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.

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 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.

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 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.

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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