One of the narratives being promoted about transgender people is that they think they are transgender because they are mentally ill. There are higher rates of depression and suicidality in the trans population compared to other groups and I previously discussed the reasons that occurs. But not everyone knows that mental illness is a result of the stigma of the identity rather than the identity being the result of a mental illness.

Today I want to point out how this idea that transgender identity is a symptom of a mental illness is a regurgitation of an idea that was commonly held about homosexuals in the middle of the last century. Knowing where that myth came from and how it was dispelled can help you know how to respond when you hear this recycled trope. Please note that I use the word homosexual because it was the term used before gay became the preferred term.

In the early 20th century, in the attempt to identify what distinguished a homosexual identity from a heterosexual identity, researchers noted that homosexuals had a higher incidence of mental illness. At that time, it was commonly thought that schizophrenia was caused by unemotive mothers, and that (male) homosexuality was caused by distant fathers.

How this myth of homosexuality as a symptom of a mental illness was disproven and knowing the life events that led Dr. Evelyn Hooker to publish the 1957 paper, “The Adjustment of the Male Overt Homosexual” are also important as you try to educate others about the myth that trans youth are mentally ill.

Dr. Hooker was born in Nebraska in 1907. She was nearly six feet tall and had personal experiences with stigma and prejudice due to her height and her sex (we know she was denied admission to Yale because she was female.) She was also in Berlin living with a Jewish family and witnessed the Kristallnacht. She later found that her host family had been exterminated by Nazi’s.

And then in 1944 she got to know a bright student at UCLA by the name of Sam From who happened to be gay. Through Sam she met a lot of gay men and undoubtedly found that many of the contemporary beliefs about homosexuals were not true. Sam urged her to “study us” and helped her get access to members of the Mattachine Society, an early gay rights group. Dr. Hooker was convinced enough that not all homosexuals were mentally ill, so she designed a study to dispel the misconception.

Dr. Hooker wondered if the pathology reported in homosexual men was an artifact of studying gays who had a history of mental illness (finding subjects in clinical settings). She compared rates of pathology in matched community-based samples of homosexual and heterosexual men. She had blind testers rate the projective testing of each group and the results showed that a community-based sample of homosexuals was no more disturbed than a community-based sample of heterosexuals. Her research was crucial in the 1973 de-pathologization of homosexuality by the American Psychiatric Association.

As I think about Dr. Hooker, my clinical work with families, and what I know about racial prejudice as well, I see factors which have a great impact on maintaining or dispelling mistaken attitudes about someone who is different or “other”. Keeping these in mind can help you reach your audience of misinformed people.

The first variable which makes one more likely to consider a more compassionate view is the ability to relate personally. The word compassion derives from Latin and means “to suffer together.” Dr. Hooker had suffered discrimination and no doubt she saw Sam and his friends suffer too. Instead of focusing on the difference between them (sexual orientation) she focused on the communality of discrimination and personal suffering.

The second variable that can help alter perceptions is of course meeting a real person rather than learning about a group of individuals through myths and stereotypes. Dr. Hooker met Sam and his friends and saw the discrepancy between what she had been taught and what she was experiencing. Though she did struggle with the fact that Chris Isherwood had a lover that was much younger, she saw that homosexuals were not mentally ill and were not child molesters. She saw what Sam and his friends did in their day to day lives and this widened her focus from sexual activity to seeing a whole person.

It is also likely that as Dr. Hooker got to know Sam and his friends, she came to understand that being gay is not a choice. She became aware that the question of what causes homosexuality was problematic given that no one questions what causes heterosexuality. Meeting so many gay men allowed her to note that just as there are many complex paths and nuances to a heterosexual orientation, there are many paths to gay identity,

So, when you hear someone repeating the opinion that transgender people are mentally ill, remind them that if they had to endure a lot of stigma and victimization, they too would suffer mentally. Remind them that being transgender is no more of a choice than being cisgender. Remind them that they only hear about the “clinical” population of transgender people and that there are transgender people who do the same things they do (watch sports, garden, pay taxes, go to family birthday parties, have career ambitions, sing in the shower…). Remind them that gender identity is only one aspect of a person, not their whole identity.

Most importantly, speak up. It is openly acknowledged that Dr. Hooker’s research was taken seriously because she was NOT homosexual. Being an ally gives you clout and speaks volumes.


Antonia Caretto, Ph.D. is a fully licensed Clinical Psychologist and a graduate of the University of Michigan and the Alliant International University California School of Professional Psychology. Dr. Caretto’s 1991 doctoral dissertation research was on “Familial Homosexuality Among Women and It’s Relationship to Childhood Gender Role Non-Conformity and Adult Sex Role.”

Dr. Caretto has a solo private practice in Farmington Hills, MI, and gender identity development continues to the focus of much of her work.