American Healthcare System and The Rights of Trans People

Trans healthcare rights are becoming more and more prominent in the United States; not only is there a push for coverage of hormones and surgery but also is pushing for an overhaul of how we approach our health care in general.

“Transgender people face massive and systemic discrimination within the health care system. From instances of humiliation and degradation to outright refusals to provide care, the health care system presents a minefield of discrimination for transgender people seeking to access care” (TLDEF, 2014).

Currently one must be diagnosed with Gender Identity Disorder (GID) by a therapist to be given hormone injections and other treatment. To ask a person to admit something is mentally wrong with them is humiliating and degrading. Rather than face abuse and humiliation many trans* people seek alternative ways of receiving treatment. This is no doubt related to the increasing number of trans* people, especially trans* women, being diagnosed with HIV and AIDS. 2.64 percent of trans people are infected with HIV, which is more than four times the national average rate of 0.6 percent in the general population. (Moskowitz, 2010).

“Where transgender people cannot access health care in a safe and non-discriminatory manner, they often will find what they need outside the mainstream health care system. The use of “street” hormones, with little direction or medical supervision, is one way that transgender people get what they need when they opt out of the mainstream health care system. Such hormones are often unsafe and unclean, and can seriously harm those who use them. When such hormones are injected, the risk of transmission of HIV and other blood borne pathogens through needle sharing is ever-present” (TLDEF, 2014).

Trans* people often experience body dysphoria, a chronic mental illness where the person experiences an incongruity between the way they perceive their body and the way it is in reality.

“For trans people, this can (but doesn’t always) include varying degrees, permutations and combinations of feelings and discomfort around the unwanted presence of breasts and the desire for a penis, testicles and a masculine, virilized body by many trans men, or the unwanted presence of a penis and testicles and desire for breasts and a less virilized, more feminine body by many trans women” (American Trans Man, 2012).

It is important to not a trans* person is not born one way and is becoming the other. To a trans* person they’ve always been the gender they identify as, they just don’t have a body that matches. Research has overwhelmingly shown that members of the LGBT+ community are more prone to anxiety and depression. An alarming 41% of trans* people in the United States have attempted to commit suicide. Often being misgendered can be triggering and upsetting for a trans* person. “LGBT people face:

• Higher rates of depression, anxiety, obsessive-compulsive and phobic disorders, suicidality, self-harm, and substance use among LGBT people
• Double the risk for post-traumatic stress disorder (PTSD) than heterosexual people
• LGBT youth and trans people face increased risk. For example:
• LGBT youth face approximately 14 times the risk of suicide and substance abuse than heterosexual peers
• 77% of trans respondents in an Ontario-based survey had seriously considered suicide and 45% had attempted suicide
• Trans youth and those who had experienced physical or sexual assault were found to be at greatest risk” (Canadian Mental Health Association, 2014). In some cases surgery and other treatments should be considered life saving and preventive due to the high suicide risk.

It is currently very hard to get health care coverage for reassignment surgery as they are seen as elective; however, in many cases regarding trans* prisoners, courts have ruled in their favor. In 2012, a Massachusetts judged ruled in favor for an inmate’s reassignment surgery. “Chief Judge Mark L. Wolf ruled that sex reassignment surgery is the "only adequate treatment" for Kosilek, and "that there is no less intrusive means to correct the prolonged violation of Kosilek's Eighth Amendment right to adequate medical care’” (Kim, 2012).

Not only is there a high suicide risk among trans* people, there is also a staggering number of assaults and and sexual assaults. “A 2009 University of California, Irvine study of prison inmates in California found that a transgender inmate is 13 times more likely to be sexually assaulted than the average inmate, adding on to security concerns above medical ones” (Kim, 2012). This surgery allowed the prisoner to then be transferred to the prison of their identified gender.

“Health care for trans people is a necessity. It is not elective, it is not cosmetic, it is life-saving” (Cox, 2014). Trans* people experience discrimination disproportionately to the rest of the LGB+ community. Being in a body where you feel like you’re a stranger… Where you feel like you don’t belong and having to deal with that plus the onslaught of transphobia and discrimination is more than anyone should have to bear. We need not just a health care system, but a world where trans* people feel included and welcomed.