Sleep is supposed to be the great reset. The body’s time to recover and the mind’s chance to drift into dreams. But for many transgender people, nighttime doesn’t offer peace. It offers more questions. More noise. More discomfort. You might lie awake in a body that doesn’t feel like home, with thoughts that won’t quiet down and fears that feel louder when the world goes still.
This isn’t rare. In fact, it’s one of the most common and under-discussed health issues in the trans community today. We call it insomnia, but for many of us, it’s something deeper than that. It’s what happens when safety and rest never learn how to coexist.
Why So Many of Us Struggle with Sleep
People love to give advice about insomnia. Put down your phone. Drink chamomile tea. Take a warm bath. And sure, those things help some folks. But if you’ve ever stared at the ceiling wondering if you’ll ever feel truly at ease in your own skin, you know it takes more than that.
For a lot of trans people, the problem isn’t the screen time or the late-night snacks. It’s dysphoria. It’s trauma. It’s anxiety. And it’s often all of the above wrapped into one long night that never seems to end.
When your body feels wrong, when your bed doesn’t feel safe, when you’re scared to dream because even your subconscious misgenders you, sleep stops being rest. It becomes something you have to fight for.
Dysphoria Doesn’t Turn Off at Night
It’s one thing to deal with gender dysphoria during the day when there are distractions to keep your mind busy. But at night, when things get quiet, dysphoria often gets louder. Maybe it’s the way your chest feels under the sheets. Maybe it’s the shape of your body in silhouette. Maybe it’s how you’re forced to interact with your body in the most vulnerable, stripped-down way, and you don’t recognize what you see.
These feelings aren’t your fault. But they are exhausting. Trying to sleep in a body you don’t feel safe in is like trying to rest on a battlefield. Your brain is doing everything it can to protect you. Unfortunately, that means it won’t let you fall asleep.
Trauma Doesn’t Sleep Either
Many trans people live with some form of trauma, whether from family rejection, physical violence, institutional discrimination, or a lifetime of being told that who we are is wrong. Trauma lives in the nervous system. It doesn’t care that you’re finally safe now. It keeps you on alert just in case. That’s why even when your bedroom door is locked and the lights are low, your heart might still race. Your breathing might stay shallow. Your thoughts might spiral.
If you’ve ever sat up at night wondering why your body won’t calm down even when your brain is telling it to, this is why. You’re not broken. You’re in survival mode. And survival mode doesn’t come with a snooze button.
Mental Health and the Margins
There’s also the constant weight of simply existing in a world that often treats transgender people as political talking points instead of human beings. You might go the whole day dodging headlines or pretending you didn’t see another attack on gender-affirming care, but at night, it catches up with you. Your mind starts cataloging every injustice, every fear, and every possibility. It’s a cruel paradox: the more you need rest, the harder it becomes to get.
Add in anxiety, depression, and hypervigilance, things many of us are managing daily, and sleep starts to feel like a luxury that belongs to other people.
Why Standard Sleep Advice Doesn’t Work for Us
Most articles about insomnia don’t speak to people like us. They assume you feel okay in your body, that you have access to a quiet home, and that you aren’t reliving your worst memories the second you lie down. They assume safety, comfort, and stability, things a lot of trans people are still fighting to find.
Being told to meditate or drink herbal tea can feel almost insulting when what you really need is a way to stop your chest from tightening every time you hear your old name in a dream. When sleep advice doesn’t acknowledge your reality, it doesn’t help. It just reminds you how invisible your struggles still are.
Making Sleep Feel Like a Kindness Instead of a Chore
So how do you start building a relationship with sleep that actually feels good? The answer isn’t to overhaul your entire routine overnight. It’s to take small steps that make your nights feel more like yours again.
Let’s start with your space. Does your bedroom reflect who you are? It doesn’t have to be Pinterest-perfect, but it should feel like a place where your identity is safe. That might mean putting up a flag. Or hiding a mirror. Or finding bedding that makes you feel comforted instead of exposed. Even small changes can shift how your body reacts to the space.
