21St Century 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.

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 those who believe they were assigned the wrong gender to fit their own gender identity. These people have an overwhelming drive to live and be accepted as a member of the opposite gender to which they were assigned at birth. They may opt for gender reassignment to make themselves look like the gender with which they identify. Gender reassignment treatment involves a combination of surgery, hormone therapy and psychological counselling.

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.

Fortunately, Nick's mother found a sensitive doctor who, by injecting hormones, was able to postpone Nick's puberty until he had made a firm choice to change his gender. Without the hormones, she would have progressed through male puberty, which would have been psychologically agonizing for her. Had that happened, she told her mother, she would have killed herself. Nick eventually proceeded to go through the complete change to Nicki.

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.

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.

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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