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 levels of trans identity. Transvestites like to wear clothing that is traditionally associated with the opposite sex but they are not interested in changing their gender assignment on a full-time basis. Drag kings and queens are individuals who do not appear to be either traditionally feminine or masculine. Others feel they are either a little of both or neither one.

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 who experience this feeling of gender misalignment feel it at a surprisingly young age. When little Nick started playing with female-oriented toys and games at the age of two, his mother noticed this but did not feel particularly concerned. By the age of four, he announced to her that God had made him a boy by mistake. When he reached the age of six years old, he told her he wanted to change his assigned 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.

Transgender individuals are confronted by high levels of discrimination and social disapproval. Often this is in the form of harassment and outright violence. Consequently, they are more vulnerable than the general population to feelings of depression. They are more prone to self-harm and to suicide. Often they avoid seeking medical altogether because they anticipate rejection.

Many providers of medical care lack the necessary grasp of transgender issues. Feeling inadequate, they may turn patients away. It is also true that many gender-associated problems are not covered by health insurance. This puts up another barrier to the transgender population to receive access to medical care. This is a serious problem, because occasionally people who have undergone gender reassignment develop cancer in their "old" sexual organs.

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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