Next, think about what you wear. If you bind, please don’t sleep in your binder. You’ve probably heard that before, but it’s worth repeating. Your lungs need the chance to expand fully. If you need something snug to feel grounded, try a compression tank top or a weighted blanket instead. For folks who tuck, sleeping tucked can also cause discomfort or injury. Try different sleepwear or body positions that reduce dysphoria without sacrificing safety.
And then there’s the mental piece. Nighttime can bring out your worst thoughts. That doesn’t mean you have to fight them with affirmations that feel fake. You can acknowledge them and still create a ritual that helps quiet them down. That might mean listening to a trans-affirming sleep meditation. It might mean reading a book that makes you feel seen. It might just mean texting a friend before bed to say, “Hey, I’m going to sleep, but I didn’t want to feel alone.”
These things don’t magically cure insomnia. But they tell your brain, gently and consistently, that it’s okay to rest.
Hormones and Sleep
If you’re on HRT, your hormones might be affecting your sleep in ways you didn’t expect. Estrogen can cause vivid dreams or emotional waves that hit right as you’re trying to wind down. Testosterone can increase energy levels or trigger restlessness, especially when you’re adjusting to your dose. Everyone’s body reacts differently, but if your sleep worsened after starting or adjusting hormones, you’re not imagining things.
It’s worth tracking how you feel at different times of day and bringing that information to your provider. Sometimes a simple change in dosage time or supplement support like melatonin or magnesium can make a big difference. The key is knowing that your rest matters just as much as your transition goals. You don’t have to choose between feeling like yourself and getting a good night’s sleep.
RELATED: Why Am I So Tired? Fatigue and the Transgender Body
Screens, Shame, and the Digital Escape Hatch
Let’s talk about screens. Yes, the blue light is a problem. But for many of us, the internet is also the only place where we feel understood. Scrolling through queer TikTok or watching a streamer who uses your pronouns correctly might be the only affirming contact you have all day.
Instead of cutting it off completely, set boundaries that serve you. Choose one or two people or creators whose content makes you feel grounded. Make that your last interaction before bed. Switch your phone to night mode. Keep the light low. Let yourself feel connected, but don’t let the scroll become a spiral.
When you finish, close with something small and kind. A note to yourself. A song. A photo. Anything that reminds you who you are and that you’re still here.
Dreams, Dysphoria, and Taking Back the Night
For some trans people, sleep is not the problem; it’s the dreams. Nightmares about being misgendered. About losing access to care. About old names and old wounds. These can be deeply distressing, and unfortunately, they’re not uncommon.
You can’t fully control your dreams, but you can influence them. Visualization techniques before bed can help. So can short, positive affirmations. Not the kind that feel fake, but the ones that feel real to you. Try something like, “I am safe. My body is changing. I am loved.” Even if you don’t fully believe it yet, the repetition can help your brain begin to.
There are also apps and podcasts designed specifically for queer and trans people to fall asleep to. Hearing your reality reflected in someone’s voice can help you release some of the tension that’s been holding you hostage all day.
When It’s Time to Ask for Help
Sleep problems can get serious fast. If you’re waking up more exhausted than when you went to bed, if you’re relying on substances to pass out, or if your insomnia is spiraling into depression or suicidal thoughts, please don’t try to handle it alone.
There are queer-affirming therapists and providers who understand this issue. There are hotlines and peer supports who won’t treat you like a problem to be fixed. You deserve medical care that includes your need for rest. You deserve to sleep well, not just survive through exhaustion.
The Bottom Line
At the heart of this conversation is a simple but radical truth: rest is a form of self-love. Not in a fluffy, commercialized way. In a quiet, defiant way. In a way that says, “Even in a world that wants me tired and afraid, I choose to rest. I choose to care for this body, however imperfect or in-progress it may be. I choose to believe that I deserve to wake up feeling whole.”
So tonight, wherever you are in your journey, however hard your day has been, try to sleep like you love yourself. Even if just a little.
Your body is worthy of peace. And you are worthy of tomorrow.
