Transgender public health


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Transgender public health

  1. 1. Transgender Health 23 February 2012 Judi Brown
  2. 2. Transition  Extremely stressful and can be disabling; the biggest change anyone can make to their lives  Many lose jobs, friends, family and homes, often all in one go and trans people need support  Only 20% feel they have encountered no problems1  34.4% say they have attempted suicide at least once1. 1 Engendered Penalties – Whittle, Turner and Al-Alami – The Equalities Review, Feb 2007
  3. 3. Quality of Life 1  Trans respondents are three times more likely than non-trans respondents to have an income of less than £10,000 a year  Only 26% of trans respondents are in full-time employment  Trans people are more likely to be parents or closely related to a child compared with LGB people  35% of trans respondents are disabled or have a long-term health impairment. Count Me In Too Trans People Report – Browne & Lim – Dec 2008 1
  4. 4. The NHS Experience 1  Over 68% of trans people who have used NHS gender identity clinics say that the quality of care they received was poor or very poor  Many trans people strongly object to the presumption that a desire to transition is a sign of mental illness  This further stigmatises trans individuals and provides a ‘one-size-fits-all’ understanding of diverse experiences. Count Me In Too Trans People Report – Browne & Lim – Dec 2008 1
  5. 5. Mental Health 1  Gender Dysphoria is not a mental health problem, although it is treated as one by most of the medical profession  The stresses of coming to terms GD and going through transition can trigger mental health issues  Inevitably leads to loss of confidence and self esteem  Can lead to isolation, depression, self harm and suicide. Count Me In Too Trans People Report – Browne & Lim – Dec 2008 1
  6. 6. Sexual Health 1  Trans people are more likely (56%) than nontrans people (37%) to not know where to find help around sex and relationships  Trans people are more likely (38%) than nontrans people (24%) to say they have never had a sexual health check up. Count Me In Too Trans People Report – Browne & Lim – Dec 2008 1
  7. 7. What Trans People Want 1  Over 65% of trans respondents would like a specialist local service  51% cite the need for a specialist GP  53% say that psychotherapy could have improved their experience of transition  47% of trans people said that their transition would have been improved by better information. Count Me In Too Trans People Report – Browne & Lim – Dec 2008 1
  8. 8. What To Do?  Note that there is a complete blank in JSNAs about the health needs of the trans community  Consult with transgender support groups  Start monitoring for trans to understand the local demographics and who is accessing services …  … But use the right questions  Use the ‘Top ten tips for health and social care workers to help make your services inclusive and welcoming for trans people.
  9. 9. What Not To Do!  Ignore the issue  Stereotype trans people  Shun qualitative research in favour of quantitative studies  Assume that treatment is less life threatening than other conditions, is low priority or is clinically unimportant  Bury the commissioning policy within the smoke and mirrors of a Interventions Not Normally Funded policy  Think that any form of Gender Confirmation Surgery is cosmetic.
  10. 10. Questions and Discussion "People changed lots of other personal things all the time. They dyed their hair and dieted themselves to near death. They took steroids to build muscles and got breast implants and nose jobs so they'd resemble their favorite movie stars. They changed names and majors and jobs and husbands and wives. They changed religions and political parties. They moved across the country or the world -- even changed nationalities. Why was gender the one sacred thing we weren’t supposed to change? Who made that rule?" Ellen Wittlinger (Parrotfish)