Transgender kids face alarming rates of bullying and abuse. GLSEN’s 2017 National School Climate Survey found 83.7% of trans and 69.9% of gender nonconforming (GNC) students experience bullying at school.

Bullying can erode self-esteem, increase isolation, and make it more difficult for a child to assert their gender identity. Some bullied children become depressed and suicidal. Centers for Disease Control and Prevention (CDC) reports that any involvement with bullying—whether as a victim, bully, or both—raises a child’s risk of suicidal behavior.

Parents, educators, and other adults have significant power to reduce bullying and support trans kids at school.

Transphobia Statistics

Transphobia is animus toward transgender people. It can cause bullying, physical aggression, and other forms of abuse.

Research consistently finds that gender-related discrimination is a problem in schools. GLSEN’s annual National School Climate Survey looked at over 23,000 children in grades 6-12. The study found 42.1% of trans and GNC kids are prevented from using their preferred pronouns. Nearly half of these kids (46.5%) are forced to use the wrong bathrooms.

Other research has found high rates of transphobic bullying.

• Research published in 2017 found trans kids are two to three times more likely than their peers to be bullied.
• A 2016 survey of adult transgender individuals found 60% have avoided public restrooms because they feared confrontation and bullying.
• A 2012 survey found 61% of students have heard peers make negative remarks about gender expression. The same survey found 27% of students face physical abuse because of their gender expression.

Creating a Safe Environment for Trans Kids

Many parents and educators worry that there’s nothing they can do to stop transphobic bullying. Yet research consistently finds that creating an inclusive, gender-affirming environment can greatly reduce bullying. Even when kids are bullied in these environments, they may feel more comfortable reaching out to an adult than they would in less inclusive environments.

According to GLSEN, students at inclusive schools with curricula that feature LGBTQ-affirming content are less likely to experience bullying, hear transphobic remarks, or feel unsafe at school. They are also less likely to be forced to use the wrong bathrooms or the wrong pronouns. Inclusive curricula can also raise self-esteem, reduce the risk of depression, and even improve grades.

Some strategies that promote a safe environment for trans kids include:

• Creating a trans-inclusive curricula. Schools can participate in LGBT History Month, feature notable transgender historic figures, and discuss transgender history and civil rights with students.
• Asking students about their preferred pronouns or names and then using them
• Educating teachers, school counselors, and others who work with students about transgender issues.
• Establishing safe spaces, such as counselor’s offices, where students can safely discuss gender issues and bullying.
• Refusing to tolerate any bullying or transphobia, even from teachers or other adults.

Parents who want to support a transgender child should urge their child’s school to promote an inclusive environment that actively works to prevent transgender discrimination. At home, parents can help by allowing children to assert their own gender identity in a safe, judgment-free zone.

It is important to let the child determine what gender means to them. Parents should avoid reinforcing gender stereotypes or rigid gender ideologies. For example, a trans girl does not need to turn her entire wardrobe pink in order to “prove” she is a girl. No toy or clothing should be off limits to anyone solely because of gender.

Parents can also support their trans or GNC children by introducing them to the wider LGBT community. They may read books with their child that feature people of many gender identities and presentations. They may identify trans or GNC role models for kids to learn about. They may also help their children meet other trans kids through support groups, trans camps, and other communities.

Lastly, parents may wish to educate themselves about transgender history and issues. Children pick up on what parents believe, not just what they say. Parents who are uncomfortable with their child’s gender presentation may inadvertently stigmatize their child. Education can help parents reevaluate their own ideas about gender and become better advocates for their children.

Understanding Your Child’s Rights

Federal, state, and local laws determine a student’s legal rights. Trans students in some states have more protections than students in other states. Individual schools may extend additional rights to trans students.

Many courts have ruled that transgender individuals are protected under Title IX. This federal law forbids schools from discriminating against students based on their sex or gender expression. Under Title IX, transgender and GNC students have the right to:

• Be protected from bullying, harassment, and violence.
• Use restrooms and locker rooms that match their gender identity.
• Be called the correct name and pronouns.
• Dress and present themselves according to their gender identity (so long as they follow the general school dress code).
• Access the same educational opportunities and school events as other students.
• Maintain their medical privacy, including the right not to disclose being transgender.

