Transgender Identity, Authenticity, & Existential Concerns
Photos by Thiago Rocha and Karollyne Videira Hubert
Minot State University. November 6, 2023.
“I feel angry when I am misgendered / my heart races / because I have been / branded / stamped / labelled / boxed / denied access / to truth and connection / completely misunderstood / not accounted for, un-protected, not remembered…”
– Keath Silva (2022, from the poem entitled “Misgendered”)
Gender identity refers to one’s deeply felt and inherent sense of being a boy/man, a girl/woman, or a non-binary gender. For many people, the gender assigned to them at birth aligns with this inherent sense of who they are. For example, doctors and parents might have assigned the gender of “girl” to a person based on sex characteristics present at birth, and this person may feel a match between this gender assigned at birth and their own inherent sense of who they are. Those who identify with the gender assigned to them at birth are referred by the term “cisgender” (often abbreviated as “cis”). However, for some people, the gender assigned to them at birth does not align with their gender identity. For example, a person assigned the gender of “girl” at birth may instead identify as a man and express this gender identity through appearances (such as dress and hair) and the use of certain pronouns (such as using “he/him” rather than “she/her”). Those whose gender identity does not align with the gender assigned to them at birth are referred by the term “transgender” (often abbreviated as “trans”).
Several states have issued book bans calling for the removal of specific titles from public school libraries, many of which focus on the topics of gender identity and expression. Local efforts in these states have been made to provide access to these books, such as “pop-up” libraries that include these titles. Photo by Steven Chubbuck
Over the last few years, conversations about trans people have become increasingly common, and at times, controversial and politicized. For example, Daily Wire host Michael Knowles received critical attention for an address in which he stated, “For the good of society… transgenderism must be eradicated from public life entirely—the whole preposterous ideology, at every level” (Wade & Reis, 2023). Comments such as these have become increasingly common, particularly among politically conservative commentators (such as Ben Shapiro and Matt Walsh) and politicians (including former President Donald Trump and Florida Governor Ron DeSantis) in their calls for restricting trans people’s rights (e.g., Seitz-Wald & Yurcaba, 2023). This focus has also found its way into a rising surge of legislation designed to limit trans people’s access to gender-affirming care, restrict their access to appropriate facilities, and criminalize their right to openly express their gender in public spaces. Indeed, the number of proposed bills in the United States targeting trans people have continued to increase over the last few years, with hundreds of bills introduced in 2023 alone (American Civil Liberties Union, 2023). As described by trans rights activist and writer Erin Reed, such efforts separate trans individuals “from all the things that allow people to experience the world,” ultimately amounting “to banning transgender people’s existence” (Wade & Reis, 2023).
These and other issues that trans people face—such as rejection from close others, harassment from those in their communities, and discrimination in settings like education and employment—can take a damaging toll on their psychological well-being. Research shows that trans people who endure these experiences report low self-esteem, high rates of feeling misunderstood, and high levels of psychological distress, including anxiety and depression (e.g., Drabish & Theeke, 2022).
Notably, these experiences also seem likely to arouse worries among trans people that focus on various existential concerns—things like their value and purpose in life, a sense of meaning in what they do, and whether they feel connected to and truly understood by others. Indeed, theory and research in existential psychology suggests that experiencing threats to one’s sense of purpose and place in the world can elevate existential concerns (Routledge & Vess, 2019). For trans people, elevated existential concerns seem especially likely due to issues such as restrictive legislation, stigmatization from others, and harassment in areas of life that are important to them. These negative experiences might shatter trans people’s sense of meaning in life and disrupt their feelings of connection with others. As a result, trans people might view life as having little meaning and experience a strong sense of existential isolation, or feeling like others do not truly understand the experiences they go through in life.
Although such elevated levels of existential concerns among trans people seem likely, this issue has been a relatively unexplored topic in psychological research. Studies have instead typically focused on other indicators of psychological well-being, such as anxiety, depression, and nervousness, and have occasionally compared trans and cis people on such measures (e.g., Hughes et al., 2021). And although research has shown that general forms of social support (such as having someone who provides emotional care and comfort) can be helpful in supporting trans people’s well-being (e.g., Falak et al., 2020; Trujillo et al., 2017), understanding the types of support that are helpful for trans people to deal with existential concerns specifically has not yet been explored. Such questions are important, as experiencing elevated existential concerns could further harm trans people’s psychological adjustment and well-being.
