Transgender people: health at the margins of society (original) (raw)
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Transgender health 1 Transgender people: health at the margins of society
The Lancet, 2016
In this paper we examine the social and legal conditions in which many transgender people (often called trans people) live, and the medical perspectives that frame the provision of health care for transgender people across much of the world. Modern research shows much higher numbers of transgender people than were apparent in earlier clinic-based studies, as well as biological factors associated with gender incongruence. We examine research showing that many transgender people live on the margins of society, facing stigma, discrimination, exclusion, violence, and poor health. They often experience diffi culties accessing appropriate health care, whether specifi c to their gender needs or more general in nature. Some governments are taking steps to address human rights issues and provide better legal protection for transgender people, but this action is by no means universal. The mental illness perspective that currently frames health-care provision for transgender people across much of the world is under scrutiny. The WHO diagnostic manual may soon abandon its current classifi cation of transgender people as mentally disordered. Debate exists as to whether there should be a diagnosis of any sort for transgender children below the age of puberty.
Psychosocial issues in transgender health and barriers to healthcare
HAL (Le Centre pour la Communication Scientifique Directe), 2019
This article aims to review critical issues in the global health of transgender and gender diverse people with a particular focus on the Italian context. Trans identities and experiences have long been pathologized. Pathologization is a form of structural stigma. In many countries, including Italy, having a trans-related mental health diagnosis is still a requisite for having one gender and name changed in identity documents and for accessing gender-affirming treatments, even though important changes are taking place, with the WHO's International Classification of Diseases-ICD-11-erasing trans-related diagnosis from the "Mental and behavioral disorders" and substituting them with the category of gender incongruence in the new chapter "Conditions related to sexual health". Trans people face social and familial rejection, as well as discrimination in housing, employment, education, and social services. Those intersecting forms of oppression and discrimination have a negative effect on their health. Trans people often experience overt discrimination and hostility in healthcare settings and face structural and interpersonal barriers in the access to general and gender-affirming healthcare. While trans people are as concerned as their cisgender counterparts by the need for sexual and reproductive health services, they face multiple barriers in accessing them. More research conducted as part of a meaningful collaboration with community stakeholders and organizations is needed on important areas of trans people's general health, as well as on the optimal content and models of service provision.
Synergies in health and human rights: a call to action to improve transgender health
The Lancet, 2016
2015 was an unprecedented year in the recognition of transgender rights in some highincome countries. However, this recognition in the public domain has yet to translate to a concerted effort to support the right to health of transgender people around the world. Transgender people continue to face a range of challenges that deprive them of respect, opportunities, and dignity and have damaging effects on their mental and physical health and wellbeing, as shown in the Lancet Series on transgender health. 2-4 These "situated vulnerabilities", as they are called in the Series paper by Sari Reisner and colleagues, 4 can prompt or aggravate depression, anxiety, self-harm, and suicidal behaviour among transgender people, which are exacerbated by biological risks, and social and sexual network-level risks, for HIV and other sexually transmitted infections. 2 In their Lancet Series paper, Sam Winter and colleagues 2 write of a "slope leading from stigma to sickness". Moving forward, these health needs and vulnerabilities can be better addressed through improved understanding of the legal and social policies that promote harms and diminish the potential impact of health programmes. There is also a need for increased knowledge of the optimal content and models of clinical service provision, as highlighted by Kevan Wylie and colleagues' Series paper, 3 and of the epidemiology of communicable and Correspondence to: Sam Winter.
Transgender Bodies, Identities, and Healthcare: Effects of Perceived and Actual Violence and Abuse
Research in the Sociology of Health Care, 2008
Disparity" implies the existence of a "markedly distinct in quality or character," difference between one group and another. Some groups, due to elevated stigma associated with group membership, are invisible as a disparate minority and therefore, while there may be a great inequity in healthcare between that group and the normative population, the invisible minority is ignored. This paper addresses the issue of healthcare for the transgender-identified population. We address how the normative viewpoint of mental illness and unacceptable religious status, along with lifelong perceived and actual abuse and violence, creates a socially sanctioned inequality in healthcare for this population.
