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Gender Euphoria and Mental Health in TGNB Young People

TGNB young people who report greater gender euphoria had 37% lower odds of seriously considering suicide in the past year.
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Key Findings

  • Higher levels of gender euphoria were associated with 47% lower odds of depression, 37% lower odds of anxiety, and 37% lower odds of suicidal ideation. 
  • Gender euphoria was highest among TGNB young people ages 18-24 and among those with higher socioeconomic status.
  • 82% of TGNB youth said they experienced gender euphoria by “feeling validated when strangers treated them like their gender in public.”

Background

Within research on the health of transgender and nonbinary (TGNB) individuals, risk factors for poor health outcomes, such as gender dysphoria, or the feelings of distress that may arise from one’s gender not aligning with their sex assigned at birth, are frequently studied.1 However, less is known about the other end of the spectrum of gender experiences: gender euphoria. Gender euphoria refers to positive feelings about one’s gender expression and experiences of gender affirmation.2,3 Experiences of gender euphoria may be facilitated by wearing clothing or hairstyles that align with one’s gender identity, being called by one’s preferred name and pronouns, or accessing gender-supportive healthcare.1 Gender euphoria has been linked to positive mental health outcomes in adults, including lower psychological distress, improved well-being, and lower rates of suicidal ideation.2,4 Whether these benefits extend to TGNB young people remains less clear, as youth face distinct structural barriers. Unlike adults, TGNB young people under the age of 18 require parent/guardian support to access things like gender-supportive healthcare and may face additional challenges navigating transgender-specific legal restrictions.5 However, the extent to which gender euphoria may protect against negative health outcomes is less studied in TGNB young people under the age of 18.6

TGNB individuals continue to face significant mental health disparities,7 underscoring the need for research that examines gender euphoria and how TGNB young people experience joy and affirmation. To this end, this brief uses data from the baseline wave of The Trevor Project’s longitudinal study Project SPARK (Studying Protective And RisK factors: A Longitudinal Mental Health and Experiences Study among LGBTQ+ Young People) to examine associations between gender euphoria and mental health in TGNB young people.

Results

Gender Euphoria “Scores”: TGNB youth were each assigned a gender euphoria score ranging from 1 to 5 according to their responses to questions about experiences of gender euphoria. A score of 1 reflected youth with the lowest reported experiences of gender euphoria, while a score of 5 reflected those with the highest, according to the Trans Youth CAN! Gender Positivity Scale (more included in the Methodology section below). Overall:

  • Gender euphoria scores were higher among TGNB young people 18 to 24 years old (3.24) than those 13 to 17 years old (2.97). 
  • Scores were higher among TGNB young people who reported being able to meet their basic economic needs or more (3.17 ) than those unable to meet their basic economic needs (2.99). 
  • By race/ethnicity, gender euphoria scores were higher among TGNB young people of color (3.19) and lower among White TGNB young people (3.04). 
  • Across gender identity groups, scores were highest among nonbinary young people (3.21) and lowest among gender-questioning young people (2.86). 
  • Among sexual orientation groups, scores were highest among queer young people (3.23) and lowest among asexual (2.89) and questioning young people (2.83).

The most common experiences of gender euphoria included among this sample of TGNB youth included:

  • 82% reported feeling validated when strangers in public treat them like their gender
  • 70% reported feeling a sense of accomplishment and pride in being able to express themselves as their gender
  • 68% reported feeling confident trying new and different clothes that express their gender.

The least endorsed indicators of gender euphoria among TGNB young people included feeling confident in their body (27%), feeling like their body ‘fits with the real me’ (26%), and feeling comfortable in their body (24%).

Transgender and Nonbinary Young People's Experiences with Gender Euphoria chart

Mental Health, Suicide, and Gender Euphoria
A majority (58%) of TGNB young people reported symptoms of recent depression, and 69% reported symptoms of recent anxiety. Over a third (38%) reported seriously considering suicide in the past year, and 15% reported attempting suicide in the past year.