Thus, to address these questions, I conducted two initial studies as part of my dissertation as a Ph.D. student at the University of Arizona. The findings from these studies bear important implications for understanding trans people’s mental health and identifying supportive actions in the midst of anti-trans legislation, stigmatization, and harassment.
Photo by Adrian Swancar
Do Trans People Experience Elevated Levels of Existential Concerns?
The first goal of these studies was to assess whether trans people indeed experience high levels of existential concerns. To address this question, in both studies, trans and cis participants completed brief questionnaires asking about various existential concerns, including their perceived level of meaning in life and how much they feel existentially isolated from others. Trans participants were those who indicated that their current gender identity differed from the one assigned to them at birth, responding “yes” to the question, “Does your current gender differ from the one you were assigned at birth?” Cis participants were those responding “no” to this question.
To measure how meaningful participants view their lives, they were presented with statements such as, “I understand my life’s meaning” and “My life has a clear sense of purpose.” They were asked to rate how much they agreed with such statements using a provided scale of numbers. Participants could select the number on the scale that corresponded with their level of agreement, ranging from 1 (Absolutely untrue) to 7 (Absolutely true). If people tend to disagree with these statements, this suggests they have low levels of meaning in their life. Similarly, to measure how existentially isolated participants feel (that is, how alone they feel in their subjective experiences), participants were presented with statements such as, “People do not often share my perspective” and “Other people usually do not understand my experiences” and were asked to rate how much they agreed with such statements using a scale ranging from 1 (Strongly disagree) to 7 (Strongly agree). If people tend to agree with these statements, this suggests they have higher feelings of existential isolation.
Results from both studies showed that trans people appear to experience greater levels of existential concerns than cis people. Specifically, compared to cis people, trans people viewed their lives as having less meaning, and they also felt more alone in their subjective experiences. Whereas previous research has found that trans people report poorer psychological adjustment than cis people on things like self-esteem and depression, the results from these two studies extend our understanding of trans mental health to show that trans people also appear to report higher levels of existential concerns. This finding is important, as elevated existential concerns can have harmful effects on people’s psychological well-being and are tied to higher levels of depression and suicidal ideation (e.g., Helm et al., 2020; Mikulincer et al., 2020). If trans people are especially likely to experience existential concerns, then they may be at an even greater risk of experiencing further psychological distress.
The Role of Autonomy Support for Gender Expression
The second goal of these studies was to examine what psychological resources might be helpful for trans people in dealing with existential concerns. If trans people indeed experience lower meaning in life and greater existential isolation—as the results from these two studies show—then an important question is identifying what might help them deal with these issues. In these two studies, the focus was on autonomy support for gender expression—that is, feeling that one’s personal control of and self-authorship for their gender identity and its expression is supported by others. Put differently, a person who feels supported in their autonomy over their gender expression is someone who feels encouraged and supported by others to be authentic and to express their true sense of self. But why might this specific type of support be worth studying in the context of existential concerns among trans people?
Photo by Markus Spiske
Notably, research in the fields of humanistic and existential psychology has found that feeling a sense of autonomy in life—and having one’s autonomy supported by others—is connected to a greater sense of meaning in life, as well as stronger feelings of being understood by and connected to other people (Ryan & Deci, 2017). In other words, autonomy—often referred to as a sense of self-direction or “self-authorship” for one’s life—has been shown to help people better deal with existential concerns. For example, people who feel like they have a sense of choice and control over what they do in life report viewing life as more meaningful, and recent studies have shown that a sense of personal volition and self-direction helps people deal with existential anxieties and concerns (Martela et al., 2018; Vail & Horner, 2023).
Such findings build on the work of writers and scholars who have long argued that finding purpose in life and keeping existential concerns at bay rely on viewing oneself as having a sense of agentic “being” in their world—capable of making choices, choosing one’s own path in life, and volitionally expressing oneself. For instance, in his book titled Art and Artist: Creative Urge and Personality Development, psychologist and writer Otto Rank (1932/1989) emphasized that the individual act of self-expression and forging one’s mark on the world can provide meaning and protect people against existential anxieties. Psychologist and scholar Esther Menaker (1982) emphasizes this same point in her book titled Otto Rank: A Rediscovered Legacy, in which she highlights how self-expression and autonomy allows one to feel in control of their life and create “a concretization of [their] personality” (p. 34).
