What's the Latest Evidence on Mental Health Among Transgender and Nonbinary Adults?

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Summary: The latest evidence on mental health among transgender and nonbinary adults shows this group experiences higher rates of mental health disorders than gender-typical adults, heterosexual adults, and cisgender adults.

Key Points:

1.5 million adults in the U.S. identify as transgender
2.6 million adults in the U.S. identify as nonbinary
The highest percentage on transgender and nonbinary people among all demographic groups appears among adults age 18-29.
Experts indicate stigma, marginalization, bullying, lack of family support, and social rejection are the most likely cause of higher rates of mental health disorders in the transgender and nonbinary population

Mental Health Among Transgender and Nonbinary Adults: What do We Know?

As of 2025, it’s safe to say we should know more than we do about mental health among transgender and nonbinary adults. A recent study, however, begins to fill the void in our knowledge, and offers the latest evidence on mental health among transgender and nonbinary adults in the U.S.

The review and meta-analysis “Mental Health Outcomes in Transgender and Nonbinary People” poses this straightforward research question:

“What available evidence describes mental health and neurodevelopmental outcomes in transgender (trans) and nonbinary people?”

The study authors clarify the need for detailed research on this topic:

“Experiences of marginalization by gender minority people may predispose them to poorer mental health outcomes than their cisgender peers. Understanding mental health conditions in transgender (trans) and nonbinary people is an essential step in addressing potential inequities in outcome for gender minority people.”

At Crownview Co-Occurring Institute, we encourage everyone to understand that statement: it’s essential to understanding the daily, lived experience of trans and nonbinary people. In our treatment center, we welcome members of the transgender and nonbinary community with open arms. Our clinicians have extensive experience supporting the LGBTQIA+ community. We understand the challenges posed by living out and open as a member of the LGBTQIA+ community, including the unique challenges transgender and nonbinary people experience every day of their lives.

Our goal is to create a positive, supportive, welcoming, and healing environment for all people who need mental health support, and at Crownview Co-Occurring Institute, all means all. Before we dive into the details of the study we introduce above, we’ll take a moment to ensure we’re on the same page when we’re talking about transgender and nonbinary people.

What Do Transgender and Nonbinary Mean?

It’s important to get the basic terminology right, starting with these two terms:

Transgender

- - Transgender people have a gender identity that differs from their sex assigned at birth and social expectations associated with their sex assigned at birth.

Nonbinary

- - Nonbinary refers to lived gender identities that exist outside of the typical, binary girl/woman and boy/man concept of gender. A nonbinary person identifies as nonbinary: neither girl/woman nor boy/man.

It’s important to understand that not all nonbinary people are trans, and not all transgender people are nonbinary. In addition, when a nonbinary or trans person tells someone they’re nonbinary or trans, any line of questioning that resembles okay but what are you really/who are you really/what genitalia were you born with is stigmatizing, marginalizing, and an active denial or intentional misunderstanding of what they just said.

We encourage you to accept trans and nonbinary people as who they are – meaning who they say they are – rather than trying to fit them into who you want them to be or find out who they were. Resolving your level of comfort with how they identify is your job, not theirs.

With that said, let’s take a look at the study we introduce above, and get up to date on the latest evidence on mental health among transgender and nonbinary adults.

About the Study: Methods, Metrics, and Outcomes

To contribute to the existing knowledge base on mental health among transgender and nonbinary (TNB) adults, a team of health scientists in the United Kingdom (U.K.) analyzed data from 24 peer-reviewed studies on the prevalence of mental health disorders among TNB people over age 18. The research team collected the latest evidence on mental health among transgender and nonbinary adults, with a focus on prevalence of the following six mental health-related diagnoses, disorders, and/or behaviors:

Suicidal ideation (SI)
Suicide attempts (SA)
Non-suicidal self-injury (NSSI)
Depression (MDD)
Anxiety (GAD)
Eating disorders

We’ll share the results now, starting with the data suicidality and non-suicidal self-injury. To clarify, suicidal ideation (SI) means thinking about, talking about, or planning to attempt suicide. A suicide attempt (SA) is an effort to harm oneself with the intent to die. Non-suicidal self-injury (NSSI) refers to intentionally harming/damaging oneself without the intent to die.

These three behaviors are related, but distinct from one another, all with one thing in common: they’re indicators that an individual is experiencing significant and/or severe and intense psychological and emotional distress.

If you know anyone at risk of a suicide attempt right now, call 988 or go to the emergency room immediately: do not wait.

With that said, let’s review the data.

Suicidality: Suicidal Ideation, Suicide Attempts, and Non-suicidal Self-Injury Among TNB Adults

Suicidal Ideation:

Transgender and nonbinary adults (TNB): 50%
- Trans men: 53%
- Trans women: 43%
Cisgender/gender typical adults: 5%
Lesbian, gay, or bisexual adults: 18%

This data shows that ten times more TNB adults engage in suicidal ideation than cisgender adults, and more than twice as many TNB adults engage in suicidal ideation than lesbian, gay, or bisexual adults. Those figures are alarming, to say the least.

Suicide Attempts:

Transgender and nonbinary adults (TNB): 29%
- Trans men: 22%
- Trans women: 26%
Cisgender/heterosexual/gender typical: 0.8%
Lesbian, gay, or bisexual adults: 15%

This data is also alarming: at least 36 times more TNB adults attempt suicide in their lives than cisgender adults, and over 17 times more TNB adults attempt suicide in their lives than lesbian, gay, or bisexual adults.

