Sunday, January 12, 2014

21St Century Issues In Transgender Health

By Marissa Velazquez

The terms, "transgender" and "trans" are used to describe individuals who do not conform to conventional divisions of female and male. This encompasses different types of people and lifestyles. Trans people are at increased risk for certain transgender health issues.

Transvestites are people who cross-dress, meaning they wear clothing of the opposite sex but they do not want to be a full-time member of that sex. Drag queens and drag kings are people who do not appear traditionally masculine or feminine. There are some people who feel they are neither male nor female; alternatively, they feel they are a little bit of both.

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.

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.

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.

Fortunately, there are a number of helpful organizations that offer help. The World Professional Association for Transgender Health (WPATH) is one such organization. Among its missions are to promote evidence based care and respect for trans patients. The Mermaids charity exists to support children, teens and families with gender identity issues. The Center of Excellence for Transgender Health focuses on HIV prevention, routine care, mental wellness and cultural competency.

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