21St Century Issues In Transgender Health

By Marissa Velazquez


Individuals who do not conform to traditional assignment to male and female genders are collectively known as "trans" or "transgender." These are people whose personal gender identity differs from the physical gender they were assigned at birth. Consequently, they are prone to several types of transgender health problems.

Transvestites are people who cross-dress, meaning they wear clothing of the opposite sex but they do not want to be a full-time member of that sex. Drag queens and drag kings are people who do not appear traditionally masculine or feminine. There are some people who feel they are neither male nor female; alternatively, they feel they are a little bit of both.

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.

Children who experience this feeling of gender misalignment feel it at a surprisingly young age. When little Nick started playing with female-oriented toys and games at the age of two, his mother noticed this but did not feel particularly concerned. By the age of four, he announced to her that God had made him a boy by mistake. When he reached the age of six years old, he told her he wanted to change his assigned 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.

Exposed to social disapproval and often open hostility, transgender individuals have a higher likelihood than the general population to experience severe mental distress. They are on the receiving end of harassment and violent behavior, to which they respond by becoming depressed, often leading them to self-harm or commit suicide. They will avoid seeking medical attention.

Many providers of medical care lack the necessary grasp of transgender issues. Feeling inadequate, they may turn patients away. It is also true that many gender-associated problems are not covered by health insurance. This puts up another barrier to the transgender population to receive access to medical care. This is a serious problem, because occasionally people who have undergone gender reassignment develop cancer in their "old" sexual organs.

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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