Identity as Illness? Rethinking Transgender Suicide Risk and Healthcare in Germany

Abstract

Transgender individuals in the twenty-first century face stigmatization across the globe. Discrimination contributes to the development of early life stress (ELS), and this may lead to depression, anxiety, and social and developmental problems as individuals enter adulthood. Suicide rates in transgender populations in Western countries peak above 41%, compared to 4.6% in the general population (Haas, Rodgers, & Herman, 2014). Though medical and social efforts to treat suicide in the community are being developed, existing measures have been unable to effect significant change regarding these disproportionately-high suicide rates. Some parts of the world are drawing ahead of others in this respect. As one of the most gay-friendly countries in the world (Rand, 2013), for example, Germany is making progress medically and legally, including recently having introduced a third gender option into legal documents and opened new discussions on depathologizing transgender identity in medical care. Germany has been able to build on its early history as the first country to publicly tolerate and provide healthcare to transgender individuals. This has fostered transgender activism from the postwar period to today and may contribute to lowered suicide rates among transgender Germans. This thesis aims to use Germany’s early history of transgender rights to contextualize the state of the transgender population there today. Using an analysis of existing literature, it looks at the effects of stigmatization on suicide rates in the transgender population. Positive and negative aspects of Germany’s LGBTQ+ and transgender culture are evaluated for their impact on neurological development and the perpetuation of suicidal behavior. The thesis concludes with proposals for improved social, legal, and medical practices regarding transgender health in Germany, with a particular focus on the development of cultural understanding of transgender identity.