Gender identities on IDs found linked to trans mental health

TORONTO (Thomson Reuters Foundation) - The mental health of transgender adults may be linked to having identity documents with their preferred name and gender, according to new research that found lower rates of distress and suicidal thoughts among people with matching IDs.

The U.S.-based findings indicate legal gender recognition in documents should be considered a “key social and structural determinant of trans people’s health,” according to the study published this week in The Lancet Public Health journal.

Several U.S. states have non-binary gender options such as “X” on drivers’ licenses and birth certificates, and advocates have pushed for more widespread use of the practice.

“For people who have often spent many years struggling to be seen for who they are, to have that validated on one’s official document is going to be really important,” said Dr. Ayden Scheim, a social epidemiologist at Drexel University in Philadelphia who co-authored the study.

Using data from the largest ever survey of trans adults, the study found those with gender-affirming IDs had a lower prevalence of serious psychological distress, suicidal ideas and suicide planning.

U.S. transgender adults, estimated to be 1.4 million people, are three to four times more likely to attempt suicide than adults among the general population, it said.

While the findings do not prove that having matching IDs directly leads to better mental health, it makes sense that a relationship exists, Scheim said.

Even something as simple as going to a bar can expose trans people to harassment and discrimination, he said.

“If you have to show a piece of ID that outs you as trans, suddenly that’s a very stressful encounter,” Scheim said.

The study found that people whose IDs reflected their preferred identity had reduced distress and suicidal thoughts, while those with some updated identity documents showed smaller reductions.

It used data from a 2015 U.S. transgender survey with 27,715 participants.

In 2018, a United Nations independent expert reported the risk of discrimination and violence for trans and gender-diverse people was “exacerbated when their name and sex details in official documents do not match their gender identity or expression.”

“Thankfully this is gaining a lot of momentum,” said Rodrigo Heng-Lehtinen, deputy executive director at the National Center for Transgender Equality (NCTE), an advocacy organization.

Jurisdictions around the United States and elsewhere have been altering their processes by lowering fees, reducing administrative hurdles and removing eligibility requirements such as surgery, he said.

Reporting by Jack Graham, Editing by Ellen Wulfhorst. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live freely or fairly. Visit