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Nonbinary people and mental health

According to a recent Pew Research Center survey, around 1% of US adults are nonbinary, and one in five adults say they know someone who uses gender-neutral pronouns.1

Mental health concerns among nonbinary people often stem from social experiences that make them feel they don’t belong or aren’t worthy of love and respect.2 There are, however, many things nonbinary people can do to protect their mental health, and there are many ways for friends, loved ones, and communities to support them.

What does it mean to be nonbinary?

When you’re nonbinary, your gender identity—your sense of your own gender—doesn’t neatly fit either of the traditional categories of “male” and “female.” Your sense of yourself may be that you have more than one gender, no gender, a changeable gender, or a separate third gender. You may also use pronouns that feel like a better fit (such as they/them/theirs).

Nonbinary gender isn’t a new way of being, and it’s not specific to any part of the world. Cultures throughout history have recognized and valued people outside the gender binary.3

What is the gender binary?

The gender binary is the idea that there are only two genders, male and female, and that everyone must be either one or the other. This traditional belief about gender is also sometimes called the gender dichotomy.

People who fit comfortably inside the gender binary are called cisgender, or cis. Cisgender people identify with the sex and binary gender they were assigned at birth, and their sense of who they are matches their external gender expression and the anatomy they were born with.

The gender binary is harmful because it invalidates the experiences of everyone who doesn’t fit its definitions. While many still believe in the gender binary, it isn’t rooted in scientific evidence: Many experts agree that gender and biological sex actually range across a spectrum, not a simplistic set of just two genders.4

Gender identity vs. gender expression

Your gender identity is your own internal, deeply held knowledge of your own gender. Everyone has a gender identity, and other people can’t determine it just by looking at you.

Your gender expression is the way you show your gender to the world. This can include your clothing and hair, the way you speak and act, and your name and pronouns.

Other gender identity terms

Anybody who doesn’t identify as strictly male or female can use the umbrella term “nonbinary” to describe themselves, but not everyone chooses to. People may instead use a term such as agender, bigender, demiboy/demigirl, genderfluid, genderqueer, or transgender.5 It’s important to respect and use the language each person affirms for themself.

Are nonbinary people transgender?

In many cases, you’ll see nonbinary and transgender people mentioned together. In the broadest sense, being transgender means your gender identity or gender expression is different from the sex you were assigned at birth. For some people, being transgender means something narrower: being the opposite binary gender from the one you were assigned at birth. Because of the many different experiences that can be contained in the term, some nonbinary people describe themselves as transgender and others don’t.

There are many different ways to be transgender and nonbinary, all of them valid. A trans or nonbinary person may express their gender in traditional or nontraditional ways.

How does being nonbinary affect mental health?

Nonbinary people often come up against significant discrimination, exclusion, and threats from the straight cisgender world—and sometimes even the LGBTQIA+ community—because they don’t fit either group’s preconceived notions of what gender should look like. These experiences can deeply undermine a person’s well-being.

Research shows that nonbinary people experience greater symptoms of anxiety and depression, with some studies suggesting the rate is double that of straight cisgender people.6, 7 In a 2020 survey, 24% of nonbinary and trans youth who felt their pronouns weren’t respected by others had attempted suicide—nearly twice the rate of those who felt that all or most people respected their pronouns.8

Below are some of the biggest mental health challenges faced by nonbinary people:

Homophobia and transphobia involve being targeted and discriminated against for being LGBTQIA+. These harmful experiences can cause isolation, anxiety, and depression. Trans and nonbinary people may also struggle with internalized oppression, which happens when you accept and adopt your community’s negative stereotypes about your own identity.

Gender dysphoria is discomfort or distress you may feel when your sense of yourself doesn’t match the sex you were assigned at birth. Research shows that gender-affirming medical care can help lower depression and suicidal thinking in trans and nonbinary young people.9

Invalidation happens when others don’t acknowledge or recognize your gender identity. This can look like being constantly misgendered or told that you’re “confused” about your gender.

Lack of accurate, positive representation in the media (as well as elsewhere) can leave nonbinary people feeling invisible, anxious, and alone.

