For the transgender community, mental illness is a harsh reality.

In an Ontario-based survey, 77% of trans respondents had considered suicide and 45% had attempted it.

Rene Murray is a clinical social worker with Capital Health. She works with individuals who have decided they want to transition and gain access to hormones or have gender reassignment surgery.

Murray says isolation is a common feeling among her clients.

“For transgender individuals, they often grow up in isolation because they don't know anybody else who is like them. So because they don't fit what they see around them, they tend to hide who they are,” says Murray.

Murray says it's hard for many trans people to form connections because they don't feel they can be honest with others.

Social stressors, such as a lack of acceptance from family and friends, and even simple everyday tasks such as filling out a form, or going to the washroom can affect mental health.

“Our washrooms are male or female. If you don't fit into that binary, you're kind of in a tough spot,” says Murray.

Studies show lesbian, gay, bisexual, and transgender people face higher rates of depression, anxiety, obsessive-compulsive disorder, self-harm, and substance abuse. They are also at double the risk for post-traumatic-stress disorder.

Madison Foster, 34, was born male, but felt, from a young age, she was living in the wrong body.

“I remember very clearly thinking to myself, I really feel like inside, at least part of me is a girl and I belong with the other girls. I felt like an exile, because I wasn't allowed and it was something I couldn't even tell people,” says Foster. “I just felt flat and beige all the time. I felt like I was a ghost and I could just float away, like I wasn't real. I didn't really feel much of anything.”

Foster says isolation and alienation have been the major themes of her life over the past 20 years.

“I never thought I'd have community, I never thought I'd have connections with family or friends that would be safe for me. I couldn't imagine that,” says Foster.

Foster was diagnosed with PTSD, ADHD, anxiety, and depression.

She began going to therapy to deal with her PTSD in September 2012 and says that's when she gained a sense of self-worth she had never experienced before.

In Febraury 2013, she started transitioning.

She calls it a 'turning point' in her mental health.

“The more whole, the more complete I felt, the more connected to myself I felt,” says Foster. “Then I felt more connected to other people in my life. I felt like I can share me with other people, I can share who I am and it's fine.”

Both Foster and Murray think the mental health system has a long way to go in supporting trans people.

Foster now does peer-to-peer counselling and is involved in many grass roots mental health initiatives.

“Talking with other trans people is incredibly validating because so many of us share this exact experience of being alienated,” says Foster. “In the community, we find a lot of ways to do for each other what professionals can't or won't.”

Proof that open, and supportive conversations are an important step forward in reducing stigma.