Friday, January 31, 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.

Children pick up on their gender identity sooner than we might think. Children as young as two may show playtime behavior in line with the opposite gender. By four, they may recognize that they are in the "wrong" gender and by six they may already be requesting to have their gender changed.

Fortuitously, Nick's mother located a sympathetic doctor who was able to delay Nick's progress through puberty by injecting him with the necessary hormones. This gave him the breathing space he needed to make the right decision without the psychological agony of undergoing the physical changes associated with male puberty. Nick ultimately went through the reassignment process and became Nicki.

Exposed to social disapproval and often open hostility, transgender individuals have a higher likelihood than the general population to experience severe mental distress. They are on the receiving end of harassment and violent behavior, to which they respond by becoming depressed, often leading them to self-harm or commit suicide. They will avoid seeking medical attention.

Many healthcare providers lack the expertise to deal effectively with transgender patients. They may even go so far as to turn them away and deny them medical care. Transgender health problems may not even be covered by peoples' medical insurance, setting up yet another barrier to access medical care. One serious issue is that of developing cancer in the remaining sexual organs. Transgender men who retain their uterus, ovaries or breasts may develop cancer in these organs. Similarly, transgender men may develop cancer of the prostate.

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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