Transgender mental health in Australia: satisfaction with practitioners and the standards of care

Objective: There is evidence that some transgender people find aspects of the Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People, and/or their implementation by health professionals, problematic and counterproductive to transitioning. This study evaluated the significance of this dissatisfaction to the transitioning and mental health of transgender people. Method: 161 self-identified transgender people responded to an online survey that assessed satisfaction with health services provided in accordance with SOC guidelines, satisfaction with health professionals assisting with their transition, personal hardiness, gender congruence, steps to transition, and depression, anxiety, and stress. Results: Although results revealed dissatisfaction with the Standards of Care and with health professionals (particularly psychiatrists), subsequent path analyses conducted via structural equation modelling failed to reveal associations between this dissatisfaction and factors relevant to transitioning or mental health. However, personal hardiness was found to be associated with greater progress in transitioning and, by way of this, improved gender congruence, self-esteem, and mental health. Conclusion: While the results reveal dissatisfaction with the Australian health system and its professionals, this does not appear to translate into poor mental health outcomes. Rather personal hardiness during transition is the important predictor of transitioning and mental health. This argues for greater emphasis to be placed on building and supporting personal resilience in transgender people.