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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 those who believe they were assigned the wrong gender to fit their own gender identity. These people have an overwhelming drive to live and be accepted as a member of the opposite gender to which they were assigned at birth. They may opt for gender reassignment to make themselves look like the gender with which they identify. Gender reassignment treatment involves a combination of surgery, hormone therapy and psychological 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.

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.

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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