Mental health impacts of anti-trans stigma on transgender people in Australia: a mixed-methods study.

BACKGROUND: Anti-trans stigma has escalated globally, yet there is limited empirical evidence examining its mental health impacts on trans populations. METHODS: In a May 2024 mixed-methods cross-sectional online survey, trans people aged ≥16 years living in Australia reported the frequency of seven anti-trans stigma experiences in the previous month, including exposure to anti-trans remarks in the news media or online; personal experience of online bullying, harassment or threats; having thought about, seen or heard about anti-trans rhetoric by Australian politicians and high-profile individuals; or anti-trans rallies; or police violence; or international anti-trans legislation and violence. Generalized linear models examined associations between multiple times weekly exposure to each stigma type and anxiety (GAD-7), depression (PHQ-9), self-harm, and suicidality. Inductive thematic analysis was applied to free-text responses. RESULTS: Among 807 respondents, multiple times weekly exposure to all seven forms of anti-trans stigma was associated with a statistically higher prevalence of anxiety, depression, self-harm ideation, and suicide ideation (relative risk (RRs) ranging 1.14 to 2.10). Six stigma types were associated with increased risk of suicide planning (RRs 1.41 to 2.55), and five with increased risk of self-harm (RRs 1.32 to 2.07). Qualitative analysis identified three themes: (1) Navigating exposure to news and social media, (2) Experienced and anticipated anti-trans stigma, and (3) Escalating and inescapable anti-trans stigma. CONCLUSION: Australian trans communities are frequently exposed to anti-trans stigma, with more frequent exposure associated with a statistically higher prevalence of adverse mental health outcomes. Urgent collaborative responses are required from governments and media platforms to reduce stigma-related harm.