Transgender- The Behaviors and Acts Leading up to a Transition
Introduction

Transgender, as a terminology, alludes to individuals whose sense of their gender is different from what would be anticipated based on the sex individualities that they are naturally born with. A transgender individual may identify as a trans woman, which means a person who has a self-concept that is female, with the endeavor to or has transitioned to living as a woman after being born with male genitalia. On the other hand, an individual who identifies as a trans man implies having a male self-concept despite being born with female genitalia. Furthermore, an individual who is non-binary does not identify stringently as a woman or a man (Sangganjanavanich, 2016).

Starting as early as a child, a transgender individual may have continuous and perpetual feelings of gender dysphoria. This refers to a detachment between the individual's primary as well as secondary sexual characteristics. Also, this refers to as detachment amid designated-gender and the gender with which that individual identified. It is imperative to note that whereas numerous children that experience these sorts of feelings do not eventually go-ahead to identify themselves as transgender when they become adults, long-lasting gender dysphoria is a prevalent experience amongst adults who identify as transgender (Psychology Today, 2020). This essay purposes to discuss transgender and the behaviors and acts that lead up to a transition.

Psychological Reasons behind Transitioning

Gender incongruence, in delineation, is a condition whereby an individual's gender identity or expression is conflicting with their assigned sex traits and characteristics. More often than not, gender incongruence is supplemented by clinically pertinent psychological anguish, also referred to as gender dysphoria. People with gender incongruence are termed as trans persons. This terminology encompasses individuals whose gender identity is contradictory to their assigned sex; therefore, both transwomen and transmen (Jellestad et al., 2018).

Notably, gender dysphoria can present with a significant indictment of the anatomical characteristics, fundamentally the sexual characteristics. Also, owing to the pervasive social stigmatization that transpersons experience, gender dysphoria can result in negative self-perception and psychological issues (Jellestad et al., 2018). Specifically, numerous transgender people face depressive incidents in the course of their lifetime, which in severe cases, are linked with suicidal behavior. Therefore, to overcome this sentiment of gender dysphoria, numerous transgender people opt to seek medical assistance and undergo gender-affirming interventions that can either include gender-affirming surgery or sex hormonal medical treatment. In the present day, it is usually embraced and acknowledge that both hormonal and surgical interventions can relieve gender dysphoria (Jellestad et al., 2018). Weinforth et al. (2019) indicate that if persons with gender incongruence develop clinically relevant biopsychological anguish and suffering in-line with the DSM-5 classification; it implies that physical transitioning is the ideal option for transgender people for alleviating gender dysphoria symptoms. In this setting, gender reassignment, surgery, and hormonal treatment play a pivotal role.

Substance Abuse and relation to transgender

Research has indicated that there is a high prevalence of substance abuse amongst transgender people. Clinical studies have demonstrated that high percentages of substance abuse are accredited to individuals facing a gender identity that is on balance with sexual anatomy. Statistics indicate that for transgender people, the level of substance abuse, including opioids, alcohol, methamphetamine, cannabis, and cocaine, are approximately 4 to 10 times greater (Nuttbrock et al., 2014). The use of alcohol as well as other kinds of drugs amongst transgender populations is usually comprehended as a consequence of internalized stigma. In addition to transgender fear that is directed to the self, or stigma that is enacted in terms of discrimination of psychological or mental abuse expressed by other persons (Bockting et al., 2013).

Glynn & van den Berg (2017) indicate that in investigating this incongruence between transgender and non-transgender persons, research has demonstrated that there are correlations between substance abuse and trans-specific discrimination and bias. These research findings are in line with the Minority Stress Model, which asserts that protracted exposure to inequality, prejudice, and discrimination faced by members of minority and marginalized groups is linked with negative psychological results and health risk behaviors and conducts such as substance use. Furthermore, when pushed to extreme limits, such as being homelessness, there is a greater likelihood that transgender persons will get involved with substance abuse.

Statistics and Average Ages around Transitioning

There are few existent sources of data that can be utilized to delineate the demographic features of transgender people in the United States. For the most part, demographic data about Americans emanate from nationwide or population-oriented surveys such as the census. The downside is that these sources hardly incorporate questions to ascertain transgender respondents, thereby generating significant knowledge gaps in transgender populations. Also, getting a precise population is challenging because there are existing convincing and logical reasons why transgender people do not openly come out and claim their identity. Significantly correct figures for this population would necessitate transgender people to voluntarily and readily identify as transgender and risk ostracism, violation, and further segregation from society. Despite increasing publication and broadcasting in media, there continues to a high level of ignorance and disregard for transgender people (Miner et al., 2012).

