Trans & nonbinary mental health

Gender identity is your own deep sense of being a man, a woman, both, neither or somewhere else. Nobody else can tell you what it is. For some people it is clear early on, and for others it becomes clear over time.

Expression is how you present yourself: clothes, hair, voice, name and how you move through the world. Anyone can express themselves in many ways, and expression does not have to match anyone else’s expectations.

Some people are not sure yet about their gender. Questioning is a normal and valid place to be, for as long as you need. You do not have to have a label to deserve support.

Trans Lifeline says you can call even if you are not in a crisis or not sure you are trans.

Being trans or nonbinary is about gender. Sexual orientation is about who you are attracted to. Trans and nonbinary people can be any orientation. In 2025, about 12% of LGBTQ+ adults in the U.S. identified as transgender.

In the 2024 Trevor Project survey, 65% of transgender and nonbinary young people said they had felt discriminated against in the past year because of their gender identity, and 28% had been physically threatened or harmed.

Among trans adults in the 2022 U.S. Transgender Survey, 9% were denied equal treatment or service in the past year because of their gender identity or expression.

• Connect with LGBTQ+ advocacy groups who know your rights
• Do something that brings you joy each day, however small
• Spend time in spaces where you are fully accepted
• Take breaks from news and social media when it gets heavy
• Write down incidents of unfair treatment, with dates, in case you want to report them later

In the 2024 Trevor Project survey, 90% of LGBTQ+ young people said their wellbeing was negatively affected by recent politics. 45% of trans and nonbinary young people said they or their family had considered moving to another state because of LGBTQ+-related politics and laws.

What helps

• Choose set times to check the news, not all day
• Lean on people who affirm you, online and off
• Mute words or accounts that keep pulling you in
• Remember that headlines do not decide your worth

In the 2022 U.S. Transgender Survey, 30% of respondents had experienced homelessness at some point in their life. Money and housing worries can add a lot of stress on top of everything else.

If you are struggling to stay housed or make ends meet, local LGBTQ+ centers can often point you to housing, legal and job help.

If you make a mistake, simply correct yourself and move on: “She, sorry, he said…”. A long apology can make things awkward.

For trans and nonbinary people, hearing an old name or the wrong pronoun can feel like being erased, especially when it keeps happening. It can show up at school roll call, on medical forms, on bank cards or from family.

What helps

• Ask an ally to correct others for you, so you don’t always have to
• Decide which battles to pick: a quick correction, a later chat, or letting it go to stay safe
• Keep a note of affirming messages to reread on hard days
• Update names on accounts and documents where you safely can

In the 2022 U.S. Transgender Survey, 48% of respondents with an ID said none of their IDs showed the name they wanted. 22% had been harassed, asked to leave or denied services after showing an ID that did not match how they looked.

Things that can help

• Ask a local LGBTQ+ center or legal aid group about name-change help
• Bring a supportive friend to appointments where you need to show ID
• Keep a list of which accounts you have updated and which are left

Some people try a new name or pronouns with one or two safe friends first, or online, to see how it feels. It is fine to change your mind or keep exploring.

Many people feel a huge sense of relief when they start living more as themselves. At the same time, there can be stress about other people’s reactions, long waits, costs, paperwork or the news. Feeling several things at once doesn’t mean you’re on the wrong path.

You might notice

• Doubts that come from outside pressure, not from inside you
• Grief for time you feel you lost, or for relationships that changed
• Impatience or frustration while waiting
• Moments of deep joy, like hearing your name used for the first time
• Worry about family, school, work or safety

Gender joy is the happiness of being seen and living as yourself: a haircut that feels right, a friend using your name without thinking, a photo you love.

Waiting lists, paperwork and changing rules can make life feel stuck. In the Trevor Project survey, 45% of trans and nonbinary young people said they or their family had considered moving to another state because of LGBTQ+-related politics and laws.

Things that can help

• Focus on the parts of affirmation you can do now, like clothes, hair, name or pronouns with safe people
• Keep routines that ground you: sleep, movement, meals, time outside
• Plan small things to look forward to each week
• Talk it through with a therapist or peer group
• Use calming skills, like slow breathing, when worry spikes

Some people make many changes, some make a few, and some make none at all. Social, legal and medical steps are all separate choices, and you can take them in any order or not at all.