Higher levels of gender euphoria were associated with 47% lower odds of experiencing recent depression (adjusted odds ratio [aOR] = 0.53, 95% CI: 0.44 – 0.64, p<0.001) and 37% lower odds of experiencing recent anxiety (aOR=0.63, 95% CI: 0.52-0.76, p<0.001). Similarly, greater gender euphoria was associated with 37% lower odds of seriously considering suicide in the past year (aOR=0.63, 95% CI: 0.52-0.77, p<0.001). Gender euphoria scores were not significantly associated with attempting suicide.

Looking Ahead

According to our findings, gender euphoria is positively associated with the mental health of TGNB young people. Within our sample, rates of depression, anxiety, and suicidal ideation were high; however, the odds of experiencing these mental health outcomes were lower among young people who reported higher levels of gender euphoria.

We identified demographic differences in levels of gender euphoria that warrant investigation to better contextualize its association with mental health. Older TGNB young people reported higher gender euphoria scores than younger individuals, which may reflect greater access to gender-affirming resources and supportive spaces. Younger TGNB people may face different barriers to accessing gender-affirming resources, thus limiting their ability to experience higher levels of gender euphoria and its associated positive outcomes. Younger TGNB people are also more likely to need parental/guardian support to access gender-affirming resources, and they are more likely to face legal restrictions when attempting to access gender-affirming resources than older TGNB people.8,9 Similarly, TGNB young people of higher socioeconomic status reported higher gender euphoria scores than those  of lower socioeconomic status. TGNB individuals have reported lower employment rates, lower household incomes and greater poverty than cisgender individuals, according to recent research.10 The intersection of socioeconomic status and gender identity leaves TGNB young people in a particularly vulnerable position that may limit their ability to experience gender euphoria.

Despite all TGNB young people having to navigate pervasive and increasing barriers associated with their gender identity, some TGNB young people experience negative mental health outcomes at lower rates than their peers. It is vital that we work to understand how these young people are able to thrive in the face of stigma and discrimination. Supporting and affirming TGNB young people by using the correct name and pronouns and helping them access gender-affirming resources are support mechanisms that improve mental health for TGNB young people.11,12  Although we did not directly assess the role of correct pronoun usage on gender euphoria, these findings, in conjunction with other scientific findings,13 indicate that future research should explore connections between supporting TGNB young people, gender euphoria, and mental health outcomes among TGNB young people. Future research should further explore whether gender euphoria functions not only as an associated factor, but also as a potential protective factor for TGNB mental health, including for suicidal ideation. Providing meaningful support to TGNB young people is one way we may be able to strengthen their sense of gender euphoria, protect their mental health, and improve long-term outcomes.14

To learn how you can help support and affirm the TGNB young people in your life, check out these resources from The Trevor Project: Guide to Being an Ally to Transgender and Nonbinary Young People and Understanding Gender Identities and Pronouns. Also, check out our past briefs about mental health in TGNB young people: How to Best Support Transgender and Nonbinary Young People and Pronoun Usage and Mental Health Impacts of Pronoun Respect in TGNB Young People.

Data Tables

Gender Euphoria Scores of TGNB Young People, by Participant Characteristics (N = 998)

Gender Euphoria Scores of TGNB Young People by Participant Characteristics table

Methods

Sample
Data were collected through The Trevor Project’s Project SPARK (Studying Protective And RisK factors: A Longitudinal Mental Health and Experiences Study among LGBTQ+ Young People). Project SPARK surveys 1,689 LGBTQ+ young people between the ages of 13 to 24 with comprehensive online surveys every six months. This brief utilizes data from 998 TGNB young people who completed the baseline survey.

