Transphobia and Transmisia: What to Know

Written by Nichole Owens
Medically Reviewed by Isabel Lowell, MD on May 18, 2025
8 min read

Transphobia refers to negative attitudes or behaviors toward transgender people.

Merriam-Webster defines transphobia as “discrimination against, aversion to, or fear of transgender people.” The Cambridge dictionary describes it as “harmful or unfair things a person does based on a fear or dislike of transgender and non-binary people.”

The word “phobia” comes from “phobos,” the Greek word for fear.

“Misia” comes from the Greek word “misos,” which means “abhorrence of, hatred, disgust for, or the revulsion of.”

It’s a step further than phobia. With transmisia, you have the ability — through power or resources — to negatively affect the lives of transgender individuals. 

“It may involve bullying, violence, or death,” says Casey Weitzman, LMFT, president and founder of Gender Wellness of Los Angeles. “It highlights the prejudice in regards to beliefs, attitudes, and behaviors and is intended to strongly hurt or deny the existence of transgender, nonbinary, and gender nonconforming people.”

Some people prefer to use transmisia because they believe the word transphobia makes prejudice and hate seem like something a person can’t control, like being claustrophobic.

What does transmisia look like?

In everyday life, transmisia could look like a transgender person being denied housing, health care, or employment. Derogatory (disrespectful or rude) language is another way it shows up.

Everyone is assigned a sex at birth, male or female. Gender refers to the roles and behaviors that society has decided are right for males and females.

When you’re transgender, the sex you were assigned at birth doesn’t match the gender you identify with. As a result, you may reject the roles, behaviors, and appearances society expects from your sex. That doesn’t necessarily mean taking hormones or having surgery to change your appearance. It could be as simple as dressing in what society considers masculine or manly outfits, even though you were assigned female at birth.

There are many categories or types of transgender people, not just transgender men and women. These include: 

  • Nonbinary transgender 
  • Genderqueer 
  • Genderfluid 
  • Androgynous
  • Multigendered 
  • Gender nonconforming
  • Third gender
  • Two-spirit

This list doesn’t include every single term or category. And it’s important to note that some people identify as one (or more) of these terms but don’t consider themselves transgender.

Is nonbinary the same as transgender?

No. Nonbinary means you don’t consider your gender identity male or female.

There are several ways transphobia shows up, including:

Using incorrect pronouns

When you assume you know a person’s gender because of their appearance, you risk disrespecting or dismissing them.

Transgender individuals may ask you to use the pronouns they identify with instead of what they were assigned at birth. Some prefer they/them, ze/hir, or xe/xim instead of she/her or he/him.

Transgender and nonbinary people reported lower rates of attempted suicide when their preferred pronouns were respected by everyone they live with and/or a gender-neutral bathroom was available at school, according to a 2024 survey of more than 18,000 LGBTQ+ people ages 13-24. The Trevor Project, a nonprofit focused on suicide prevention among the LGBTQ+ population, conducted the survey.

Using a transgender person's deadname 

A deadname is the name a transgender person was given at birth. It usually matches the gender associated with the sex they were assigned, such as someone assigned male at birth being given the name James. Transgender people sometimes change their names to match their true gender identity and expression.

Deadnaming someone, especially when done on purpose, can be harmful. It may trigger gender dysphoria, the discomfort someone feels when their gender identity doesn’t match the sex they were assigned at birth. Symptoms of gender dysphoria include anxiety and depression. One study showed that transgender youth display less suicidal ideation when others honor their chosen name.

If you use someone’s deadname by mistake, just apologize and try to remember the next time. 

Bullying

Merriam-Webster defines bullying as “abuse and mistreatment of someone vulnerable by someone stronger, more powerful, etc.”

Nearly half of the people aged 13-17 who responded to The Trevor Project’s 2024 survey reported being bullied in the previous 12 months. They also attempted suicide at much higher rates than those who weren’t bullied.

Violence

The FBI reported more than 1,600 hate crimes related to gender identity in 2023. More than 7,500 hate crimes were committed against people because of their sexual orientation.

According to a study by the Williams Institute at UCLA School of Law, transgender people are four times more likely to experience violent incidents, including sexual assault and aggravated assault, than cisgender people. About 25% of transgender people believed the crime they survived was a hate-related incident.

Legislation

A wave of anti-transgender bills — over 1,000 — were introduced across the U.S. in 2023 and 2024. More than 120 were passed into law. These laws:

  • Govern which bathroom transgender people can use
  • Ban transgender youth from getting gender-affirming care
  • Stop transgender people from participating in gendered sports
  • Limit what teachers can tell students about transgender people

Workplace discrimination

A little over 10% of those who responded to the National Center for Transgender Equality’s 2022 U.S. Trans Survey, which reached a little over 92,000 people, said they’d been fired, forced to quit, or laid off because of their gender identity or expression.

Medical discrimination

As mentioned earlier, recent laws now stop transgender children from getting the gender-affirming care that’s right for their age.

