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Transgender Community’s Treatment in Healthcare

Introduction

A transgender is an individual whose gender identity or expression does not conform to the social standards and expectations associated with the biological sex to which he was allocated at birth (UNDP, 2016). The transgender community comprises three groups: individuals denoted as males at birth and experience female characteristics (MTFs), those assigned female gender at birth, and have tendencies towards the male character (FTMs), and those who neither recognize themselves as males nor females (genderqueer).

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It is a diverse community encompassing all racial, tribal, and religious backgrounds and consists of people we live, work, and socialize with daily. This community experiences considerably less social support and diverse forms of harassment and discrimination from their families and the public compared to their non-transgender counterparts. The magnitude of discrimination varies depending on gender, race, or whether from the majority or minority groups.

According to the UNDP (2016), the unfair treatment saddens given that all people are entitled to “a life free from violence, persecution, discrimination, and stigma” by the international human rights law (p. 2). Although the visibility of transgender people is on the increase, this community still faces blatant discrimination, stigma, and profound inequality.

Transgender and Gender Identity

Transgender individuals usually have difficulties disclosing their gender identity. It has been observed that the MTFs and FTMs are more likely to disclose their gender identity to their families, coworkers, and physicians than the genderqueers are (Factor & Rothblum, 2008). The researchers linked the tendency by the “latter group to hide their identity to the inability to describe themselves outside the traditional gender binary” (Factor & Rothblum, 2008, p. 88). Besides, the society refuses to recognize the gender identity of transgender people by not availing gender-affirming services, refuses to accept them, and creates structural barricades that only complicate the crisis.

There lacks comprehensive state non-discriminatory laws or legislations that can accord the transgender groups immunity against employment and housing bias, discrimination against accessing public utilities such as bathrooms and toilets, and segregation on religious grounds (Factor & Rothblum, 2008). Again, there is a general lack of accurate documents to identify transgender people. This state of affairs has a bearing on every facet of their lives since without proper identification, it is almost impossible to move, work, and access education, medical care, or any other important services in the society.

Poverty

Due to employment discrimination that the transgender people are subjected to, many of them live in abject poverty with a “projected income of less than $ 10,000 annually” (Salisbury & Dentato, 2016, p.119). The inability to get basic living requirements leads to increased cases of homelessness, prostitution, drug trafficking, and violence. In addition, it also contributes to the low educational success witnessed in this community. These vices are likely to incline the transgender people on the wrong side of the law, resulting in frequent arrests and imprisonment.

Harassment, Stigma, and Anti-transgender Violence

The transgender community still experiences some stigma that is grounded in the history of being perceived as mentally ill, socially abnormal, and sexual predators. These false perceptions dominate the mindset of many in the society who ridicule the transgender people and slow down the initiatives of their acceptance and integration into the wider community. The stigma leaves the trans people vulnerable to “mischievous politicians who exploit their plight for political gain, to segregation by family, employers and to people who stalk, bully, and violate their freedom” (Barr, Budge & Adelson, 2016, p. 90).

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Cases of transgender people being physically assaulted and murdered are on the increase. The victims are mostly women. Regrettably, efforts to seek protection from the police are most of the time futile as most transgender people end up frustrated or denied equal service by law enforcers. They are even labeled criminals and indicted for homosexuality and impersonating other genders. This encounter makes it difficult for them to seek help from police, hence, an increased tendency to avoid reporting incidences of anti-transgender violence. In fact, these factors contribute drastically too high anxiety, deteriorating mental health, and risky sexual habits among transgender people.

Barriers to Healthcare

Though access to transgender–sensitive care remains the major priority for transgender people, challenges of obtaining essential health services, experiences of humiliation, facing medical experts who are indifferent and have no transgender healthcare competency, and denial of access to medical care remain a reality (Factor & Rothblum, 2008). Reports of transgender people being insulted, physically assaulted, or refused to access equal treatment in doctor’s offices or hospitals have been documented.

Healthcare has also been slow to incorporate transgender-sensitive healthcare services into the system. For example, transgender people find it hard to identify themselves on medical forms because there is no place assigned for them.

In primary health care, prejudice by healthcare givers may include abusive labeling, condescending interactions, insults, or failure to uphold confidentiality. This scenario is especially true in institutions where the staffs are untrained, insensitive, and judgmental. These experiences make transgender people reluctant to seek treatment. Transphobia aggravates the mental health of transgender people who may be suffering from depression and suicidal contemplations.

Psychosocial facilities and services for transgender people are most of the time lacking or underdeveloped. If available, the services may be very costly and inaccessible. In addition, due to diagnostic techniques being based on binary gender standards and the unprepared healthcare givers, it is possible for doctors to misdiagnose transgender people and give incorrect results, which contribute to their suffering. Additionally, very few mental health experts specialize in caring for the transgender community. Governments have not availed funds and training opportunities for such training.