Measures
Analyses only included TGNB young people who identified as transgender or nonbinary. (Nonbinary refers to a wide range of genders that exist outside of the male/female/man/woman binary, including genderfluid, polygender, and bigender.15) Demographics (i.e., race/ethnicity, gender identity, sexual orientation, and socioeconomic status), were assessed by asking participants to select a response from a provided list of answers.16 Gender euphoria was measured using the Trans Youth CAN! Gender Positivity Scale.17 This measure asks participants to indicate how strongly they agree or disagree with 10 gender-positive statements: “I feel a sense of accomplishment and pride being able to express myself as my gender,” “I enjoy going out in public and doing social activities because I can express myself as my gender,” “I feel validated when strangers in public treat me like my gender”, “I feel confident trying new and different clothes that express my gender,” “I am relieved I don’t have to work as hard as I used to for people to see me as my gender,” “I feel confident in my body,” “I feel attractive,” “I am comfortable in my body,” “I feel like my body fits with the real me,” and “Things about my body that used to bother me don’t bother me as much anymore.” Response options included a Likert scale ranging from “Disagree completely” (1) to “Agree completely” (5). The mean of the 10 items was calculated to create a total score of gender euphoria. Symptoms of depression and anxiety were assessed using PHQ-2 and GAD-2, respectively.18,19 Past-year suicidal ideation and past-year suicide attempt were assessed using items from the Center for Disease Control and Prevention’s Youth Risk Behavior Survey.20

Analysis
A one-way ANOVA was used to test for differences in gender euphoria scores across demographic groups. Logistic regression models were used to examine associations between gender euphoria and mental health outcomes, controlling for age, socioeconomic status, gender identity, sexual orientation, race/ethnicity, and census region. Unless otherwise noted, all analyses are statistically significant at p<0.05, meaning reported differences would be expected to arise in analysis less than 5% of the time if there were no true difference (i.e., the null hypothesis should not have been rejected). Percentages in tables may not add up to 100 because of rounding.

References

  2. 1. Austin, A., Papciak, R., & Lovins, L. (2022). Gender euphoria: A grounded theory exploration of experiencing gender affirmation. Psychology & Sexuality, 13(5), 1406–1426. https://doi.org/10.1080/19419899.2022.2049632 
  3. 2. Grant, R., Amos, N., Cook, T., Lin, A., Hill, A., Carman, M., & Bourne, A. (2025). From euphoria to wellbeing: Correlates of gender euphoria and its association with mental wellbeing among transgender adults. International Journal of Transgender Health, 26(4), 1111–1119. https://doi.org/10.1080/26895269.2024.2324100

    3. Jacobsen, K., & Devor, A. (2022). “Moving from gender dysphoria to gender euphoria: Trans experiences of positive gender-related emotions.” Bulletin of Applied Transgender Studies, 1 (1-2): 119-143. https://doi.org/10.57814/ggfg-4j14

    4. Hall, T., Rees, C. & Newnham, E. Pathways to Euphoria: Deconstructing Gender-Expansive Adults Conceptualizations of Wellbeing. International Journal of Applied Positive Psychology, 9, 719–745 (2024). https://doi.org/10.1007/s41042-024-00149-2

    5. Reisner SL, Pletta DR, Harris A, et al. (2023) Exploring gender euphoria in a sample of transgender and gender diverse patients at two U.S. urban community health centers. Psychiatry Research, 329: 115541. https://doi.org/10.1016/j.psychres.2023.115541

    6. Kidd KM, Sequeira GM, Katz-Wise SL, et al. (2023) “Difficult to find, stressful to navigate”: Parents’ experiences accessing affirming care for gender-diverse youth. LGBT Health, 10(7):496-504. doi:10.1089/lgbt.2021.0468

    7. Azagba, S., de Silva, G.S.R. & Ebling, T. (2025). Examining general, physical, and mental health disparities between transgender and cisgender adults in the U.S. International Journal of Equity & Health, 24, 37. https://doi.org/10.1186/s12939-024-02364-4

