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, 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.

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.

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.

In the past two decades, several organizations have been established to help correct these problems. The Mermaids charity, for example, supports kids, teens and their families with gender identity topics. The Center of Excellence for Transgender Health focuses its attention on preventing HIV, mental well-being, routine care and cultural competency. The World Association for Transgender Health (WPATH), formerly the Harry Benjamin International Gender Dysphoria Association, exists to provide advocacy, care and respect for trans patients.




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