By Imtiyaz Razak –

Dr. Imtiyaz Razak

This paper examines the psychological, medical, and social struggles faced by transgender individuals, drawing on both personal observations and established research. While gender reassignment surgery and hormone therapy are often framed as pathways to liberation, evidence suggests that these interventions do not fully resolve underlying identity conflicts. Instead, they may compound psychological distress and physical burdens. By combining first-hand workplace observations with findings from psychiatric and sociological studies, this paper argues that the transgender experience requires deeper reflection beyond medical affirmation.

Introduction

On August 27, a gun man who identifies as woman killed two kids inside the church.  Kids were students of attacked catholic school. Police said the shooter, Robin Westman, 23, died of a self-inflicted gunshot wound. Though local police officers didn’t comment about shooter’s gender transformation from being male to female, evidence indicates that the shooter is transgender woman. This horrific incident raises questions such as are transgender people suffer more mental illness than non- transgender people? Do those treatments and surgery contribute to health deficits and mental illness?

In recent decades, gender reassignment surgery and hormone therapy have become increasingly common in Western societies. Advocates present these interventions as essential for affirming identity and reducing psychological distress. However, critics argue that altering the body in such a profound way represents a struggle against biological reality and introduces new burdens rather than solutions.

This article brings together personal observations of transgender individuals in the workplace with existing psychological and sociological research. The aim is not to stigmatize but to critically examine whether medical and social approaches to gender identity truly address the struggles they intend to resolve.

Observations from Professional Experience

In my professional career, I have directly supervised transgender individuals. The following patterns of behavior and struggle emerged:

* Frequent lateness, early departures, and high absenteeism.

* Reduced productivity and difficulty maintaining focus.

* Regular absences for hormone therapy or related treatments.

* Persistent depression, distraction, and emotional distress.

* Anger expressed toward God and religious believers.

Evidence from Research

Academic studies reinforce these observations. A landmark Swedish longitudinal study found that individuals who had undergone gender reassignment surgery were 19 times more likely to die by suicide compared to the general population (Dhejne et al., 2011). The American Psychiatric Association has acknowledged disproportionately high rates of depression and anxiety among transgender individuals (APA, 2018). Similarly, a UK study reported that transgender individuals were significantly more likely to seek treatment for mental health conditions, including substance abuse disorders (McNeil et al., 2012).

These findings suggest that medical interventions, though intended to reduce suffering, do not fully resolve underlying psychological and spiritual conflicts. Rather, they may perpetuate cycles of distress by creating lifelong dependence on hormonal and surgical treatments.

Discussion

The persistence of mental health struggles among transgender individuals, even after reassignment procedures, raises important questions. If transitioning truly represents liberation, why do depression, distraction, and suicidal ideation remain elevated?

One possible explanation is that gender identity struggles are rooted not only in physical appearance but in deeper existential and spiritual conflicts. Attempting to alter the body may therefore fail to provide the peace sought. Compassion, in this context, requires honesty: affirming individuals without addressing these deeper struggles risks worsening rather than alleviating their suffering.

Conclusion

The transgender experience is complex and cannot be reduced to either medical solutions or social affirmation. Observations from the workplace, combined with evidence from psychiatric studies, reveal persistent struggles with depression, distraction, and spiritual conflict. These findings suggest that transitioning is not a complete solution but a lifelong burden requiring careful reflection from medical, psychological, and moral perspectives.

References

1. American Psychiatric Association. (2018). Position statement on issues related to transgender and gender diverse individuals. Washington, DC: APA.

2. Dhejne, C., Lichtenstein, P., Boman, M., Johansson, A. L., Långström, N., & Landén, M. (2011). Long-term follow-up of transsexual persons undergoing sex reassignment surgery: Cohort study in Sweden. PLOS One, 6(2), e16885. https://doi.org/10.1371/journal.pone.0016885

3. McNeil, J., Bailey, L., Ellis, S., Morton, J., & Regan, M. (2012). Trans mental health study 2012. Edinburgh: Scottish Transgender Alliance.

A.R.M. Imtiyaz is a Sri Lankan-America political scientist and academic specializing in ethnic conflict, identity politics, and Muslim minority issues in South Asia. He has taught at universities in the United States and Sri Lanka and is recognized for his research on the Sri Lankan civil war, Tamil-Muslim relations, and the challenges of post-war reconciliation. Dr. Imtiyaz’s work has been published in peer-reviewed journals and international media outlets. He is also a sought-after speaker on ethnic relations and conflict resolution. Through his scholarship and public engagement, he advocates for inclusive governance, minority rights, and sustainable peace in multi-ethnic societies.