However, not all states share this interpretation of Title IX. According to the American Civil Liberties Union, only 17 states have laws explicitly protecting transgender students from harassment and discrimination. These include Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Minnesota, New Jersey, New York, North Carolina, Oregon, Vermont, and Washington. The District of Columbia also has anti-discrimination laws.

Even between these states, the extent of civil protections can vary. For example, only California, Connecticut, and Washington currently allow transgender students to join school sports teams consistent with their gender identity. School districts within a state may also vary in their policies.

The rights of transgender students at school are continually evolving. Parents who worry their child is facing discrimination should consider consulting a lawyer who specializes in educational law or who has experience with transgender issues.

How Therapy Can Help Transgender Kids

Therapy can offer immense support to transgender kids and their families. Family counseling can help a family identify strategies for supporting a child’s gender identity and fighting back against bullying. When family members do not fully understand or accept a child’s trans identity, family therapy can educate them and encourage acceptance.

Individual counseling can help transgender kids who struggle with depression, low self-esteem, and anxiety due to bullying. The right therapist can also affirm a child’s gender identity and point them toward trans role models and literature. In therapy, a child can learn that being trans is not a mental health problem or a weakness, but an important component of a person’s identity that should be respected and celebrated.

You can find a therapist here.

References:

1. GLSEN 2017 National School Climate Survey. (2018). Retrieved from https://www.glsen.org/article/2017-national-school-climate-survey-1
2. Know your rights: Transgender people and the law. (n.d.) ACLU. Retrieved from https://www.aclu.org/know-your-rights/transgender-people-and-law
3. McKay, T., Misra, S., & Lindquist, C. (2017). Violence and LGBTQ+ communities: What do we know, and what do we need to know? RTI International. Retrieved from https://www.rti.org/sites/default/files/rti_violence_and_lgbtq_communities.pdf
4. Supporting transgender and gender diverse students in schools [PDF]. (2015). American Psychological Association. Retrieved from https://www.apa.org/pi/lgbt/programs/safe-supportive/lgbt/school-administrators.pdf
5. The relationship between bullying and suicide: What we know and what it means for schools [PDF]. (2014). Chamblee: Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/violenceprevention/pdf/bullying-suicide-translation-final-a.pdf
6. Trotta, D. (2016, December 08). U.S. transgender people harassed in public restrooms: Landmark survey. Reuters. Retrieved from https://www.reuters.com/article/us-usa-lgbt-survey/u-s-transgender-people-harassed-in-public-restrooms-landmark-survey-idUSKBN13X0BK
7. What are my rights at school? (n.d.). Retrieved from https://transequality.org/know-your-rights/schools

More and more Americans with mental health concerns are becoming incarcerated. This population of has reached “crisis proportions,” according to the National Alliance on Mental Health (NAMI).

Evidence shows incarceration is likely to worsen mental health symptoms. Most institutions do not have the resources to treat such a great number of people. Reduced mental health can lead to recidivism, meaning a recurrence of criminal behavior. When more people are rearrested, the population of imprisoned people stays high.

However, there are ways to reduce recidivism in these populations. People who receive mental health treatment during and after their sentences are less likely to reoffend. Alternatives to imprisonment can also reduce recidivism.

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Mental Health in the Criminal Justice System

In the United States, around 2 million people go to jail or prison each year. In general, jails are run by local forces. They hold inmates for terms of one year or less. Prisons are run by state or federal forces. They typically house prisoners for longer periods.

Many people in prisons and jails have a mental health diagnosis.

• A 2005 Department of Justice study found 64% of inmates in local jails have a mental health concern. The rates were 56% for state prisoners and 45% for federal prisoners.
• Around 50% of incarcerated people have a dual diagnosis. A dual diagnosis occurs when someone has both a mental health concern and substance addiction.
• According to NAMI, 20% of incarcerated individuals been diagnosed with “serious mental illness.” Someone with a “serious” condition may require daily assistance. This category includes conditions such as schizophrenia, major depression, and bipolar.

Estimates on recidivism rates vary. Most studies show offenders with diagnoses have higher recidivism rates than those without.

• The 2005 study above found 75% of incarcerated individuals with a diagnosis had been arrested before.
• A 2017 study showed offenders with diagnoses have a 9% greater chance of rearrest one year after release. Five years after release, the difference increases to 15%.
• The same 2017 study found people with severe diagnoses are 4% more likely to be rearrested than those with milder conditions.

