Gender Transitioning

HAPPY LGBT HEALTH AWARENESS WEEK!

I kicked my final week of this rotation off with a workshop I facilitated with the women of trans experience and gender non-conforming clients at the Bronx Community Pride Center.  The topic was Gender Transitioning: A Medical Perspective, and it was such an energizing hour of dialogue with these amazing folks, who were so engaged in the discussion, asking really informed questions, and contributing their thoughts on controversial issues such as black market hormones.

So what are some general requirements/recommendations for individuals interested in transition-related health care?

• May begin puberty-blocking therapies (GnRH analogs) after the beginning of onset of puberty, usually around age 11-12
• It is important to have a knowledge of the benefits, risks, and limitations of hormones -- that is, people need to be realistic about what hormones can accomplish for them.  For example, there are more challenges to becoming "passable" as a member of the opposite sex the later one begins hormone therapy.
• It is recommended to go through 3+ months of real-life experience (dressing and assuming the identity of someone of the opposite sex) or psychotherapy before initiating hormone therapy.  However, this is often bypassed in the harm reduction approach because it is preferred to get high-risk trans patients into care rather than losing them to pursue black market hormones because of the barriers.

We discussed the different hormone therapy options, including estrogen and anti-androgen therapies for biological men and testosterone for biological women.  I also made sure to highlight not only expected results of using these hormones, but also possible side effects and important lab work that needs to be conducted to keep them safe.  Furthermore, I put a lot of emphasis on the extreme risks of black market hormones and injecting silicone into the body, which happens all too often in the MTF trans community because of the pressure to get quick results and look "passable".

My main goal with this presentation was to emphasize the possible effects of hormone therapies and underscore the need for close monitoring by a physician due to the potential risks of this treatment.  I also encouraged the clients to be patient with the transition process, discuss concerns with their physician, and avoid the temptation to seek out quick fixes with extra hormones or silicone injections.  

Another concern on the part of many of these clients is seeking out insurance coverage for transition-related health care, and I pointed them to a great LGBT advocacy resource, Lambda Legal, who has been helpful for many trans individuals in appealing a denial of coverage and pursuing legal action as needed.

Speaking of legal issues, I want to draw attention to another political issue that's on the forefront of transgender advocacy right now.  It's called GENDA, the Gender Expression Non-Discrimination Act.  It may be hard to believe that this is the case in 2012, but it's not illegal in New York for an employer to fire you solely because you are transgender.  And this discrimination is currently legally permissible in several other spheres, from housing to schools to financial institutions and much more.  The purpose of GENDA is to advocate for the inclusion of gender identity and expression in the human rights law to forbid discrimination against individuals of trans experience.  Want to learn how you can be involved in this advocacy work?  Check out the Empire State Pride Agenda.

Spread the word!  Advocate!  Celebrate LGBT Health Awareness Week!