“Sticks and stones may break my bones – but words will never hurt me,” goes the playground rhyme.

But the adage is only half right, according to my research on transgender mental health.

Words can hurt.

In October, The New York Times published a story headlined, “‘Transgender’ Could Be Defined Out of Existence Under Trump Administration.” The story was about the Department of Health and Human Services’ efforts to create a new legal definition of sex under Title IX, the 1972 federal civil rights law which forbids gender discrimination in education programs that get money from the government.

That move would define sex as determined solely by the genitals that a person has at birth, strictly male or female, and unchangeable.

I study how media affects transgender identity across the U.S. The travel for my work is in part funded by the Caitlyn Jenner Foundation. I maintain complete autonomy over what I research and how.

From my prior research, I knew The New York Times story would produce negative emotions among transgender people. So, I conducted an online survey of more than 100 transgender people in the 72 hours following the story, to ask how negatively the story affected them on a 7-point scale. This was followed by a question about how painful those emotions were.

The proposed new definition of gender eliminates the very idea of a transgender person. Therefore, what I found was not surprising. It’s one thing for people to have to defend their rights as equals in society. But when people have to defend their very existence, both the frequency and degree to which transgender people experience negative emotions significantly increases.

When words do damage

In my survey, more than three-quarters of respondents said they felt their identity was under increased threat.

Many people noted that they had already felt that way, even before the story ran. But the story had made the feelings worse.

In other words, those transgender people who were already under stress became even more so.

An open-response section of the survey made clear what type of emotional impact transgender people felt after reading this story.

“Shock,” “horror,” “a sense of uncontrollable doom,” were just some of the responses my interviewees had.

“I feel like they’re trying to erase me as a person,” was a frequent response.

For some it was more than just emotional – it took a physical toll. One transgender person told me that even though their transition had been largely free of problems, this news left her curled up in a ball, crying on the bottom of the shower.

Three people I interviewed told me of a teenager they knew for whom the emotions brought on by the story were the last straw. Less than two weeks after the story was published, she tried to take her own life.

Ten days after the story ran, Trans Lifeline, a national grassroots organization, reported that calls to their suicide hotline had increased 400 percent.

When identity is denied

Now, can one story in a newspaper result in someone committing suicide? This would be impossible to claim.

What’s clear is that the impact of statements or actions that are subtly and even unintentionally discriminatory, what researchers call “microaggressions,” is measurable and real.

“Micro” is not meant to describe how the aggression is perceived, but rather how effortlessly it is delivered. Research shows that microaggressions, such as being the object of a joke, the subject of a put-down – or the topic in a demeaning headline – take only take a few seconds to make their impact.

The New York Times headline is an example of the specific types of microaggressions that my research focuses on: those that deny transgender identity exists. The emotions these produce are more intensely negative, and depending on the person, can lead to a decreased willingness to engage with others. I call this “transgender identity defense-related emotions,” or TIDE.

My previous research has specifically looked at the link between these intensely negative emotions and suicide. One in 5 transgender people report having attempted suicide, a rate six times higher than the U.S. population at large.

Certainly, where causation ends and correlation begins remains unknown. But there’s clearly a negative impact on the mental health of transgender people when their identity is denied in this way.