Experiencing the world as a different gender than one’s biological sex is a struggle in itself. In addition to the toll of day-to-day life, transgender individuals often experience a higher level of mental health stressors and poorer mental health outcomes than individuals who identify with the gender they were assigned at birth.

According to Ilana Sherer, Assistant Medical Director of the Child and Adolescent Gender Center at the University of California Benioff Children’s Hospital in San Francisco, transgender individuals are often “treated extremely poorly by their parents, by their schools, by society at large, and that can lead to problems in school and at work, as well as poverty and increased risk of substance use.” Happiness, success, and mental wellbeing are greatly affected by a person’s feeling of self-worth and confidence, two factors that result from being validated and supported by family, friends, and the community. While some research has been done to determine the full scope of factors contributing to mental health outcomes in the transgender community, much more work can be done. “With time, as more research attention is focused on transgender individuals, we will start to get a better understanding of the factors that are associated with better versus worse mental health, and use that information to improve the lives of all transgender people, both before mental health problems emerge and to provide support to reduce or eliminate their impact later in life,” according to Johanna Olson-Kennedy, Medical Director of the Center for Transyouth Health and Development at Children’s Hospital in Los Angeles—the largest transgender youth clinic in the United States.

Read the full article from NPR.