Health·Second Opinion

Better mental health among trans people addressed by their preferred name: Study

Transgender youth who were allowed to use their chosen name at work, at school or at home showed a reduced risk of depression and suicide.

'I was surprised by how clear that link was,' researcher says

Transgender young people may be vulnerable to unintended disclosure, or 'outing,' if teachers use a legal name rather than the student's preferred name, a researcher says. (Shutterstock)

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What's in a name?

Well, quite a bit for most of us.

It's a fundamental part of our identity. It expresses who we are.

And being addressed by the name you prefer is a sign of respect and dignity.

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In a recent study at the University of Texas, researchers took a closer look at the importance of a name for young people who are transgender.

They found that participants who were allowed to use their chosen name at work, at school or at home showed a lower risk of depression and suicide.

"Many kids who are transgender have chosen a name that is different than the one that they were given at birth," says Stephen Russell, a professor in the department of human development and family sciences at the university and lead author of the study.

The settings where they were able to use their preferred name, the stronger their mental health was.- Stephen Russell, University of Texas

"We showed that the settings where they were able to use their preferred name, the stronger their mental health was."

For their study, which was published in the Journal of Adolescent Health, Russell and his team interviewed 129 people between the ages of 15 and 21 from three American cities.

The question was simple: Were they able to go by their preferred name at home, at school, at work or with friends, or were they stuck with the name that appears on their official documents? 

"The roster the teacher has is going to have whatever your enrolment name was, and for many people that's been since their parents enrolled them in kindergarten," said Russell, adding that trans youth may be vulnerable to unintended disclosure, or "outing," if teachers use a legal name rather than the student's preferred name.

"So being in a class and every morning that name called — if it's not your name, if it's not the name that you want it to be, especially if it isn't how you look and present yourself to the world, is just really frustrating, undermining, and can be overwhelming for students."

For example, says Russell, "If your name is Mary and you feel like a boy, that might be a hard name to live in." Or "if you go to a new high school as a girl but you keep getting called Robert by your teachers, that would be undermining."

In the study, the participants who said they could use their name at school, home, work or among friends were significantly happier compared to their peers who could not. Those whose preferred name was used in all four areas experienced 71 per cent fewer symptoms of depression, 34 per cent lower reported thoughts of suicide and 65 per cent lower occurrence suicide attempts.

Being addressed by their preferred name in just one of the four areas was associated with a 29 per cent decrease in suicidal thoughts.

"I've been doing research on LGBT youth for almost 20 years and even I was surprised by how clear that link was," Russell told CBC News.

'Fairly simple thing we can do'

"Transgender youth are at higher odds of having serious mental health problems," says Gu Li, a postdoctoral research fellow at the University of British Columbia who helped crunch the numbers for this study. 

They face stigma, bullying and victimization.

"Calling them by their chosen name is a fairly simple thing we can do for them," Li says.

Elizabeth Saewyc, a professor at UBC's school of nursing, calls it "pervasive distress."

Saewyc has for the past 20 years done extensive research into vulnerable and marginalized adolescents and says, "When you're transgender and everywhere you go there are subtle and obvious ways that people try to negate who you are, where people refuse to allow you to use the bathroom of your choice or refuse to accept your name or your gender identity, call you by the wrong pronouns, refuse to acknowledge you, that basically … says you don't belong." 

Russell recognizes that the issue is complicated: "Emotionally complicated for families, administratively silly and complicated for education and health systems," he said. "But it's very clear that it makes a difference. So we should get over those silly administrative hurdles, and for families and friends, to try to figure out a way to get over our emotional hurdles, and try to support young people to be who they need to be."

And that is what's in a name.

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Kas Roussy

Former CBC reporter

Kas Roussy was a senior reporter with the Health unit at CBC News. In her more than 30 years with CBC, Kas’s reporting took her around the globe to cover news in countries including Pakistan and Afghanistan, Chile, Haiti and China, where she was the bureau producer.