The transition by the former Bruce Jenner into Caitlin Jenner is another symbol of how ideas about gender are changing in America. But when it comes to rural communities, it can be more complicated for people who are, or would like to be transgender.
Not everyone who comes out as transgender gets as warm a welcome as Caitlin Jenner has. In rural areas where access to medical care and treatment is already limited, it can be a challenge for people who wish to transition to the gender identity they feel is truly theirs. Radford University, Associate Professor of Psychology, Tracy Cohn is a therapist and part of the graduate school of counseling psychology.
"So if you have a kid who has a gender identity or a sexual orientation that does not fit with the mainstream, access to care is really important because those guys and girls are more likely to experience depression and anxiety and a whole host of mental health concerns.
Cohn stresses it’s not being gay or transgender that causes psychological issues. According to the research, it has more to do with the level of acceptance people get from their families, friends and society.
"Now, one of the beautiful things about Appalachia is the heavy emphasis on kinship bonds. Like, you don’t leave your family. You are loyal to your family and in some ways that can be supportive for that transgender individual."
While most people don't’ have the kind of resources Jenner had to make the gender transition, that level of support and affirmation has been shown to dramatically decrease the anxiety depression and rates of suicide in gay and transgendered people.