Psychology & Sexuality, 2019
Around the globe, trans and gender diverse people have a wide range of access to health care, psychological as well as physical, that is unique to their home country's context. Some of the contributing factors are nations' health care systems, laws and policies surrounding discrimination, adequate resources, and under-trained health care professionals. Unfortunately, inability or difficulty in accessing transition related health care and support leads to negative impacts on mental health. In this article, the authors describe the unique contexts related to transgender health care in Canada, Japan, South Africa, and the United States. We focus specifically on the financial cost of transition for trans and gender diverse people, including gender affirming surgeries as well as mental and health care more broadly. We discuss the role of mental health professionals as advocates for gender affirming care and the fundamental human right to health care. We include discussions of therapy, assessment, medical care such as hormone replacement therapy (HRT) and surgeries, and additional invisible costs. We highlight the importance for all mental health professionals to be aware of the impacts to trans and gender diverse people's mental health when their fundamental health care needs are not met. Furthermore, we provide recommendations for how mental health professionals can advocate for their clients' access to transition related care.
Transgenders: The Neglected Group in Health Care
Journal of Complementary and Alternative Medical Research
Transgenders have always caught my attention. Be it at the signal where they are seen begging or in a moving bus where everyone shuns away from sitting near them. My initial fears about them turned to curiosity as to who they are. Are they normal? No one around me was able to give me any answer. I was apprehensive to talk to anyone too as I was always told they may harm me. But I made it a point to attend meetings that transgenders attended, squeezed myself into talking to them and getting acquainted with the group, and to my surprise I found out they were such a welcoming group. I gelled with them faster than I thought and today I am glad they are a part of my journey. As I explored their lives, the one thing I realized was that even healthcare members are not fully aware of transgenders, rather, they have too many misconceptions. And so, the need of the hour is that healthcare professionals should be trained on transgenders especially when statistics show that as per the 2011 cens...
Transgender social inclusion and equality: a pivotal path to development
Journal of the International AIDS Society, 2016
IntroductionThe rights of trans people are protected by a range of international and regional mechanisms. Yet, punitive national laws, policies and practices targeting transgender people, including complex procedures for changing identification documents, strip transgender people of their rights and limit access to justice. This results in gross violations of human rights on the part of state perpetrators and society at large. Transgender people's experience globally is that of extreme social exclusion that translates into increased vulnerability to HIV, other diseases, including mental health conditions, limited access to education and employment, and loss of opportunities for economic and social advancement. In addition, hatred and aggression towards a group of individuals who do not conform to social norms around gender manifest in frequent episodes of extreme violence towards transgender people. This violence often goes unpunished.DiscussionThe United Nations Development Pro...
Global health burden and needs of transgender populations: a review
The Lancet, 2016
Transgender people are a diverse population aff ected by a range of negative health indicators across high-income, middle-income, and low-income settings. Studies consistently document a high prevalence of adverse health outcomes in this population, including HIV and other sexually transmitted infections, mental health distress, and substance use and abuse. However, many other health areas remain understudied, population-based representative samples and longitudinal studies are few, and routine surveillance eff orts for transgender population health are scarce. The absence of survey items with which to identify transgender respondents in general surveys often restricts the availability of data with which to estimate the magnitude of health inequities and characterise the population-level health of transgender people globally. Despite the limitations, there are suffi cient data highlighting the unique biological, behavioural, social, and structural contextual factors surrounding health risks and resiliencies for transgender people. To mitigate these risks and foster resilience, a comprehensive approach is needed that includes gender affi rmation as a public health framework, improved health systems and access to health care informed by high quality data, and eff ective partnerships with local transgender communities to ensure responsiveness of and cultural specifi city in programming. Consideration of transgender health underscores the need to explicitly consider sex and gender pathways in epidemiological research and public health surveillance more broadly.
Yearbook 2014 of the Institute for Advanced Studies on Science, Technology and Society
Transsexuality has been organised within the biomedical framework since the middle of the twentieth century. The gendered body is produced through a complete set of socio-medical practices in order to regulate the human variation on gender expressions. In this binary model, there are only two sexes and two possible gender positions. People who do not fit in this very normative model have to change the body to adjust it to the normative idea on how a male or a female body should be. However, at the turn of the century, several activist movements and certain feminist-queer academic traditions have questioned this version of sexual difference. In this article, I will analyse how a particular transgender activist group is questioning the production of both sexual difference and specific models of gender identity through the medical practices on transgender bodies.