policies and procedures that enable a trans young person's gender, name and pronouns to be accurately recorded are also important. Research shows having identity documents that match one's affirmed gender is associated with lower rates of serious psychological distress and suicide.

Finally, the media itself may help to promote better health for trans young people. For instance, trans adolescents have reported experiencing happiness and increased hope after exposure to positive news reports about other trans people.

Trans young people flourish with support from family, friends, and the broader community. Hopefully, future commentary about trans young people's rights takes this into account.