Understanding Deadnaming: The Psychological Impact on Transgender Individuals

Introduction

In recent years, conversations about gender identity and inclusion have become more prominent in both social and medical circles. One particular area of concern within these discussions is the harmful practice of deadnaming. Deadnaming refers to the act of calling a transgender or non-binary person by their birth name or a previous name that they no longer use, often because it does not align with their gender identity.

For many individuals, transitioning—whether socially, legally, or medically—is an essential process of affirming their true selves. The name change is a significant and powerful part of this journey. When someone is deadnamed, either accidentally or intentionally, it can be a profoundly harmful experience that invalidates their identity, disrupts their mental health, and perpetuates social stigma. This article aims to explore why deadnaming is harmful, delving into the psychological, social, and ethical dimensions, and offering insight for psychiatrists and mental health professionals who work with transgender individuals.

Deadnaming and Its Impact on Mental Health

1. Invalidating Identity

At the core of deadnaming’s harm is its ability to invalidate a person’s identity. Names are not just arbitrary labels; they are central to how we perceive and present ourselves. For transgender individuals, the process of selecting a name that aligns with their gender identity is often an act of self-empowerment and affirmation. When someone uses their former name, it can feel like an erasure of this deeply personal decision.

Psychologically, invalidating a person's chosen name can create feelings of dysphoria—the distress that arises from a disconnect between a person’s experienced or expressed gender and their assigned sex at birth. Dysphoria can intensify if the individual perceives that others are not respecting their identity, leading to feelings of isolation, depression, and anxiety.

2. Triggering Gender Dysphoria

Deadnaming can act as a direct trigger for gender dysphoria, which is already a significant mental health issue that transgender individuals experience at disproportionately high rates compared to the cisgender population. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gender dysphoria is characterized by a strong desire to be another gender or be treated as another gender, accompanied by significant distress.

When a transgender person hears their old name, it often drags them back into a mental space of conflict between who they were assigned to be and who they truly are. This jarring reminder of their previous identity can magnify their dysphoria and undo much of the progress they may have made in feeling comfortable in their affirmed gender.

3. Reinforcing Social Stigma

Deadnaming perpetuates the broader societal stigma that transgender and non-binary individuals face. Intentional deadnaming, in particular, is a tool that can be used to deliberately disrespect and demean someone's identity. It can feel like an attack that is rooted in transphobia, making the person feel unsafe or unwelcome.

Furthermore, accidental deadnaming—although less malicious—can still have similar effects, especially in social or professional settings. It serves as a reminder that, despite progress in legal and societal recognition, many people still do not fully understand or respect the transgender experience. In the workplace or in academic settings, this can reinforce the notion that transgender people are "othered," making it difficult for them to feel included or equal to their cisgender peers.

The Psychological Toll of Deadnaming

1. Anxiety and Stress

One of the most immediate emotional responses to deadnaming is a spike in anxiety and stress. Being confronted with a name that no longer feels like your own can produce a sense of vulnerability, as it may expose one's transgender status in situations where they were not prepared for disclosure. This can lead to feelings of embarrassment, shame, or frustration.

Many transgender people live in constant fear of being deadnamed, which can result in hypervigilance—a heightened state of stress where they feel constantly on guard against the possibility of being misnamed. This chronic stress contributes to long-term mental health conditions such as generalized anxiety disorder and panic disorder.

2. Depression and Suicidality

The link between deadnaming and depression is strong. Transgender individuals already experience disproportionately high rates of depression due to societal pressures, discrimination, and identity-based trauma. Being deadnamed, especially when it occurs repeatedly or maliciously, can deepen depressive feelings by reinforcing the notion that the world does not accept their identity.

A 2018 study published in the journal Pediatrics found that transgender youth who are not respected in their chosen names or gender identities have dramatically higher rates of suicidal ideation and attempts. While suicidal thoughts and behaviors are multifactorial, deadnaming plays a significant role in intensifying the hopelessness and despair that underpins these outcomes.