Almost 50% of those who took part in the National Center for Transgender Equality’s survey and had seen a doctor in the past 12 months said they’d had at least one negative experience with a health care provider because they were transgender. These experiences included: 

  • Being refused health care 
  • Being misgendered 
  • A provider speaking rudely to them 
  • A provider being rough or physically abusive when treating them

Housing discrimination

According to the National Center for Transgender Equality, 20% of transgender people have experienced discrimination when searching for a new home or apartment, and 10% have been evicted due to their gender identity. This could be one reason why 20% of transgender people have been homeless at some point in their lives and why transgender people represent about 20%-40% of the homeless population in the U.S.

Dealing with transphobia can lead to a host of issues, including depression, anxiety, and suicide.

A 2023 study in the journal Nature Human Behaviour estimated how state-level anti-transgender laws affect suicide risk among transgender and nonbinary people ages 13-17. It found that suicide attempts by transgender youth rose by as much as 72% after some states passed anti-transgender laws. 

Public health research shows that inequalities exist between the LGBTQ+ population and the heterosexual and cisgender populations. They include: 

  • Limited access to health care or no access at all
  • Delaying doctor visits because of a fear of discrimination
  • Higher rates of negative health behaviors, such as smoking and binge drinking
  • Poorer health outcomes, such as higher rates of depression

Some researchers think these inequalities exist in part because of minority stress theory. This theory suggests that the ongoing discrimination, shaming, and other negative experiences lead to negative health outcomes for the LGBTQ+ population.

Minority stress is different from general stress, which most everyone experiences at some point. Minority stress is triggered by prejudice against a sexual and/or gender minority. For example, losing your job because of layoffs is a general stressor. But if you are fired or forced to resign because your manager doesn’t like people assigned male at birth wearing dresses and makeup, it would be considered a minority stressor.

Internalized transphobia

Internalized transphobia happens when a transgender person absorbs messages of shame about being different from gender norms (gender nonconformity), either from others or their own behaviors and desires.

A small study published in the Journal of Adolescent Health revealed a link between greater levels of internalized transphobia and symptoms of depression and anxiety in transgender youth. Researchers found that a high level of gender identity pride helped fight depression symptoms specifically.

How to be a trans ally

Educating yourself about transgender rights, gender identity issues, and how to respect transgender people is the best way to fight transphobia. Here are some tips:

Be mindful of what you ask. It’s not right to question a transgender person about their genitals, if they’ve had surgery, or if they’re on hormones.

Avoid backhanded compliments. Don’t say things like “I would never guess you’re transgender!”

Don’t “out” them. It’s not your place to share a transgender person’s identity, even if they’ve shared it with you. That doesn’t mean they want others to know.

Ask people for their pronouns. Don’t assume.

Use a transgender person’s correct name and pronouns. Don’t ask them about their previous name or pronouns. 

Use gender-inclusive language. Say “folks” or “people” when talking to a group.

Stand up for transgender people. Call out people who use slurs, make transphobic jokes, or are being transphobic in other ways.

Learn about policies and laws affecting transgender people. Work to change or support them.

“Go to rallies, go to Pride events, volunteer at the local LGBTQI+ centers that do exist. Buy an ally tee shirt or pride flag,” says Weitzman. “It can also be about donating your time or money to causes like PFLAG, the ACLU, The Williams Institute at UCLA, the Transgender Law Center, or Gender Justice to name a few.”

Lastly, know there’s no such thing as a perfect ally. Be respectful, do your best, and when you mess up, apologize and try again.

Transgender resources

If you’re a trans person dealing with transphobia:

  • Document what is happening in writing.
  • Tell a trusted adult, friend, teacher, or counselor.
  • If it happens at school, go to the principal.
  • If violent threats have been made, consider filing a police report. Violent threats are against the law.
  • Create a safety plan with friends or family. For example, if bullying happens when you walk home, try to get a ride.
  • If you’re feeling suicidal or depressed, call the Trans Lifeline at (877) 565-8860. You can also call the Trevor Project at 1-866-488-7386 or text “START” to 678-678.

Organizations that you can reach out to include:

Transphobia is a fear of or disgust for transgender people. It’s a bit different from transmisia, which is a hatred for transgender people that results in someone going out of their way to harm them.

Both transphobia and transmisia show up in many ways, such as bullying, laws that prevent transgender people from getting the health care they need, and discrimination in housing and the workplace.

How do I apologize for unintentionally saying something transphobic?

If you say something to hurt or offend a transgender person, what matters most is the impact of your words — not your intention.

 Here’s how to make things right:

  • Listen to the person you hurt.
  • Seek to understand and empathize with their experience.
  • Take responsibility for causing harm.
  • Commit to doing better.

Is transphobia a disease?

No. It’s a fear of or disgust for transgender people. It seeks to isolate, discriminate against, and even harm them. Over time, transphobia can have lasting, negative effects on the physical, emotional, and social well-being of transgender people. This can look like mental health issues, substance abuse, self-harm, or mood disorders.

Why should I be concerned about trans issues if I’m not a transgender person?

Trans people have the right to live without fear of violence and discrimination.