• Ask a clinic before booking: “Do you have experience caring for trans and nonbinary patients?”
• Ask for explanations in plain words, and take notes
• Bring a trusted person for support
• Remember you can get a second opinion or change providers
• Tell the front desk your name and pronouns, and ask that they be noted on your file
• Write your questions down before the visit

A good therapist will use your name and pronouns, follow your lead, and help with what you want to work on, whether that is stress, family, relationships or something else entirely.

Any approach that tries to change a person’s gender identity is harmful. In the 2024 Trevor Project survey, 16% of trans and nonbinary young people had been threatened with or subjected to conversion therapy.

If you were misgendered, mocked or refused care, it is normal to feel angry, shaken or put off going back. Your reaction makes sense.

Things you can do

• Ask for a different provider at the same clinic
• Make a note of what happened, with the date
• Tell a trusted person and take time to recover
• Use patient feedback or complaint routes if you want to

In the 2024 Trevor Project survey, 54% of trans and nonbinary young people described their school as gender-affirming, and 78% of LGBTQ+ students had at least one supportive adult at school.

What helps

• Find one trusted teacher, counselor or nurse
• Join or start an LGBTQ+ and ally club
• Keep a record of bullying, with dates
• Tell a trusted adult if you feel unsafe

You get to decide whether, when and how to share your gender at work. Some people talk to one trusted colleague or a manager first. Others start fresh at a new job.

Things that can help

• Check for an LGBTQ+ staff network or inclusive policy
• Find a workplace ally who will correct others for you
• Keep notes of any unfair treatment, with dates
• Talk to an LGBTQ+ legal or advocacy group about your rights

Many trans and nonbinary people plan ahead for everyday places, like knowing where a single-stall bathroom is or going out with a friend. Being on guard all the time is tiring, and it is not your fault.

• A friend or family member who “gets it” and can come to appointments
• A peer support group of other trans and nonbinary people
• An affirming clinical provider for anything medical
• An affirming therapist or counselor
• Online communities from trusted LGBTQ+ organisations

Trans Lifeline’s hotline is answered by trans and nonbinary peer operators. You can call even if you are not in crisis.

Local LGBTQ+ centers and online groups often run trans and nonbinary support groups, where you can share tips, wins and hard days.

If your family isn’t supportive yet, chosen family and peer groups can fill some of that gap. Chosen family means the people who truly see you, related or not.

In the 2022 U.S. Transgender Survey, 11% of adults who grew up with family said a family member had been violent toward them because they were trans. If home is not safe, your safety comes first.

• “I love you, and I’m here for you.”
• Ask “What would help most right now?” instead of guessing
• Celebrate milestones they want to celebrate
• Offer to come to appointments or help with forms
• Use their name and pronouns, even when they aren’t in the room

• Asking about their body or medical details unless they bring it up
• Asking for their old name
• Making their journey about your own feelings in front of them
• Saying “It’s just a phase”
• Sharing their story with others without permission

It’s okay if you have your own feelings to work through, like worry, confusion or a sense of loss. Find a separate space for them, like a family support group or your own counselor, so your loved one gets your full support.

Correct others gently when they use the wrong name or pronouns, so your loved one does not always have to. Challenge hurtful jokes when it is safe to do so.

• U.S.: (877) 565-8860
• Canada: (877) 330-6366

Calls are answered by trans and nonbinary peer operators. It is open on weekdays (it lists 1 PM to 9 PM Eastern), and you can press 2 for Spanish. Check their website for current hours and holiday closures.

Trans Lifeline does not call emergency services without your explicit request.

Call or text 988, or chat at 988lifeline.org, any time of day or night. It is for anyone in emotional distress or thinking about suicide, and for people worried about someone else.

• Call: 1-866-488-7386
• Chat: thetrevorproject.org/get-help
• Text: START to 678-678

Free, confidential and available 24/7, 365 days a year, from anywhere in the U.S.

Text HOME to 741741 in the U.S. to reach a live, trained crisis counselor. It is free and confidential.

Find A Helpline lists free, confidential helplines around the world, and you can search by country and topic.