Health care disparities stop many nonbinary and trans people from getting the same quality of treatment cisgender people receive. As examples, many areas don’t have gender-affirming care providers, many insurance plans don’t cover gender-affirming care, and many care providers aren’t trained to offer knowledgeable, respectful treatment to nonbinary and trans patients.

Barriers to legal gender recognition can prevent nonbinary and transgender people from changing the gender markers on their identification documents. Not having your gender legally recognized can affect your ability to get health care, housing, and Social Security. It can also make people targets for discrimination, violence, and exclusion in social settings like schools and workplaces.

Discriminatory legislation limits the rights of nonbinary and transgender people. Recent examples include “bathroom bills” that restrict restroom use, and “conscience clauses” that allow medical professionals to refuse to treat trans and nonbinary patients. These types of laws create additional stress, fear, and anxiety for people who may already feel unsafe or unwelcome in public spaces or using public services.

Lack of social support, understanding, and acceptance among family, friends, or the wider community can be extremely hard on your mental health. Lack of parental support, in particular, has been shown to put gender-diverse people at a higher risk of experiencing homelessness.10

If you’re in crisis and need immediate help, you can reach out to:

  • Trans Lifeline: 877-565-8860

  • Trevor Project: Call 1-866-488-7386 or text START to 678-678

  • 988 Suicide & Crisis Lifeline: Call or text 988

  • Crisis Text Line: Text HOME to 741741

How nonbinary people can protect their mental health

Build a support network of people who understand and accept you for who you are. If friends and family are unsupportive, consider connecting with other nonbinary and trans people through online or in-person support groups.

Educate yourself about your rights and how to assert them. Knowing your rights can help you feel more empowered and less alone. If you can’t find the information you’re looking for, consider reaching out to a legal aid or LGBTQIA+ rights organization for help.

Look toward accurate and positive representations of nonbinary people in the media. Many websites, blogs, books, and movies feature nonbinary characters and stories, and many online influencers and celebrities are openly nonbinary or trans.

Find a therapist or counselor who’s knowledgeable about trans and nonbinary experiences and gender-affirming mental health care. Therapy can be a safe space for you to explore your identity, work through your feelings, and find answers to questions and concerns about hormone therapy or surgery.

Seek out resources. The National Center for Transgender Equality offers a list of resources that can help you find and access gender-affirming health care, as well as legal advocacy and other forms of support. Additional resources are available at GLAAD.

Get involved in activism to help make the world a better place for trans and nonbinary people. Activism can help you feel more empowered and connect you with other trans and nonbinary people. It can also be a way to make lasting change.

How to support nonbinary people

If you know someone who’s nonbinary or trans, you have the opportunity to support them in their journey. Here are some things you can do:

Increase your awareness of trans and nonbinary issues by learning as much as you can. Read books, watch movies, and visit websites that feature transgender and nonbinary people’s voices and stories.

Respect people by using the pronouns, names, and terms they use for themselves. If you don’t know someone’s person’s pronouns, you can ask them (“My pronouns are she/her. What are yours?”), or share yours when you introduce yourself to give them an opportunity to do the same. Don’t assume you know someone’s pronouns if they choose not to share them.

Create a safe and welcoming environment for the people in your life who are nonbinary or trans. This can mean making your home a safe space, or being an ally at work or school.

Listen to and respect the wishes of the people in your life who are nonbinary or trans. If they don’t want to talk about their experiences, that’s okay. Just let them know that you’re there for them.

Support people’s decisions around gender-affirming health care like hormone therapy and surgery. This includes respecting their decision to transition, even if you don’t agree with or understand their choice.

Be an advocate for trans and nonbinary rights. This can be as simple as speaking up when you hear someone making discriminatory comments, or writing to your government representatives to support inclusive and affirming policies.

Attend family therapy or couples therapy with your nonbinary or trans loved one, if they feel it will help. Therapy can help you offer better understanding and support.

If you’re transgender or nonbinary—or someone you know is—remember that you’re not alone. You deserve to live authentically and to be respected and supported along the way. Visit our directory to find a gender-affirming therapist.

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