    8. Abreu, R. L., Sostre, J. P., Gonzalez, K. A., Lockett, G. M., Matsuno, E., & Mosley, D. V. (2022). Impact of gender-affirming care bans on transgender and gender diverse youth: Parental figures’ perspective. Journal of Family Psychology, 36(5), 643–652. https://doi.org/10.1037/fam0000987
  4. 9. Lee, W. Y., Hobbs, J. N., Hobaica, S., DeChants, J. P., Price, M. N., & Nath, R. (2024). State-level anti-transgender laws increase past-year suicide attempts among transgender and non-binary young people in the USA. Nature Human Behaviour. https://doi.org/10.1038/s41562-024-01979-5

    10. Carpenter, C. S., Eppink, S. T., & Gonzales, G. (2020). Transgender status, gender identity, and socioeconomic outcomes in the United States. ILR Review, 73(3), 573-599. https://doi.org/10.1177/0019793920902776

    11. Goetz, T. G., & Arcomano, A. C. (2023). “Coming home to my body”: A qualitative exploration of gender-affirming care-seeking and mental health. Journal of Gay & Lesbian Mental Health, 27(4), 380–400. https://doi.org/10.1080/19359705.2023.2237841

    12. Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K. (2022). Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Network Open,5(2):e220978. https://doi.org/10.1001/jamanetworkopen.2022.0978

    13. The Trevor Project (2025). Pronoun usage and mental health impacts of pronoun respect in TGNB young people. https://doi.org/10.70226/KTUU7547

    14. The Trevor Project. (2023). Affirming actions and gender euphoria among transgender and nonbinary young people. https://doi.org/10.70226/JGQD2137

    15. The Trevor Project. (2024). Understanding gender identities and pronouns. https://www.thetrevorproject.org/resources/article/understanding-gender-identities-and-pronouns/ 

    16. Nath, R., Matthews, D.D., Hobaica, S., Eden, T., DeChants, J.P., Clifford, A., Taylor, A.B., & Suffredini, K. (2025). Project SPARK interim report: A longitudinal study of risk and protective factors in LGBTQ+ youth mental health (2023-2025). West Hollywood, California: The Trevor Project. https://doi.org/10.70226/OSCY3344

    17. Bauer G, Churchill S, Ducharme J, Feder S, Gillis L, Gotovac S, Holmes C, Lawson M, Metzger D, Saewyc E, Speechley K, Temple J, for the Trans Youth CAN! Research Team (2021). Trans Youth CAN! Gender Positivity Scale (TYC-GPS). London, Canada: Trans Youth CAN! Research Team.

    18. Richardson, L. P., Rockhill, C., Russo, J. E., Grossman, D. C., Richards, J., McCarty, C., McCauley, E., & Katon, W.. (2010). Evaluation of the PHQ-2 as a brief screen for detecting major depression among adolescents. Pediatrics, 125(5),e1097-e1103. https://doi.org/10.1542/peds.2009-2712

    19. Plummer, F., Manea, L., Trepel, D., & McMillan, D. (2016). Screening for anxiety disorders with the GAD-7 and GAD-2: A systematic review and diagnostic meta-analysis. General Hospital Psychiatry, 39, 24–31. https://doi.org/10.1016/j.genhosppsych.2015.11.005
  5. 20. Mpofu, J. J., Underwood, J. M., Thornton, J. E., Brener, N. D., Rico, A., Kilmer, G., Harris, W. A., Leon-Nguyen, M., Chyen, D., Lim, C., Mbaka, C. K., Smith-Grant, J., Whittle, L., Jones, S. E., Krause, K. H., Li, J., Shanklin, S. L., McKinnon, I., Arrey, L., Queen, B. E., & Roberts, A. M. (2023). Overview and methods for the Youth Risk Behavior Surveillance System—United States, 2021. MMWR Supplements, 72(1), 1–12. https://doi.org/10.15585/mmwr.su7201a1

The Trevor Project. (2026). Gender Euphoria and Mental Health among TGNB Young People. https://doi.org/10.70226/CWMM4632

For more information please contact: [email protected]

© The Trevor Project 2026

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