However, following research conducted by the Williams Institute, the fraction of the population that recognizes and identifies as trans, ranges between 13 and 17 years. Statistically, about 150,000 youth signifying 0.7 percent of the American population identifies as transgender. Also, approximately 1.4 million adults or 0.6 percent of the adult population identify as transgender (The Williams Institute, 2017).

Figure 1: Age of Individuals Who Identify as Transgender in the United States (Source: The Williams Institute)

What Transitioning Entails

The transition process entails plenty of challenges and problems for transgender people. For numerous people, the process of transitioning encompasses hormonal therapy as well as surgery for altering facial features, genital expression, and also physical aspects such as the size of the chest. As expected, this is a costly and lengthy process for any individual. Transgender people face marginalization, societal discriminations, rejection from friends and family, and abuses of human and legislative rights and freedoms in different areas, including education, health care accessibility and treatment, employment opportunities, adequate housing, and legal systems. Significantly, these violations can give rise to diminished human capital, greater levels of unemployment, and high poverty levels, homelessness, and detrimental health and mental outcomes encompassing greater rates of depression and self-damaging as compared to cisgender people (Drydakis, 2020).

Transgender individuals who express and embrace their gender identity at an early life stage are usually rejected by the families. For the most part, they experience castigation out from the homes, and even when they are not, they continue to be rejected within the home setting giving rise to a lack of prospects for education and no hopes of assessing their mental and physical health necessities....…linked with an increase in health, social relationships, self-confidence and self-esteem, and also positive body image. These individual assessments of an individual's quality of life have shown to influence life satisfaction. It has been established that after transitioning, transgender people had the feeling of increased confidence, being able to express oneself, and also toughness. In contrast, preoperative transgender people experience plenty of insecurity and feel ugly or unattractive owing to worry about their body image.

One of the solutions for these problems experienced is having programs for Transgender people. For instance, in combating substance abuse, it is essential to have specialized transgender programs that utilize gender minority theoretical backgrounds and models to detect specific issues that impact transgender persons and then target them when creating interventions. Secondly, community-centered participatory intervention design approaches can aid in pinpointing noticeable matters that necessitate being addressed exclusively concerning the transgender community. Furthermore, these interventions need to be rendered by transgender peers in addition to promoting a constructive and positive identification with the transgender community (Glynn & van den Berg, 2017).

Psychological interventions are also a pivotal solution for transgender persons. It is imperative to provide interventions that are empirically based on addressing mental health issues. Nonetheless, these interventions have to be culturally espoused to guarantee clinical work that is respondent to minority populations. Regarding interventions such as trans-affirmative psychotherapeutic work ought to take into consideration particular stressors such as discrimination, prejudice, and victimization. This can be achieved by working in tandem with transgender persons, comprehending the detrimental effect of transphobic ostracization on mental health. There is also the need for taking into account theoretical contexts such as the stress experienced by transgender people, which elucidates heightened risk for adverse results and maladaptive behaviors amongst transgender people (Catelan et al., 2017).

Conclusion

Gender incongruence is defined as a noticeable and prevailing incongruence between a person's experienced gender and the assigned sex. However, when there is persistent psychological distress, this is considered to be gender dysphoria. Essentially, gender dysphoria encompasses trans individuals feeling a great deal of discomfort in their sex, distress, and also anxiety. This is the psychological basis of why individuals opt to transition. Dysphoria usually gives rise to adverse self-image and self-esteem.

Consequently, numerous transgender people opt to seek medical assistance and undergo gender-affirming interventions that can either include gender-affirming surgery or sex hormonal medical treatment. Statistics indicate that the proportion of the population that recognizes and identifies as transgender ranges between 13 and 17 years. Due to the severe level of rejection, discrimination, prejudice, and violence experienced by trans people in all facets of society, their level of substance abuse, including opioids, alcohol, methamphetamine, cannabis, and cocaine, are significantly higher compared to cisgender people.

The transition process is significantly challenging for numerous trans people. They experience severe marginalization, societal prejudices, denial from friends and family, and abuses of human and legislative rights and freedoms in various societal aspects including education, health care accessibility and treatment, employment opportunities, adequate housing, and legal systems. Despite this, research has shown that transitioning has had a positive impact on transgender people regarding having a positive perspective towards life, having life satisfaction, and being more self-confident and positive self-perspective. In this regard, key solutions include increased awareness of transgender people, advocating for their rights and freedoms akin to any individual in the society, and having psychological and health programs that are catered to them.

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