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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 powerful desire to live and be recognized as a member of the opposite gender to which they were born. Many of these people have gender reassignment treatment to make their appearance look more like their desired gender. This may include a combination of hormones and surgery with rigorous counselling.

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.

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.

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.

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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