But a decade ago, when he was a vulnerable 22-year-old transitioning from female to male, a snide comment from his boss was enough to send him into a spin.

"How's the 'official' name change going?" this boss would say, in front of a room full of colleagues. "You had the op yet?" he rang up and inquired when Jeremy applied to HR to change his gender on the payroll system.

Little was known about transgender people (where a person's gender identity does not match the gender they were assigned at birth) and gender diversity, says Wiggins.

"We were still trying to get the 'g' and 'l' to catch up with the 't' (as in gay, lesbian, bisexual and transgender), let alone the rest of the world. It was very difficult. I lost a lot of friends."

Analysis of Australia's largest survey of lesbian, gay, bisexual and transgender (LGBT) people shows that life is still difficult for many.

Based on a national survey of almost 4000 people, the report A Closer Look at Private Lives 2 reveals strong links between psychological distress and drug use among LGBT Australians.

It finds psychological distress is highest among people who have transitioned from one gender to another.

Rates of LGBT drug use are higher than in the population as a whole, and linked to experiences of discrimination.

For example, 9 per cent of people identifying as LGBT had used methamphetamine in the past year, compared with 2 per cent nationally.

The initial La Trobe University survey was undertaken in 2012 and funded by mental health advocate beyondblue and men's health organisation Movember.

The report, to be launched on Thursday by Victorian Mental Health Minister Martin Foley, focuses on mental health and drug use.

Trans males and trans females recorded the highest level of harassment, with about half reporting gender-based abuse.

Economic status was a strong indicator of mental health problems. If a person was employed it made them more resilient, the report found.

On a positive note, rates of psychological distress generally decreased as people get older.

The report found LGBT people felt less distress if they took part in community events where they felt they could be themselves, whether the events were LGBT or mainstream.

This could be a key to prevention, said researcher William Leonard, director of Gay and Lesbian Health Victoria at La Trobe.

"For the first time we're saying, 'Don't just think about mental health services or drug services, think about a mainstream approach that includes LGBT people in all community spaces, from sporting events to political forums'," Mr Leonard said.

"This will have dramatic flow-on effects for their mental health."

Now a drug and alcohol support worker at the Victorian Aids Council, Jeremy Wiggins, 33, is a proud trans man with a female partner, two-year-old twins and a home in Melbourne's inner-west.

He is heartened by findings that show psychological distress decreases as people age.

"It could be that people are developing social networks and becoming more comfortable with themselves."

In the past year:

37% diagnosed or treated for a mental health disorder

9% used methamphetamine in past year (national average 2%) 

25% used cannabis (national average 10%) 

Mental health disorders highest among:

transgender men 55%

transgender women 55%

Source: Private Lives 2

For help, call Lifeline on 131 114, beyondblue on 1300 224 636 or LGBT phone counselling service QLife on 1800 184 527, 5.30pm to 10.30pm, 7days a week.