Transgender Health Issues

So far, we have been talking about sex and gender as if each was a binary category— one with only two possibilities: male or female in the case of sex, masculine or feminine in the case of gender. Life, however, is more complicated.

The term transgender refers to people whose sense of their own gender does not match the physical sex (male or female) they were assigned at birth. This term is used to describe two groups. The first consists of individuals who would like to change their bodies to better fit the physical sex that matches their sense of their true selves. The second consists of those whose gender identity crosses cultural boundaries that divide masculinity from femininity but who have little interest in changing their bodies to fit within those boundaries.

Currently, around 1 of every 200 persons in the United States identifies as transgender. This statistic, however, undoubtedly under- states the size of the transgender population, because many fear identifying them- selves as such even to researchers. Others may no longer identify as transgender because they have used surgeries and hormones to change their bodies and have fully transitioned to the sex they always believed themselves to be.

Unfortunately, obtaining proper health care remains difficult for many trans- gender people. Medical schools typically provide almost no education regarding the needs of transgender patients.

As a result, doctors might not understand, for example, that calling patients by their birth names rather than their chosen names might lead patients to distrust their doctors. Nor might doctors realize that an individual who has transitioned to living as a man might still have ovaries that need to be periodically checked for disease. On the other hand, getting access to sex-transition surgeries and medical care is easier than it was 20 years ago because of both technological advancements and increasing acceptance of interventions among doctors, insurance companies, and the general public. That said, there are still many who object to providing such care; as of 2017, for example, the state of Wisconsin officially excludes sex- transition health care from the health insurance it offers to state employees.

At the same time, this change in attitudes reinforces the idea that anyone who does not fit into one and only gender is biologically and psychologically defective. Indeed, doctors seem to regard their inter- ventions as a success only if their former patients now closely match stereotypical ideas about what a man or woman should be like. Such attitudes continue to stigmatize transgender people who cannot or will not seek medical interventions.

Whether or not transgender individuals are comfortable living outside our society’s gender expectations, they often face harrowing levels of stigma and dis- crimination (Bockting et al., 2013). As a result, as a group they are less likely to attend college and more likely to attempt suicide, experience poverty, suffer from poor health, or face difficulty obtaining health care