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6 Health Priorities for Transgender Persons
Transgender is commonly understood to be individuals, who self-report the biology of their gender is not compatible with their gender identity. For example, a biological male feeling “trapped inside the body of a female” and wants to be identified as female is said to be transgender (male to female) and vice versa for female to male “trans people.”
Due to the increased health and mental risks associated with identifying as a transgender person, there are health issues the Gay and Lesbian Medical Association and other providers recommend transgender persons talk to their doctor about. Here are 6 key topics.
Access to Health Care
Transgender persons often do not have a regular doctor and can be distrusting of a traditional provider-patient relationship. And still in 2011, some transgender people are turned away by providers. A doctor who refuses to treat a trans person may be acting out of fear and transphobia, or may have a religious bias against GLBT patients. Plus, health care related to transgender issues is usually not covered by insurance, so it is more expensive. Finding local clinics, health centers, and indigent service providers often times becomes the best option.
Complete Health History
Trans persons may hide important details of their health history from their doctors. Even many years after gender re-assignment surgery, they may omit the history of their transition when seeing a new provider. Patients should see their provider as an equal partner in their health care, not as a gatekeeper or an obstacle to be overcome. Trust works both ways.
Cross-gender hormone therapy gives desirable feminizing (or masculinizing) effects, but carries its own unique risks. Estrogen has the potential to increase the risk of blood clotting, high blood pressure, elevated blood sugar and water retention. Anti-androgens such as spironolactone can produce dehydration, low blood pressure, and electrolyte disturbances. Testosterone, especially when given orally or in high doses, carries the risk of liver damage. Hormone use should be appropriately monitored by the patient and provider. Some resort to buying unsafe, unregulated hormones from the street and sometime with tragic outcomes.
Hormone-related cancer (breast in trans women, liver in women or men) is very rare but should be included in health screening. A greater worry is cancer of the reproductive organs. Trans men who have not had removal of the uterus, ovaries, or breasts are still at risk to develop cancer of these organs.
HIV/STI Risks and Safer Sex
Trans people, especially youth, may be rejected by their families and communities, finding themselves in violent situations and/or homeless. They may be forced into sex work and therefore at high risk for sexually transmitted infections (STIs) including HIV. Other trans people may practice unsafe sex when they are beginning to experience sexuality in their desired gender. Safer sex is still possible even in transgender relationships.
For obvious reasons, trans people are particularly prone to depression, anxiety, and substance abuse. In addition to the loss of family and friends,
they face social stigma, job stress, risk of violence, and increased risk of depression. Trans people who have not transitioned and remain in their birth gender are very prone to major depression. Suicide is a risk, both prior to transition and afterward. Mental health support services are often extremely beneficial for trans people across age groups.
Below are also a few resources for transgender people and their allies.
National Center for Transgender Equality
The National Center for Transgender Equality (NCTE) is a 501(c)3 social justice organization dedicated to advancing the equality of transgender people through advocacy, collaboration and empowerment.
Intersex Society of North America
The Intersex Society of North America (ISNA) is devoted to systemic change to end shame, secrecy, and unwanted genital surgeries for people born with an anatomy that someone decided is not standard for male or female.