Understanding Internalized Cissexism (Internalized Transphobia) and Its Impact on Mental Health

Teenager scowls at the camera with arms crossed

Introducing Internalized Cissexism

Definition of internalized cissexism

As a psychotherapist, I understand that internalized cissexism is a complex and deeply rooted issue that affects many transgender and gender-nonconforming individuals. Internalized cissexism occurs when a person judges themselves through society’s anti-trans bias, which can have a significant impact on their mental health and overall well-being. It is vital to recognize and address internalized cissexism to foster a more inclusive and affirming environment for all gender identities.

Connection to internalized homophobia/heterosexism

The concept of internalized cissexism is closely related to internalized homophobia, or internalized heterosexism, which occurs when LGBTQ+ individuals internalize society’s negative attitudes and discrimination towards their sexual orientation. Just as internalized homophobia can harm the mental health of those affected, internalized cissexism can cause significant distress and impact the lives of transgender and gender-nonconforming individuals in similar ways.

Problem with the term “transphobia”

The term “transphobia” has often been used to describe the prejudice and discrimination against transgender and gender-nonconforming individuals. However, this term inaccurately focuses on an individual’s irrational fears as opposed to the oppressive systems that affect a person’s health. By using the term “cissexism” instead of “transphobia,” we can more accurately recognize and address the systemic issues that contribute to the marginalization and harm experienced by transgender and gender-nonconforming people. In doing so, we can work towards dismantling these oppressive systems and promoting mental health and well-being for all.

How Internalized Cissexism Happens

Gender stereotypes in mainstream culture

Internalized cissexism is often a result of the pervasive gender stereotypes that exist in mainstream culture. From early childhood, individuals are exposed to messages and expectations about what is considered “appropriate” or “normal” for their assigned gender. These expectations can include anything from clothing choices and personal interests to career paths and relationship dynamics. These societal norms can create a harmful environment for transgender and gender-nonconforming individuals, who may feel pressured to conform or experience guilt and shame for not fitting into these narrow definitions of gender.

Shame for not conforming to society’s expectations

For transgender and gender-nonconforming people, the pressure to adhere to society’s gender expectations can lead to feelings of shame and self-doubt. This internalized shame can be deeply damaging to their mental health, as it may cause them to question their worth and validity as individuals. Furthermore, the constant struggle to fit into a cisnormative society can be exhausting and demoralizing, further contributing to feelings of isolation and low self-esteem.

Fear of violence and discrimination

The fear of violence and discrimination is a significant factor that contributes to internalized cissexism. Transgender and gender-nonconforming individuals often face high rates of violence, harassment, and discrimination in various aspects of their lives, such as employment, housing, and public spaces. This constant threat can lead to heightened feelings of vulnerability and self-loathing, as individuals may internalize the harmful messages they receive from society, believing that they deserve such treatment due to their gender identity.

Struggles with healthcare and social acceptance

Transgender and gender-nonconforming people also face numerous challenges in accessing healthcare and achieving social acceptance. Many healthcare providers lack the knowledge and training to provide appropriate care for transgender patients, which can result in misgendering, denial of necessary treatments, and even outright refusal of care. Furthermore, transgender individuals may struggle to have their identities recognized and respected by their families, friends, and colleagues, further exacerbating feelings of isolation and rejection. These ongoing struggles can contribute to the internalization of cissexist beliefs, as individuals may begin to blame themselves for the challenges they face and doubt the legitimacy of their identities.

Factors Affecting Internalized Cissexism

Rejection and prejudice

Rejection and prejudice are significant factors that contribute to internalized cissexism. Experiencing rejection from loved ones, peers, or society at large due to one’s gender identity can be incredibly painful and may lead to feelings of unworthiness and self-blame. Prejudice, whether overt or subtle, reinforces harmful stereotypes and further marginalizes transgender and gender nonconforming individuals, making it more likely for them to internalize these negative attitudes.

Obsessive thinking about negative emotions and experiences

Obsessive thinking about negative emotions and experiences can exacerbate internalized cissexism. When individuals constantly ruminate on the difficulties they face or the negative emotions they experience due to their gender identity, it can create a cycle of negativity that is difficult to break. This persistent focus on the negative aspects of their lives can reinforce feelings of shame and self-loathing, further entrenching internalized cissexism.

