Transgender youth face ‘pervasive stigma’ in health care

© Evren Kalinbacak

In a review of 91 studies from 17 countries, it was found that transgender and non-binary youth face “pervasive stigma and discrimination” in healthcare.

According to a review of data from 91 studies, which covered 884 participants, the situation for trans and non-binary access to health care remains difficult, fraught with barriers and “pervasive stigma” in 17 countries.

When it comes to accessing health care, LGBTQ communities have long faced significant barriers. Only now, 40 years after the devastation of an epidemic, trials of an HIV vaccine are beginning. People living in countries without legal protections continue to hide their existence and attempt their own transitions, which can lead to medical emergencies.

0.5% of the world’s population is transgender and non-binary

Currently, 0.5% of the world’s population is transgender, not binary. Disproportionately, this group is 20 times more likely to die by suicide than the general population, and accounts for an immense 20% of HIV cases worldwide.

There are probably even more transgender and non-binary youth, who are too at risk of retaliation to document their gender identity. While COVID has highlighted the existence of racial and economic disparities in healthcare, the pandemic has also served to expose more of the existing disparities that existed before the virus evolved.

Gender identity is an issue often misunderstood in public, with UK-based gender-critical feminists asking if a trans woman is really a woman, and countless newspapers featuring fear-mongering rhetoric about children making irreversible decisions in the name of a trend.

Transgender and non-binary youth are a protected class, which is often disbelieving and stoically debated as a matter of philosophy – as opposed to a complex and nuanced community of people with their own dreams, needs and lives. . Dehumanization is a common discriminatory action against trans and non-binary people, whose existence often seems to be interpreted as an implicit threat.

“You better find out for yourself”

The real threat appears to be the discrimination faced by trans and non-binary youth trying to access health services.

In this cohesive review of existing qualitative studies, scientists found that contemporary healthcare systems are flawed, especially when it comes to helping transgender and non-binary youth. An anonymous young trans said: “They don’t want to treat him [gender dysphoria], then you’d better find out for yourself.

Three key issues for trans and non-binary youth:

  1. Limited availability of gender affirmation services;
  2. Strict control measures to access therapy;
  3. And limited insurance coverage.

Lack of knowledge of physicians about anatomy

In some cases, young women assigned at birth feared physical harm due to their doctor’s lack of knowledge. They experienced pain during speculum examinations if their doctor was unaware of the effects of testosterone therapy on vaginal atrophy and “refused to use a very small speculum”.

In other cases, participants from the Global South said they were unsure of the potential impact of being transgender on their risk of sexually transmitted infections or cervical cancer. . They were unable to access a credible source of information, learn more about their bodies and their health care needs, which left them vulnerable to specific risks.

“Strict control measures” prevented access

When the “strict controls” in place for trans and non-binary youth to access therapy came, some felt they needed to perform a gender-perfect interpretation. For example, transmasculine youth had to have their hair cut to prove they were “trans enough” to receive help making the transition – as if longer hair made their gender less than valid. Others were at the mercy of anti-trans parents, whose permission was required to begin therapy.

Prostitution has become the only tool for survival

The cost of the transition was often too high for those who grew up or found themselves in financial deprivation. For some older young transfeminines, they have turned to prostitution or “survival sex” as “the only way to get enough money” to make the transition and pay for health care – like HIV testing. , fertility preservation, hormones and surgery.

This review clearly reflected the world of trans and non-binary healthcare, highlighting many nuanced and disturbing events, including where they stemmed from. Several problems stem from “legal, economic and social deprivation” imposed by “discrimination, violence and homelessness”.

‘Care disengagement’ leads to dangerous results

The authors commented: “This review found that transgender youth face feelings of gender incongruity, fear and vulnerability in accessing health care, which are compounded by legal, economic and social barriers. .

“This can lead to disengagement of care and the use of high-risk and dangerous interventions. “

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