For trans people, feeling supported in this expression of their authentic self—feeling that their self-authorship for their gender identity and its expression is supported rather than challenged by others—should help boost their sense that they are leaving their own personal and true mark on the world, or a “concretization” of who they truly are. Indeed, some research has found that people who report feeling more autonomy in their life have a stronger sense that they are making a lasting impression that will be remembered by others (Horner et al., 2021; 2022). Thus, being supported in one’s autonomy for their gender expression should help trans people feel purpose and meaning in what they do, as well as feel seen, validated, and heard by others.
Building on these ideas, the two studies also tested whether trans people who felt higher levels of autonomy support for their gender expression—feeling like others support their personal control of and self-authorship for their gender identity and its expression—would report more meaning in life and lower existential isolation compared to trans people who felt lower levels of this type of support.
Do Trans People Who Feel Autonomy Support for Gender Expression Have Lower Levels of Existential Concerns?
In both studies, trans participants who felt higher levels of autonomy support for their gender expression reported more meaning in their life and lower feelings of existential isolation.
To examine this question, trans participants in both studies completed a questionnaire asking whether they feel supported by others to be in control of their gender identity and its expression. Specifically, they were asked to rate how much they agreed with statements such as, “When I am around people who are important to me, I feel a sense of choice and freedom in my gender expression,” “When I am around people who are important to me, I feel my gender expression reflects who I really am,” and “When I am around people in society, I feel encouraged to express my true self in my gender expression.” Their level of agreement with each statement could be indicated using a scale ranging from 1 (Not at all true) to 7 (Completely true). If people tend to agree with these statements, this suggests they feel a greater sense of autonomy support for their gender expression.
Results from both studies showed that trans people who tended to agree with such statements—that is, those who indicated they felt supported by others to be authentic and in control of their gender expression—also showed higher levels of meaning in life and lower levels of existential isolation compared to trans people who did not feel as much autonomy support. In other words, feeling more autonomy support for their gender expression was connected to better outcomes on levels of existential concerns.
The Path Ahead
These two studies highlight something important about trans people’s mental health—not only do trans people tend to report high rates of depression, distress, anxiety, and suicidal ideation, but the results from these studies suggest that they also appear to report greater levels of existential concerns compared to cis people. Trans people are already at a greater risk of experiencing elevated stress as a minority group (Hendricks & Testa, 2012), and experiencing low levels of meaning in life and greater feelings of existential isolation are likely to make matters worse.
Photo by Alexander Grey
As described at the outset of this article, trans people also face rising numbers of legislation designed to limit their access to gender-affirming care, restrict their access to appropriate facilities, and criminalize their right to exist openly and freely. If these and other issues such as rejection, harassment, and discrimination continue, levels of existential concerns among trans people will likely continue to be a threat to their psychological well-being, and identifying resources that help trans people deal with such concerns will be especially important.
Ultimately, legislative efforts and cultural changes are needed to protect and solidify trans people’s right to authentically exist. Nevertheless, the findings from these two studies suggest one path forward for helping support trans people’s well-being. Specifically, the findings suggest that feeling supported by others to be autonomous and authentic in their gender expression could be an important resource for trans people to deal with existential concerns while issues such as anti-trans legislation, stigmatization, and harassment persist. Although future research will be needed to better understand the impact of this support, the findings from these initial studies suggest that supporting trans people in their autonomous and authentic expression is important for their well-being. To offer such support, people can use the pronouns and language that trans people use for themselves, become familiarized with policies and experiences that negatively impact trans people, and be outspoken in support of trans people’s rights. For resources and to learn more about supporting trans people, please visit the National Center for Transgender Equality.
Additional Reading
For excellent coverage of issues and topics related to trans people’s mental health and experiences, readers are encouraged to read the book titled Everything You Ever Wanted to Know about Trans (But Were Afraid to Ask) written by Brynn Tannehill (2018).
For additional coverage of the studies described in this article (as well as other findings and discussion about existential concerns among trans people), readers are directed to my dissertation (Horner, 2023) and published work in Horner et al. (2023).
Dylan E. Horner, Ph.D., is an Assistant Professor of Psychology at Minot State University and director of the RiSE (Research in Social and Existential) Psychology & Well-Being Lab. His research investigates how feelings of autonomy and self-authorship in life (feelings of personal choice, self-direction, and volition over one’s actions and decisions) can help people manage existential concerns and promote well-being. Much of his work has focused on autonomy’s role in helping people manage death-related anxiety and concerns, and his ongoing work is aimed at applying these understandings to identify ways to support people who are especially vulnerable to experiencing psychological distress. Website: dylanehorner.com