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Madilyn Radcliff

SOC-2370
Summer 2016

Transgender Healthcare is Very Stigmatized, and We Need to Stop It.

Have you ever dreaded going to the doctor for a routine checkup? Many people have, and
they each have their own reasoning why. It is a big step for transgender people to go to the
doctor, and for many they delay it because they do not feel safe in the kind of environment that
caters to the binary genders. Although valid, many cisgender fears may not compare to the strong
stigma attached to being transgender. This paper will explain the stigmas associated with being
trans in an institution catering to a two-gender view, and offer ways for medical professionals to
help ease the burden many trans people face when going to the doctor.
Background:
Trans people often face added reasons for having to go to a doctor, compared to cis
people. There tends to be the added need for mental health, hormone treatment, or gender
reassignment surgery. In the United Kingdom, they have gender identity clinic services (GICs).
The National Health Service was interested to see the current satisfaction of patients attending
the GICs. The responses in the surveys shined a light into the views of the trans people they are
working hard to help. Thirty-one percent of the patients surveyed were dissatisfied with the
current local psychiatric services offered (Davies, et al., 2013). When it is compared it to the
only 5% of the cis people (King, et al., 2014), the problem with transgender healthcare sticks out
like a sore thumb. It seems that reproductive care for transgender people is also lacking. Many do
not go to the doctor because of the poor stigma associated with transgender reproductive and
sexual healthcare (Reisner, Perkovich, & Mimiaga, 2010).
Arguments:

Madilyn Radcliff
SOC-2370
Summer 2016

A mixed methods survey was conducted between May and September of 2009. Sixteen

transmen who had reported having sex with non-transgender men had completed an interviewer
based survey, among other research gathering tasks. Twenty-five percent of those surveyed had
confessed to not being tested for HIV in the two years prior to the beginning of the survey. Fifty
percent had said they have had sex with a partner without knowing their HIV status. Although
many of the transmen surveyed were knowledgeable about sexual health issues. The researchers
made note that it was common among this surveyed group of transgender to have learned from
informal channels, such as close friends. What little information that is out there, many transmen
believed is inadequate. They thought it is poorly tailed from knowledge of traditional
heterosexual experience and knowledge (Reisner, Perkovich, & Mimiaga, 2010).
It is estimated that 6% of the sex workers in the world are transgender. A National
Transgender Discrimination Survey in the United States reported that 28% of those surveyed
vocalized that they postpone medical care due to a fear of being discriminated against. Even with
the stigma and the risks involved, proportionately why would there be a large number of
transgender people in the sex work field? The most commonly reported reason is a lack of other
job opportunities, but that is a whole other issue (Roche & Keith, 2014).
It is not just people in the sex work field that fear the stigmatization of being transgender.
There are people who yearn to live their lives how they want. Forty-three percent of transgender
people from Ontario report to using hormones, 26.8% of those have ever gotten their medication
from a nonmedical source. Ten people reported that they had been denied a prescription for
hormone use in the past, It has been determined that suboptimal care is being given by the clinics
because 24.9% of the respondents had said they were not receiving the recommended follow up
care, such as the needed blood tests. Ten out of the fourteen people who are using non-prescribed

Madilyn Radcliff
SOC-2370
Summer 2016

hormones have reported negative outcomes from healthcare providers in response to trans
specific experiences (Khobzi Rotondi, et al., 2013).

Along with using non-prescribed hormones, do-it-yourself surgeries are a scary practice
some people have gotten into. In the Ontario study, 5 people had indicated that they had selfperformed surgeries like removing their testes or removing their breasts (Khobzi Rotondi, et al.,
2013).
The Virginia Transgender Health Initiative Survey was a multiyear project to assess the
healthcare and social care needs of transgender people. Sixty percent of the people surveyed said
they have a primary care provider, but 15% of those people indicated that they feel very
uncomfortable or uncomfortable to speaking with their provider about transgender specific
health concerns. Twenty percent had to educate their primary care provider about their healthcare
needs. (Bradford, Reisner, Honnold, & Xavier, 2013)
Discussion:
It seems that the barriers concerning clinical experiences is mainly due to the lack of
knowledge. The lack of information is the driving force to doctors not being able to fulfil their
trans patients needs. The first time coming across a special case patient, many general physicians
are at a loss of how to help that patient. There is a lack of training in the past, and currently
during medical school for aspiring healthcare professionals. The field of trans healthcare is
viewed as a unique practice opportunity (Snelgrove, Jasudavisius, Rowe, Head, & Bauer, 2012).
Creating an environment of safety is a critical factor for offering supportive care. It will
take research and adjustments for so many people working in the healthcare field, but it is not
impossible. A simple, yet effective way to establish a safe environment would be to use the

Madilyn Radcliff
SOC-2370
Summer 2016

correct pronouns the patient prefers. If not used correctly, the patient could feel excluded or

alienated. Working with transgender people is not difficult, it just requires sensitivity, empathy,
and an interest to provide optimal care for a population who has been treated in the past with a
strong stigma attached to it.

Bibliography

Bradford, J., Reisner, S. L., Honnold, J. A., & Xavier, J. (2013). Experiences of Transgender-Related
Discrimination and Implications for Health: Results From the Virginia Transgender Health
Initiative Study. American Journal of Public Health, 103(10), 1820-1829.

Davies, A., Bouman, W. P., Richards, C., Barrett, J., Ahmad, S., Baker, K., . . . Stradins, L. (2013). Patient
satisfaction with gender identity clinic services in the United Kingdom. Sexual & Relationship
Therapy, 28(4), 400-418.

Khobzi Rotondi, N., Bauer, G. R., Scanlon, K., Kaay, M., Travers, R., & Travers, A. (2013). Nonprescribed
Hormone Use and Self-Performed Surgeries: 'Do-It-Yourself' Transitions in Transgender
Communities in Ontario, Canada. American Journal of Public Health, 103(10), 1830-1836.

King, K., Nicholas, A., Fletcher, J., Bassilios, B., Reifels, L., & Pirkis, J. (2014). Assessing patient satisfaction
in an Australian primary mental health care context. Advances in Mental Health, 12(3), 161-166.
Reisner, S., Perkovich, B., & Mimiaga, M. (2010). A Mixed Methods Study of the Sexual Health Needs of
New England Transmen Who Have Sex with Nontransgender Men. AIDS PATIENT CARE and
STDs, 24(8), 501-513.
Roche, K., & Keith, C. (2014). How stigma affects healthcare access for transgender sex workers. British
Journal of Nursing , 23(21), 1147-1152.

Snelgrove, J. W., Jasudavisius, A. M., Rowe, B. W., Head, E. M., & Bauer, G. R. (2012). "Completely outat-sea" with "two-gender medicine": A qualitative analysis of physician-side barriers to providing
healthcare for transgender patients. BMC Health Services Research, 12(1), 110-122.