Key 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.

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.

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, Nick's mother found a sensitive doctor who, by injecting hormones, was able to postpone Nick's puberty until he had made a firm choice to change his gender. Without the hormones, she would have progressed through male puberty, which would have been psychologically agonizing for her. Had that happened, she told her mother, she would have killed herself. Nick eventually proceeded to go through the complete change to 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 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.

In the past two decades, several organizations have been established to help correct these problems. The Mermaids charity, for example, supports kids, teens and their families with gender identity topics. The Center of Excellence for Transgender Health focuses its attention on preventing HIV, mental well-being, routine care and cultural competency. The World Association for Transgender Health (WPATH), formerly the Harry Benjamin International Gender Dysphoria Association, exists to provide advocacy, care and respect for trans patients.




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