3. Erosion of Trust in Relationships

When family members, friends, or colleagues deadname a transgender person, it can create a rupture in trust. Even if the deadnaming is unintentional, it signals to the transgender person that the other party may not fully understand or support their identity. This can lead to strained relationships and even social withdrawal, as transgender individuals may distance themselves from people who repeatedly fail to affirm their identity.

In more severe cases, this breakdown in trust can discourage transgender people from seeking help or disclosing their identity to healthcare providers, leading to a lack of medical care and support. As a result, individuals may avoid necessary mental health services, which can exacerbate their symptoms of anxiety, depression, and dysphoria.

Ethical Considerations for Mental Health Professionals

1. Affirming Names and Pronouns as a Standard of Care

For mental health professionals, deadnaming is not just a social faux pas—it is an ethical issue. Affirming a person’s name and pronouns is a fundamental aspect of providing respectful, patient-centered care. Using the correct name and pronouns communicates empathy, respect, and acceptance, which are essential in building a trusting therapeutic relationship.

Failure to use a person’s chosen name can harm the therapeutic process, making the patient feel unseen or invalidated. This may result in the individual feeling hesitant to disclose their true feelings, limiting the effectiveness of treatment. Therefore, psychiatrists and therapists must take conscious steps to avoid deadnaming, including updating medical records promptly and ensuring that all members of the treatment team are aware of the patient’s preferred name.

2. Trauma-Informed Care

For many transgender individuals, deadnaming can evoke memories of trauma related to past rejection, discrimination, or even violence. Mental health professionals should approach the issue of deadnaming through a trauma-informed lens, recognizing that even a seemingly small error can have significant emotional repercussions.

Adopting a trauma-informed approach requires providers to actively acknowledge the past harms their patients may have faced and work to avoid re-traumatization. This includes consistently using the correct name and creating a safe space where the patient feels their gender identity is respected.

3. Avoiding Microaggressions

Unintentional deadnaming can still qualify as a microaggression—a subtle, often unintentional, form of discrimination that reinforces harmful societal norms. Microaggressions, such as misgendering or deadnaming, may seem small, but their cumulative impact can be deeply damaging.

Mental health providers should actively educate themselves about the experience of transgender and non-binary individuals to avoid such microaggressions. This includes learning about common triggers, the importance of chosen names, and the harmful effects of gendered language that doesn’t align with the patient’s identity.

Legal and Social Implications of Deadnaming

1. Legal Name Changes and Documentation

In many jurisdictions, transgender individuals have the legal right to change their name on official documents, such as driver’s licenses, passports, and medical records. However, the process can be complex, costly, and time-consuming. Even after completing a legal name change, transgender people may continue to face challenges in having their new name respected, especially in settings where older records or legal documents are still in use.

Legal protections against deadnaming are becoming more common, with some places enacting anti-discrimination laws that require schools, employers, and other institutions to respect a person’s chosen name. However, enforcement of these laws can be inconsistent, and many transgender individuals find themselves in situations where they must constantly advocate for the correct use of their name.

2. Deadnaming in Media and Public Spaces

Deadnaming is not just a private issue; it often plays out in the public sphere, particularly in the media. When journalists or media outlets use a transgender person’s deadname, whether through negligence or transphobia, it can have significant consequences. Public figures such as celebrities or politicians who are transgender may experience deadnaming at a national level, further compounding their distress and setting back public understanding of transgender issues.

Deadnaming in public spaces or institutions such as schools can also have damaging effects on younger transgender people, who may not yet have the legal or social autonomy to fully control their own narrative. This underscores the need for broader social education on the importance of respecting chosen names.

Conclusion: Creating a More Respectful World

The harms of deadnaming are profound, extending beyond simple mislabeling to a form of emotional and psychological violence that can exacerbate mental health issues, trigger dysphoria, and perpetuate social exclusion. For transgender and non-binary individuals, being acknowledged by their chosen name is an essential part of their well-being, identity, and dignity.

Mental health professionals, along with society at large, must recognize the importance of using the correct names and pronouns for transgender individuals. By doing so, we create a more inclusive, respectful world where people are free to live as their authentic selves, without fear of being disrespected or invalidated. Through education, empathy, and understanding, we can reduce the harm caused by deadnaming and support the mental health of transgender communities.