Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
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Washington Blade - May 19, 2006
Elizabeth A. Perry
For transgender men and women, the fear of revealing their life-changing decision while seeking medical care can be an inconvenience at best - or a nightmare.
Sponsors of a new Virginia-based study are hoping to shed some light on the unique challenges facing trans patients.
Funded by the Centers for Disease Control & Prevention in Atlanta, the three-year Virginia Transgender Health Initiative Study on health concerns of transgender Virginians will wrap up next month. It is intended, in part, to expose the fears and prejudices that often force trans people to avoid health care altogether.
The survey is being conducted by the Virginia Health Department and Virginia Commonwealth University, which together make up the Transgender Task Force. The survey consists of 83 questions related to health status, doctors' attitudes, ability to get care, housing, employment, violence and substance abuse.
Ted Heck, coordinator of the Transgender Task Force, said the last phase of the study will end June 15, at which time researchers will compile and analyze the results. One of the goals of the study, which is to create a statewide transgender resource and referral list, is already available online at the Virginia Department of Health website, www.vdh.virginia.gov/std/hotline.asp.
So far the list includes about 40 listings for doctors, mental health and substance abuse counselors, as well as health clinics, HIV and legal services.
"We already have an HIV/AIDS resource and referral list," Heck said. "But we wanted to have one specifically for transgender individuals because it is so hard for them to find services."
Another outgrowth of the study is an HIV/AIDS risk assessment brochure, currently in the works. Heck said the brochure is designed for medical professionals and anyone working with transgender people in a health care setting. Sections will include HIV/AIDS prevention, definitions of terms such as "transgender" and "transsexual", health issues, transphobia and gender dysphoria.
Invasive questions
While some transgender participants have undergone full gender reassignment surgery, others only take hormones. According to Trans-Health.com, female-to-male transgender people need to continue PAP smears and breast tissue exams, and all transgender people need to be monitored for hormone-related cancers.
Mara Keisling, executive director of the National Center for Transgender Equality in Washington, D.C., said transgender people have to contend with some invasive questions before medical treatment even begins.
Keisling, who is transgender, said when she went to a new doctor recently, she was asked if she had reassignment surgery and was asked for details. None of the questions were related to why she was seeking medical help. She said she felt the questions were an invasion of her privacy.
"It's assumed that because we are transgender that we all have surgery," she said. "It's only 3 to 5 percent of transgender people who actually have it.
Keisling said that some medical personnel could stand to improve their people skills when it comes to treating transgender patients with sensitivity.
Medical nightmares
She said a nursing student told her of an incident in class when a student asked the teacher, who was an emergency room nurse, how they care for a transgender patient.
"The teacher said, 'We get those all the time. We just let them die,'" said Keisling. "I like to think most doctors want to help people, not pass moral judgment."
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