People with Gender Diversity in Portugal: A Brief Insight into Psychological Welfare and Family and Social Environments

Abstract

Introduction: Transgender people experience many life challenges, often by relatives or peers, which can lead to multiple mental health issues.
Methods: Given the described family and social challenges in people with gender diversity and their impact on mental welfare, the need for a brief description of these settings arose. Being so, an original questionnaire was constructed and, afterwards, provided to different healthcare professionals and organizations who contact with transgender people. Subsequently, these partners applied the questionnaire to people who met the following criteria: self ‑identifying as a transgender person, being 18 years old or older and residing in Portugal. This was done to try to encompass as many adult transgender people as possible who may contact Portuguese health services and have a broad notion of their family, social and psychological background. By having a general comprehension of these matters, we hope to inform the clinical community, impact clinical assessment and promote an empathic relationship with the patient.
Results: Regarding tolerance towards gender diversity, we found that it increased substantially from childhood and adolescence to current life; also, we ascertained that, when the trans person’s household is not tolerant, neither are the peers, and vice ‑versa (p=0.023). As for the topics of gender and sexuality, we found a gap between the amount of trans youth who think about these topics and the amount of households, peers or schools who approach them. In regards to mental health, we found that anxiety, depression and suicidal issues remain significantly present among trans people; however, a non ‑binary gender identity may be a protective mental health factor.
Conclusion: Mental health challenges remain prevalent within trans people, whether they are feelings of anxiety, depression, suicidal issues, family or social struggles. This paper wishes to raise awareness of these struggles to promote a better healthcare professional–patient relationship. We also wish to impact clinical practice, namely to do an early distinction between a case of gender diversity or gender dysphoria, identify potential therapeutic targets and goals and to help formulate a therapeutic plan together with the patient.