How Jails and Prisons Became Mental Health Facilities

The criminal justice system has not favored people with mental health concerns in the past. From straitjackets to lobotomies, history is full of inhumane attempts to manage mental health. Pervasive stigma impacted nearly every step of incarceration and treatment.

In the 1950s and 1960s, the government closed many mental institutions and psychiatric hospitals. The intent was to serve people through community resources instead. Yet a lack of funding and commitment left many states with few treatment options.

In a Stanford Law Report, Senator Darrell Steinberg and Professor David Mills write, “Although deinstitutionalization was originally understood as a humane way to offer more suitable services … in community-based settings, some politicians seized upon it as a way to save money by shutting down institutions without providing any meaningful treatment alternatives.”

Many prisons and jails are ill-equipped to provide adequate mental health care. But for some people, these facilities are where they first encounter treatment. In the 1980s, the “war on drugs” complicated matters. The government began assigning mandatory sentences for drug-related offenses. More people with substance addiction were put behind bars. Many of these people had co-occurring mental health concerns. In the last 40 years, the rate of incarceration has increased five-fold in the U.S.

People with mental health issues are more likely to be the victim of a crime than commit one. Yet research shows living with untreated conditions can be extremely damaging to individuals. An untreated condition may affect a person’s judgment and lead to criminal behavior. This likelihood increases if other large-scale stressors (poverty, abuse, etc.) are present.

Many prisons and jails are ill-equipped to provide adequate mental health care. But for some people, these facilities are where they first encounter treatment. A person may not get a diagnosis until they are already behind bars.

The Incarceration Cycle for People with Mental Health Concerns

Today’s criminal justice system treats individuals more humanely than in the past. Yet offenders with mental health concerns still face discrimination. Someone with a diagnosis is likely to get a longer, harsher sentence than a neurotypical peer convicted of the same crime. They are also less likely to be granted release.

Incarceration itself can worsen mental health. Offenders often experience a drastic drop in agency. Strict rules and isolation can exacerbate stress. An individual may develop additional mental health concerns as they adjust to the transition.

Incarceration itself can worsen mental health.The Bureau of Justice Statistics held a survey asking offenders about their mental health in the prior 30 days. Fourteen percent of state or federal prisoners reported having severe psychological distress. The rate was almost double (26%) for jail inmates.

Compromised mental health and relative isolation can promote substance abuse. Andrew Archer, LCSW explains, “American incarceration operates as a perfect recipe to perpetuate habitual patterns for individuals. Extreme isolation and societal alienation demoralize the person to the extent that often times substances are the only form of self-regulation.”

In this way, alcohol and drug addiction can spread through populations of offenders. The sale, trade, and consumption of drugs can broaden one’s criminal network. Being insulated with other offenders can also reinforce attitudes that encourage further crime.

After years of incarceration, prisoners tend to struggle once they are released. Trey Cole, PsyD, says, “Relationally speaking, incarcerated individuals often become accustomed to the externally controlled environment (i.e. when to eat, sleep, etc.). When released, then, usually with few resources, becoming accountable to oneself and internally motivated become more difficult.”

Released offenders may find themselves without any resources or support. They may struggle to find housing or employment due to stigma. Reduced mental health can also impact one’s ability to make a living.

In other words, the factors which led a person to crime may be even stronger after release. Their ability to survive within the law may have been reduced. In this context, a person can easily be drawn into recidivism.

Compassionate Solutions for Lowering Recidivism Rates

A report by the Council of State Governments (CSG) Justice Center calls for an overhaul of the way U.S. criminal justice systems address people with mental health issues. Special attention was called to the way such people are released from jail and prison.

According to the CSG, a successful system of reentry into society would:

• Combine a range of services and professional efforts.
• Coordinate treatment for substance abuse and other mental health issues.
• Integrate both mental health care and primary healthcare.
• Provide housing for individuals with mental health issues.
• Draw upon family connections and community resources for treatment.
• Ensure people can access the full range of government entitlements for which they are eligible, such as Social Security Disability Insurance.

Some states have already begun to implement these measures. Colorado, Texas, and North Carolina have used grant money to expand mental health care and substance abuse treatment for offenders. These states also saw large drops in recidivism.

• North Carolina had a 42% reduction in people sent back to prison after probation violations between 2006 and 2015.
• Texas had a 25% reduction in the 3-year reincarceration rate between 2004 and 2013.
• Colorado saw probation revocations and the 3-year reincarnation rate reduced by at least 23% in around the same time frame.

