Thursday, January 30, 2014

Key Issues In Transgender Health

By Marissa Velazquez


Gender identity is the internal personal sense of being a man, woman, or outside the binary gender identity. For transgender people, this identity differs from the gender they were assigned at birth. While gender identity differs from sexual orientation, it is no easier to change. For this reason, transgender individuals seek to align their bodies with their gender identity. Consequently, certain transgender health issues frequently arise within this population.

There are different degrees of transgender identity. Transvestites like to cross-dress as members of the opposite sex but do not wish to become the other sex. Drag queens and drag kings are somewhat intermediate, appearing neither feminine nor masculine. Then there are those who feel they either do not belong to either the male or female gender, or they feel a little bit of each.

Transexuals are people who have a strong desire to live as a member of the opposite sex to which they were assigned at birth. Often they will undergo gender reassignment to formalize the transition to become recognized and accepted as the other sex. Treatment involves a combination of psychological counselling, hormone treatment and surgical intervention.

From a surprisingly young age, children may begin expressing behavior that may indicate they have been born with the "wrong" gender. Take the case of Nick, whose mother noticed that he started playing conventionally girly games from the age of two. By the age of four, he told her God had made a mistake when he made him a boy. By the age of six, he expressed the desire to change his gender.

Fortunately, sympathetic doctors exist who will offer to administer hormone injections to block the child going through a psychologically distressing puberty until they have made a thorough decision as to which gender feels right for them. Some of these teens follow through with a full gender reassignment. Many of these people may have otherwise been driven to commit suicide.

Trans people are more likely than the general population to feel mentally distressed because of the levels of social disapproval and discrimination that they often face. They experience higher levels of harassment and violence and are therefore at an increased risk of depression, self-harm and suicide. They will often avoid seeking medical care because they are afraid of being rejected.

Not all healthcare providers have the necessary trans savvy to deal effectively with these patients and may even turn them away. Frequently, gender-related problems are not covered by insurance. This, too, acts as a barrier to medical care access for transgender individuals. Another issue is cancer of the retained pre-op sexual organs. Transgender men who still have ovaries, a uterus and breasts may get cancer in these organs. Trans women may be prone to prostate cancer.

A number of organizations have sprung up over the past two decades to help improve both access and quality of medical care for the transgender population. One such organization is the Center of Excellence for Transgender Health. This organization focuses on cultural competency, mental wellness, routine care and prevention of HIV. Another organization, aimed at children and teens and their families, is the Mermaids Charity. The World Professional Association for Transgender Health (WPATH) is another such organization. Its aim is to provide advocacy, promote evidence based care and respect for transgender individuals.




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