Non-suicidal Self-Injury:

Transgender and nonbinary adults (TNB): 46.7%
Cisgender/heterosexual/gender typical: 14.5%
Lesbian, gay, or bisexual adults: 29.7%

These results are less alarming but still disturbing. Over three (3) times more TNB adults attempt suicide in their lives than cisgender adults, and 1.5 times more TNB adults attempt suicide in their lives than lesbian, gay, or bisexual adults.

Next, we’ll review the data on depression and anxiety.

Depression and Anxiety: Mental Health Among Transgender and Nonbinary Adults

Depression:

Transgender and nonbinary adults: 33.3%
Cisgender/heterosexual/gender typical adults: 15.4%
Lesbian, gay, or bisexual adults: 30.0%

Anxiety:

Transgender and nonbinary adults: 29.6%
Cisgender/ heterosexual/gender typical adults: 14.3%
Lesbian, gay, or bisexual adults: 46.0%

These results continue to show disparities between TNB adults, cisgender/heterosexual/gender typical adults and lesbian, gay or bisexual adults. Over twice as many TNB adults report depression than cisgender/heterosexual/gender typical adults, and over twice as TNB adults report anxiety than cisgender/heterosexual/gender typical adults. However, the differences in depression between TNB adults and lesbian, gay or bisexual adults is small, and over 50 percent mor lesbian, gay or bisexual adults report anxiety than TNB adults.

We’ll close this section with the data on eating disorders.

Eating Disorders: Mental and Behavioral Health Among Transgender and Nonbinary Adults

Any Eating/Feeding Disorder:

Transgender and nonbinary adults: 17.7%
- Trans men: 19.5%
- Trans women: 14.7%
Cisgender/gender typical adults: 7.6%
Lesbian, gay, or bisexual adults: 11.7%

While these differences are not as significant as those reported above, they confirm the trend noted above across a variety of mental health disorders, from suicidality to depression to disordered eating: TNB adults show far greater prevalence of eating disorders than cisgender/gender typical adults or lesbian, gay, or bisexual adults.

We’ll discuss these results below.

The Importance of This Research: Why the Large Differences?

Here’s how the study authors characterize their findings:

“This review has identified a consistent body of evidence reporting poor mental health outcomes amongst TNB people and has highlighted critical evidence gaps which should be urgently addressed to ensure their mental health needs can be addressed by evidence-informed policy and practice.”

First, as to the causes of the large differences. We mention them above, but they’re worth reiterating, starting with a disclaimer we didn’t share above:

The primary cause of increased mental health problems among TNB adults is not the default fact of being TNB or identifying as TNB.

The primary causes are:

Stigma
Marginalization
Bullying
Lack of family support
Lack of peer support
Social rejection

Those are all preventable causes, but responsibility for those doesn’t fall to TNB people. It falls to everyone else. They’re things that others need to do to reduce the prevalence of mental health problems among TNB adults. But what can TNB people and their families do that’s within their control, and not dependent upon others changing their behavior, points of view, or both?

The Importance of This Research: What Can Help?

There is something that can improve mental health among TNB people: gender-affirming care.

In 2022, a group of researchers published a study called “Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care” with this research goal:

“To investigate changes in mental health over the first year of receiving gender-affirming care and whether initiation of puberty blockers (PBs) and gender-affirming hormones (GAHs) was associated with changes in depression, anxiety, and suicidality.”

We understand questions around gender-affirming care can be contentious. That’s why we’ll report on the mental health outcomes related to gender-affirming care only and leave the debate around gender-affirming care writ large for another time and place.

Our question is this:

What helps TNB people improve mental health?

In this study, researchers recruited 104 TNB young people, aged 13 to 20 years, with the following characteristics:

Transmasculine individuals: 60.6%
Transfeminine individuals: 26.0%
Nonbinary or gender fluid individuals: 9.6%

Mental health status at baseline:

Depression: 56.7%
Anxiety: 50%
Suicidal ideation/NSSI: 43.3%

After receiving gender-affirming care such as puberty blockers (PB) or gender-affirming hormones (GAH) for at least a year, researchers reported the following:

Depression: 60% lower odds after gender-affirming care
Suicidality: 73% lower odds after gender-affirming care
Anxiety: No statistically significant association between symptoms of anxiety and PBs or GAHs.

Here’s how the study authors view these results:

“This study found that gender-affirming medical interventions were associated with lower odds of depression and suicidality over 12 months. These data add to existing evidence suggesting that gender-affirming care may be associated with improved well-being among TNB youths over a short period, which is important given mental health disparities experienced by this population, particularly the high levels of self-harm and suicide.”

While this study focused on teens and younger adults, it’s important to recognize that gender affirming care helped improve mental health. That was our question:

What helps TNB people improve mental health?

In addition to the things other people need to do, e.g. reduce stigma and marginalization and increase support, empathy, and compassion, the evidence shows something TNB people can do to improve their mental health is engage in gender-affirming care. This fact is important for members of the general public, for friends and family of transgender and nonbinary people, and for transgender and nonbinary people to understand.

Please remember that at Crownview, we embrace members of the LGBQIA+ community, which absolutely, one hundred percent means that if you’re transgender or nonbinary and need mental health support, we’ll welcome you with open arms and an open heart.