21St Century Issues In Transgender Health

By Marissa Velazquez


The terms, "transgender" and "trans" are used to describe individuals who do not conform to conventional divisions of female and male. This encompasses different types of people and lifestyles. Trans people are at increased risk for certain transgender health issues.

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.

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.

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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