Four dimensions and predictors of internalized cissexism

  • Pride in transgender identity: Having pride in one’s transgender identity can act as a protective factor against internalized cissexism. When individuals feel a strong sense of self-worth and celebrate their unique identity, they are less likely to internalize the negative messages they may encounter. Embracing and taking pride in one’s transgender identity can help build resilience and challenge the harmful beliefs perpetuated by cissexism.
  • Investment in “blending in” as a cisgender person: A higher investment in blending in as a cisgender person can increase the risk of internalized cissexism. When individuals place great importance on being perceived as cisgender, they may inadvertently reinforce the belief that being transgender or gender nonconforming is less desirable or valid. This emphasis on blending in can contribute to feelings of shame and self-doubt, making internalized cissexism more likely.
  • Isolation from other transgender people: Isolation from other transgender individuals can also contribute to internalized cissexism. When people lack connections with others who share similar experiences, they may feel disconnected from the larger transgender community and view themselves as fundamentally different or “less than” other transgender individuals. This sense of isolation can increase the likelihood of internalizing the negative stereotypes and beliefs surrounding transgender identities.
  • Shame: Feelings of shame around one’s gender identity, expression, or transition are strong predictors of internalized cissexism. When individuals feel ashamed of their authentic selves, they may internalize the harmful messages they receive from society, perpetuating the belief that there is something inherently wrong with them. Addressing and challenging these feelings of shame is crucial for overcoming internalized cissexism and fostering a positive sense of self.

Effects of Internalized Cissexism on Health

High rates of suicide and self-harm

Internalized cissexism is linked to higher rates of suicide and self-harm among transgender and gender-nonconforming individuals. The feelings of shame, self-loathing, and isolation that often accompany internalized cissexism can contribute to a sense of hopelessness and despair, making individuals more vulnerable to engaging in self-destructive behaviours.

Mental health issues (depression, anxiety, low self-esteem)

The negative self-perceptions associated with internalized cissexism can lead to various mental health issues, including depression, anxiety, and low self-esteem. These conditions can significantly impact an individual’s daily life, making it difficult for them to maintain relationships, work, or engage in self-care.

Reluctance to seek help or report crimes

Internalized cissexism can make individuals hesitant to seek help or report crimes when they are victimized. They may feel unworthy of assistance, fear further discrimination or ridicule, or believe that their experiences will not be taken seriously. This reluctance can leave individuals more vulnerable to ongoing harm and perpetuate cycles of abuse and violence.

Stress-related illnesses

The constant pressure to conform to cisnormative expectations and the ongoing experiences of discrimination and prejudice can create chronic stress for transgender and gender-nonconforming individuals. This chronic stress can contribute to a range of stress-related illnesses, including heart disease, gastrointestinal issues, and autoimmune disorders.

Lower quality of life

Internalized cissexism can have a significant impact on an individual’s overall quality of life. Struggling with negative self-perceptions, mental health issues, and the various challenges that accompany being transgender or gender nonconforming in a cisnormative society can make it difficult for individuals to experience happiness, fulfillment, and a sense of belonging.

Difficulties in coming out and seeking gender-affirming care

The feelings of shame and self-doubt that often accompany internalized cissexism can make it difficult for individuals to come out as transgender or gender nonconforming and seek gender-affirming care. This reluctance can delay or prevent individuals from accessing the support and medical interventions that may be essential for their well-being, further exacerbating the negative health outcomes associated with internalized cissexism.

How to Get Support

Gender-affirming care

Seeking gender-affirming care is an essential step for many transgender and gender-nonconforming individuals in addressing internalized cissexism. This care can include hormone therapy, surgeries, or other treatments that help individuals align their physical appearance with their gender identity. Gender-affirming care can improve mental health, self-esteem, and overall well-being.

Advocacy groups

Connecting with local, national, or international advocacy groups can provide valuable support and resources for transgender and gender-nonconforming individuals. These groups often offer educational materials, legal assistance, and opportunities to connect with others who share similar experiences. Building a network of supportive individuals and organizations can help combat feelings of isolation and reinforce a positive sense of identity.


