Monday, August 19, 2013

THE DIVIDE: Transgender Mental Health Disparities - why they exist & what we can do…

By Anthony Dobner, Medical Student
Reviewed by Claudia Reardon, M.D.

The Basics…
A transgender individual is someone with the desire to live and be accepted as a member of the opposite sex. This can be accompanied by the wish to make his or her body as congruent as possible with the preferred sex. A transsexual individual is someone who has taken measures, through surgery or hormone therapy, to achieve their desire of living and being accepted as a member of the opposite sex. In general, transgender individuals prefer to be addressed using pronouns and other culture norms that are congruent with their preferred gender identity.

Mental Health Issues Affecting Transgender Individuals…
Lesbian, gay, bisexual, and transgender individuals (LGBT) in general are 2-3 times more likely than the general population to suffer from anxiety and depression. This is probably because anyone who experiences discrimination is more likely to have anxiety or depression.

Almost half of transgender individuals report having attempted suicide. Transgender individuals are also more likely to suffer from substance abuse compared to the general population. Interestingly, transgender individuals who are accepted by their families are less likely to abuse substances. Also, transgender individuals who undertake hormone therapy are less likely to report depressed mood.

Many LGBT individuals experience unintentional discrimination from health care professionals. This may be because they use behavior and language that make assumptions about sexuality. Examples of this include assuming a lesbian or transgender woman does not need to receive education on condoms because she will “never have to worry about getting pregnant.” Research indicates that other barriers include:

  • Homophobia
  • Assumptions of heterosexuality (or homosexuality in transgender individuals)
  • Real or perceived lack of confidentiality
  • Lack of training
  • Insurance policies and laws that create loopholes for employers that do not provide coverage to domestic partners.
5 Tips for Overcoming Disparities & Receiving Quality Health Care...
SEEK friends and allies who love and accept you for who you are no matter what. Research shows that having a strong support system decreases depression and suicidal ideation.

ASK friends and allies what resources are available in your community. Some communities have LGBT-specific clinics. Smaller communities may not have these services, but there may be individual clinicians who have experience working with LGBT patients.
TALK to your doctor! He or she should care about you and want you to be happy and healthy but may not know the best way to address your unique needs. Don’t be afraid to bring up the issue if they don’t. Refer them to this excellent resource for clinicians who want to improve the accessibility of their clinics for transgender individuals.
ENCOURAGE your doctor to use gender neutral language during your visit, and on surveys, signs, and intake forms.
SUPPORT efforts in your community to pass laws that change language in insurance policies that make it difficult for LGBT individuals to receive quality care.

For more information, check out this great resource for transgender individuals on a variety of health care issues.