How Diversion can Reduce Recidivism

Diversion has also been shown to reduce recidivism rates in people with mental illness. Diversion is a practice of placing offenders in mental health treatment instead of prison or jail. It often takes one of two forms.

The first form is forensic hospitalization. Offenders who have been found not guilty by reason of insanity are typically sent to forensic hospitals. These facilities do confine people like prisons and jails do. Yet their aim is typically rehabilitation rather than punishment. Less than 1% of people in the criminal justice system qualify for the insanity defense.

A 2005 study found offenders released from forensic hospitals had very low recidivism rates. They were less likely to reoffend than released inmates with mental health concerns. They were also less likely to offend than inmates without a diagnosis.

It is often cheaper to send nonviolent offenders to mental health treatment than jail. The other path of diversion involves mental health courts. These courts are for offenders who have mental health concerns but don’t qualify for the insanity defense. Judges may offer defendants reduced sentences in exchange for getting treatment. In many cases, a defendant may not go to jail or prison at all.

A 2007 study found participation in mental health courts cut the risk of violent offense in half. People who had gone through mental health courts also went longer without reoffending than those who went through traditional courts.

NAMI strongly supports diversion as a more humane and cost-effective approach to incarceration. According to NAMI, the cost of jailing adults with mental health concerns is two to three times the cost of keeping other inmates. It is often cheaper to send nonviolent offenders to mental health treatment than jail.

Just as psychotherapists who practice good therapy see people as whole beings independent of any mental health issues they may have, NAMI’s compassionate justice system would see all individuals as worthy of treatment and change. This system would classify mental health concerns not as moral defects, but as results of adversity or strain. Prioritizing treatment over punishment could have lasting benefits for the criminal justice system.

References:

1. Agnew, R. (2001). Building on the foundation of general strain theory: Specifying the types of strain most likely to lead to crime and delinquency. Journal of Research in Crime and Delinquency, 38(4), 319-361. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/0022427801038004001
2. Bales, W.D., Nadel, M., Reed, C. & Blomberg, T. G. (2017). Recidivism and inmate mental illness. International Journal of Criminology and Sociology, 6(1) 40-51.
3. Bloom, J. D., & Novosad, D. (2017). The Forensic Mental Health Services Census of forensic populations in state facilities. The Journal of the American Academy of Psychiatry and the Law, 45(4), 447-451. Retrieved from http://jaapl.org/content/45/4/447
4. Bronson, J. & Berzofsky, M. (2017). Indicators of mental health problems reported by prisoners and jail inmates, 2011-12. Bureau of Justice Statistics. Retrieved from https://www.bjs.gov/content/pub/pdf/imhprpji1112.pdf
5. Criminals need mental health care. (2014, March 1). Scientific American. Retrieved from https://www.scientificamerican.com/article/criminals-need-mental-health-care
6. What is the difference between jails and prisons? (n.d.). Bureau of Justice Statistics. Retrieved from https://www.bjs.gov/index.cfm?ty=qa&iid=322
7. Lerman, A. E. (2013). The modern prison paradox: Politics, punishment, and social community. Cambridge University Press. Retrieved from https://gspp.berkeley.edu/research/selected-publications/the-modern-prison-paradox-politics-punishment-and-social-community
8. NAMI warns senate about criminalization of mental illness; Supports Cornyn bill. (2016, February 10). NAMI. Retrieved from https://www.nami.org/Press-Media/Press-Releases/2016/NAMI-Warns-Senate-about-Criminalization-of-Mental
9. The new asylums: Some frequently asked questions. (2005, May 10). PBS. Retrieved from https://www.pbs.org/wgbh/pages/frontline/shows/asylums/etc/faqs.html
10. Reducing recidivism: States deliver results. (2017). The Council of State Governments Justice Center. Retrieved from https://csgjusticecenter.org/wp-content/uploads/2018/03/Reducing-Recidivism_State-Deliver-Results_2017.pdf
11. Steinberg, D. & Mills, D. (n.d.) When did prisons become acceptable mental health care facilities? Stanford Law School: Three Strikes Project. Retrieved from http://law.stanford.edu/wp-content/uploads/sites/default/files/child-page/632655/doc/slspublic/Report_v12.pdf