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.

Fortunately, sympathetic doctors exist who will offer to administer hormone injections to block the child going through a psychologically distressing puberty until they have made a thorough decision as to which gender feels right for them. Some of these teens follow through with a full gender reassignment. Many of these people may have otherwise been driven to commit suicide.

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.

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.

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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