OPINION: Healthcare needs to do better for trans lives

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A doctor showing a patient a syringe used to inject testosterone and pointing at the recommended injection site. (Zackary Drucker | The Gender Spectrum Collection)
By Leo Cabral

A trip to the hospital can induce anxiety in some and total horror in others.

I’m not talking about the fear of needles. I’m talking about being queer in the healthcare system.

There are many reasons why transgender people express trepidation when the time comes to see a doctor — this can include misgendering, dead-naming, anti-LGBTQ+ legislation and transphobia.

Trans and nonbinary people have to convince their doctors of their trans identity, endure uncomfortable questions unrelated to health care about their genitals, educate medical professionals about basic terms and more.

They feel the necessity to choose between their mental health and their transition. There have been cases where sharing a history of mental illness while being trans has led to doctors withholding gender-affirming care because they deem that our transness is the source.

The 2015 report of the U.S. Transgender Survey revealed one-third of survey respondents had at least one bad experience related to being transgender when seeking treatment. Another 23% of respondents did not seek any health care due to fear of being mistreated.

Our gender identity is not the source of our distress. It is navigating one’s queerness in a world that often violently rejects our authenticity and pleas for equal healthcare that creates the mental illnesses.

According to the American Psychiatric Association, the Diagnostic and Statistical Manual of Mental Disorders (DSM) didn’t mention gender identity before 1980. Additionally, the manual only recently replaced the outdated term “gender identity disorder (GID)” with “gender dysphoria” in the 2013 DSM-5.

As a trans-masculine nonbinary person, I loathe the entire healthcare experience. Every aspect fills me with dread, from finding new providers to mental health.

I have had hormone treatment delayed by my endocrinologist because he didn’t believe my lived experience as a nonbinary person. I have been told to exaggerate my case so I would be more likely to receive care.

I have educated several therapists and nurses about my identity and sexuality. And I have avoided getting help out of fear of discrimination.

On the other hand, a cisgender man can have testosterone prescribed if he is experiencing sexual dysfunction. A cisgender woman can receive breast augmentation without letters of recommendation from mental health professionals.

The lack of knowledge on the LGBTQ+ community across medical fields is preposterous. Many queer people are left with the burden of finding inclusive, unbiased and affordable care themselves, frequently having to create the spaces they desperately need.

Due to lack of representation and proper education, I have had to self-educate and unlearn toxic narratives that have been instilled throughout my youth.

So when a healthcare professional doubts my gender identity, gate-keeps or needs me to educate them on LGBTQ+ experiences outside of inaccurate media portrayals, I feel exhausted, angry and let down.

The picture I have painted isn’t every trans person’s experience with health care because the trans experience isn’t a monolithic one. Trans people have friends, family, jobs and complex lives outside of their gender identity.

Transgender people deserve the same respect and access to care as our cisgender counterparts. We are human and are deserving of dignity and autonomy.

Actions need to go further than a simple recommendation from the American Medical Association to remove the sex marker from the public side of birth certificates.

It must go further than a brief educational chapter inserted in a care manual.

If medical professionals listened to queer folk, viewed it as an educational experience, and saw us as human, we would have fewer premature trans deaths in the community.

Hospitals, providers and mental health institutions must do better. There’s no lack of information, resources, educational workshops and reading material.

What I ask is to be met halfway. Do not burden an already marginalized and oppressed group to hold you accountable.

Refusing to listen and make an effort is perpetuating violence against the trans community.

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