Key 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.

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, 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.

Transgender individuals are confronted by high levels of discrimination and social disapproval. Often this is in the form of harassment and outright violence. Consequently, they are more vulnerable than the general population to feelings of depression. They are more prone to self-harm and to suicide. Often they avoid seeking medical altogether because they anticipate rejection.

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.

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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