You Think…

This is like stating the obvious but maybe it needs to be said.

Why Transgender People Experience More Mental Health Issues
It has nearly everything to do with the way they are treated.
Psychology Today
By Katherine Schreiber
Posted Dec 06, 2016

Individuals who identify as transgender tend to experience higher rates of mental health issues than the general population. While approximately 6.7 percent of the general United States population suffers from depression and 18 percent grapple with some iteration of an anxiety disorder, nearly half of all individuals who identify as transgender experience these issues. What's more, over 41 percent of trans men and women are estimated to have attempted suicide — a rate that's nearly nine times as high as the rate of cisgender Americans.

What underlies this astonishingly elevated rate of mental health issues? According to a study published in the July 2016 edition of The Lancet offers significant evidence that the "distress and impairment, considered essential characteristics of mental disorders" among transgender individuals primarily arises in response to the discrimination, stigma, lack of acceptance, and abuse they face on an unfortunately regular basis.

Nothing new here, I think we all knew this. The article goes on to state the obvious to the trans community,

Shame and Stigma
Psychologists have been documenting the effect that stigma, rejection, discrimination, and abuse have on mental and physical health for decades. As the American Psychological Association pointed out in its March 2016 report on the impact of discrimination, "for many adults, dealing with discrimination results in a state of heightened vigilance and changes in behavior, which in itself can trigger stress responses—that is, even the anticipation of discrimination is sufficient to cause people to become stressed."
[…]
Further research by Wendy Berry Mendes and colleagues at the University of California, San Francisco has unearthed discrimination's causative role in inclining those on it's receiving end to engage in risk-taking behaviors. Out of 91 subjects participating in an online discussion with confederates who offered them rejecting or encouraging feedback, those who were on the receiving end of rejecting feedback (i.e., "Someone's a little high on themselves" or "I can't tell where you're going with this...") were more likely to take risks in a subsequent card game with small amounts of money at stake. Rejection also led to to "greater cortisol increases, less efficient cardiac output, increased vascular resistance, and impaired memory recall — a pattern of physiological reactivity that, when experienced chronically and excessively, has been linked to accelerated 'brain aging,' cognitive decline, and early risk for Alzheimer’s disease," as the Association for Psychological Science reported.

I think that fear of rejection also increases over achieving; we have to prove that “we are someone.” That we are just as good as cisgender people.

Hiding creates stress which results in medical problems such as heart conditions.

Being Deprived of a SelfRejection, discrimination, abuse, and other mistreatment of transgender individuals can impede their psychosocial and identity formation. There's a theory in Heinz Kohut's self psychology, Cathers explained to me, that you only develop a fully formed 'self' if three fundamental needs are met: Mirroring (a caregiver's accurate and consistent reflection of your emotional state), idealization (someone to look up to; a role model) and twinship (having someone who is 'like you,' that makes you feel you aren't alone in the world." Many trans people grow up lacking one or more of these crucial elements, Cathers added, which leaves them feeling isolated, unprotected, and much more vulnerable to life's inevitable stressors.

Cathers knew "there was something missing" from his body from an early age but it wasn't until he encountered transgender role models and other who could relate to his feelings in college that he began identifying as trans.

And fear keeps us in the closet until that fear and stress builds up to a breaking where we come out or look for other way relieve the stress such as self-harm.

What will cause all this fear, stress to go away?

The answer is simple…

How Acceptance Helps
When someone who identifies as transgender is surrounded by a supportive community (teachers, friends, family, school, or work colleagues) their rates of mental health issues are markedly decreased. By no means is this fact intended to diminish the discomfort of realizing you're either in the wrong body or that others aren't relating to you as the person you feel you truly are; rather, it's a testament to the power our environments (and those who populate them) have over our emotional wellness and risk for pathology.

One study found that just by having a supportive family all the self-harm and suicidal idealization drops back to the levels of the general population.

It is amazing. Not therapy, not laws, not anything lowers all the negative effects of transitioning as having a support network.