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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 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 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.

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.

Fortunately, there are a number of helpful organizations that offer help. The World Professional Association for Transgender Health (WPATH) is one such organization. Among its missions are to promote evidence based care and respect for trans patients. The Mermaids charity exists to support children, teens and families with gender identity issues. The Center of Excellence for Transgender Health focuses on HIV prevention, routine care, mental wellness and cultural competency.




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