Working with a therapist who specializes in supporting transgender and gender-nonconforming individuals can be beneficial in addressing internalized cissexism. A knowledgeable therapist can help individuals explore their feelings, challenge negative self-perceptions, and develop healthy coping strategies for managing stress and discrimination.


Becoming involved in activism can help individuals take pride in their transgender or gender nonconforming identity while working towards positive change. Engaging in activism can involve volunteering with advocacy organizations, attending rallies, or using one’s voice to raise awareness of the issues facing the transgender community. Being an active participant in the fight for equality can be empowering and help reduce the impact of internalized cissexism.


Choosing healthcare providers who are knowledgeable about and supportive of transgender and gender-nonconforming individuals is crucial for receiving affirming care. Access to competent healthcare can help individuals address both the physical and mental health challenges associated with internalized cissexism. Seeking out providers who are experienced in transgender care can make a significant difference in one’s overall well-being.

Community and identity

Building a supportive community and embracing one’s transgender or gender-nonconforming identity can be powerful tools in combating internalized cissexism. Connecting with others who share similar experiences, whether through support groups, online forums, or local events, can help individuals develop a sense of belonging and foster positive self-perceptions. Embracing and celebrating one’s unique identity can be a crucial step in overcoming internalized cissexism and cultivating a healthy sense of self.

How to Be an Ally

Active listening and supporting trans individuals

Make an effort to listen to the experiences of transgender and gender non-conforming individuals and offer your support. Remember that being an ally is an ongoing commitment and requires consistent effort.

Sharing pronouns and using inclusive language

When introducing yourself, share your pronouns and encourage others to do the same. Use inclusive language whenever possible and avoid making assumptions about someone’s gender or pronouns.

Avoiding cissexist language and behaviour

Be mindful of your language and avoid using terms or expressions that reinforce cisnormative expectations or belittle trans identities. Educate yourself about the issues facing the transgender community and strive to be an ally in both words and actions.

Intervening in cissexist situations

When you witness cissexist behaviour, speak up and intervene if it is safe to do so. By challenging discriminatory actions and attitudes, you can help create a more inclusive and supportive environment for transgender and gender-nonconforming individuals.

Respecting trans identities and experiences

Acknowledge and validate the experiences of transgender people without questioning the legitimacy of their identities. Be sensitive to the unique challenges they face and offer your support without judgment.

Supporting transition and challenging gender stereotypes

Recognize that everyone’s transition journey is different, and offer your support without imposing expectations. Challenge and question gender stereotypes, both in your own thinking and in society at large, to create a more inclusive and affirming environment for all.

Joining organizations for friends and family of trans individuals

Consider joining organizations that support friends and family members of transgender individuals. These groups can provide valuable resources, information, and opportunities to connect with others who are committed to being allies to the transgender community.


Importance of addressing internalized cissexism

Addressing internalized cissexism is crucial for the well-being of transgender and gender non-conforming individuals. By acknowledging and challenging the harmful effects of cissexist attitudes and expectations, we can help create a more inclusive and supportive society for all.

Support and advocacy for transgender and gender non-conforming individuals

It is essential for transgender and gender non-conforming individuals to access support and advocacy to combat internalized cissexism. This can include gender-affirming care, therapy, community connections, and engagement with advocacy groups. Building a strong network of support and resources can foster resilience and improve mental health outcomes.

 Allies’ role in promoting positive mental health outcomes

Allies play a crucial role in promoting the positive mental health of transgender and gender non-conforming individuals. By actively listening, using inclusive language, challenging cissexist behaviour, and supporting the transgender community in various ways, allies can help create a more inclusive environment and contribute to better mental health outcomes for transgender and gender non-conforming people.

Disclaimer: This blog shares general information only, not professional advice or recommendations. Consult healthcare providers for personal guidance. Decisions based on content are the reader's responsibility. Thank you.

Clayre runs a group practice of three queer and trans therapists, including youth therapist Audrey Wolfe, RCC, LGBT therapist Camber Giberson, RCC, CCC, and gender-affirming therapist Clayre Sessoms, RP, RCT, RCC, CCC, ATR-P. Work with us: book a session.

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