Meta Analysis: Social Anxiety Levels in MTF Transgender People

Of the two studies that I reviewed which quantify this issue [1,2] a 55% average was found. Within the general American population, similar types of anxiety are experienced by only 6.8% [3] of the population. While this is not a perfect comparison, it does speak to a disparity of experiences. This graph compares the social anxiety transgender people feel within the context of a cisgender social situation against levels of social anxiety within the general American population. The National Institute of Health defines Social Anxiety Disorder as a, “Social phobia… characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.” While this comparison is somewhat imperfect in that it is not a strict apples-to-apples comparison, it is a comparison of an experience of, “persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions.” To wit:

“… ethnic minority MtF transgender persons who experience negative interactions with health providers and face discrimination in the health care system feel strong barriers to utilizing health care services, and consequently exacerbate health disparities. Transphobia experience, depression, and economic pressure would also contribute to the barriers to utilizing services experienced by MtF transgender persons of color. This vicious cycle must be eliminated by developing health intervention programs specific to MtF transgender persons.” – Nemoto, Operario and Keatley, 2005 [4]

The imperative to avoid violence and cultural shame while surviving impacts seems to define and/or shape the way in which transgender people contextualize social interactions. The studies I reviewed found that over half of respondents claim significant anxiety over the way in which the cisgender population may react to them as transgender women. This is not a baseless concern; the trans population suffers significant rates of housing and employment discrimination, rape and assault. Housing discrimination contributes to homelessness; employment discrimination contributes to chronic unemployment and participation in underground economies such as sex work. Violence and discrimination narrows the experience of life to the simple need to physically and psychologically survive. Thus begins a cycle which reinforces depression and shame while simultaneously validating disempowerment and fatalism.

NOTES:

1. Kenagy, G., & Bostwick, W. (2005). The health and social service needs of transgender people in Chicago. International Journal of Transgenderism, 8(2/3), 57-66. doi: 10.1300/J485v08n02_06
2. Padgett, P., & Risser, J. (2010).Transgender HIV behavioral survey (thbs): Pilot study in Houston, TX. Unpublished manuscript, School of Public Health , The University of Texas, Houston, Texas.
3. NIH Social Anxiety: http://www.nimh.nih.gov/statistics/1SOC_ADULT.shtml
4. Nemoto, T., Operario, D., Keatley, J., Han, L., Soma, T. (2006) HIV risk behaviors among male-to-female transgender persons of color in San Francisco. American Journal of Public Health,  94(7):1193-1199