Surgical and other medical interventions that make transgender people lead genuine lives within their gender uniqueness are usually inaccessible because of denial and high costs. According to the UNDP (2016) report, these procedures are often used for the treatment of malignancies, for reproductive health or as contraceptives but “frequently denied to transgender people because of the belief that in their case these interventions are cosmetics, medically unnecessary. or even the expression of a mental disorder” (p. 27). In addition, these services are not covered by health insurance schemes. Consequently, many transgender people opt for unsafe sources of treatment like silicone and hormonal injections purchased illegally, possess risks of contamination, and administered by unqualified persons.

Measures to Avert Discrimination

Studies to identify hurdles and facilitators of transgender people’s involvement in various programs have led to an understanding of key areas that require improvement, especially in healthcare. The inclusion of transgender components in medical education curricula is imperative. Secondly, there is need to train healthcare givers of which long term results may demand instituting a “methodical training program that is backed up by the government and that starts all the way at university or college level” (Rutherford, McIntyre, Daley & Rosi, 2012, p. 904).

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This approach ensures a healthcare profession that is trans-community sensitive, competent, and able to restore transgender people’s confidence in healthcare services. Training also prepares healthcare givers to handle these people properly given the realities of life they face.

It is also necessary to intensify research that is directed towards the healthcare needs of this community. Thirdly, there is a need for true collaboration between local trans-competent entities and the healthcare providers principally as pertains to the provision of psychosocial services. Moreover, it is tenable to strengthen programs such as HIV/AIDS diagnosis, control and management, alcohol and drug abuse treatment, suicide prevention, and anti-smoking initiatives and make them include transgender cases. Such a move ensures reduced incidences of HIV contraction and deaths, suicides, alcoholism, and drug addiction, which are ultimately fatal.

Similarly, working towards the formulation and execution of non-discriminatory curative, health, and institutional policies and laws governing social service provision helps remove the barriers to accessing health and other social services. In addition, health systems and health insurance systems should be amended to end transgender bias to allow them to access transition-allied healthcare. For those without correct identification documents, the issuance of special identification cards should be considered.

This approach will enable them to access healthcare and other services as well. Transgender people should be enlightened about their rights as consumers of healthcare services. The awareness not only creates good relationships with healthcare givers, but it also ensures knowledge of where to get such healthcare services and proper utilization of health facilities available. It also creates a platform on which transgender people can air their healthcare-related grievances and be part of the solution.

In non-healthcare setup, several initiatives can help stop transgender prejudice in families, schools, workplaces, police stations, jails, and courts. These initiatives include the provision of homes to the homeless and emotional support to those who are suffering from rejection and neglect, providing support, and encouraging transgender people who report cases of discrimination to denounce cases of anti-transgender jokes and other gestures meant to demean them.

Legally recognizing transgender identity, enabling room for equal job opportunities, formulating and strengthening anti-bias policies that protect transgender workers, and promoting safety and security in the workplace ensure that these people are treated equally in the human capital market. To promote transgender education, students ought to be allowed access to school using names, uniforms, gender identity, and expression they prefer. They should be allowed to use gender-based facilities like bathrooms and toilets of which they are comfortable. They should be protected from segregation, bullying, defamation, and harassment by instituting an active anti-discriminatory policy within the schools.

Global, national, state, or federal laws that outlaw unjustified unfairness against transgender people should be enacted. The police departments should be front runners in this by making sure the police are trained on the laws and on how to interact with transgender people. Jail and prison systems should ensure that the trans-prisoners are safe and handled respectably. The same also holds true for the judicial system.

Conclusion

While plenty of work is being done to correct the disparities that exist in the lives of transgender people, it is a slow process. A lot of positive images of the transgender community have been portrayed in the media and society and made key changes to how the general public perceives these people. However, a lot needs to be done to promote sanctity, recognition, safety, and fair treatment of this community.

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Human rights advocacy efforts should be geared to the creation of common ground to ensure that transgender people who are our family members, friends, neighbors, and workmates get an equal chance and enabling the environment to flourish. The involvement of many global, governmental, and non-governmental organizations in fighting for, defending, and establishing the rights of this group heralds a brighter future for the transgender community.

References

Barr, S., Budge, S. & Adelson, J. (2016). Transgender Community Belongingness as a Mediator between Strength of Transgender Identity and Well-Being. Journal of Counseling Psychology: Business Source Complete, 63(1), 87 – 97.

Factor, R. & Rothblum, E. (2008). Exploring Gender Identity and Community among Three Groups of Transgender Individuals in the United States: MTFs, FTMs, and Genderqueers. Academic Search Premier, 17(3), 253-253.

Rutherford, K., McIntyre, J., Daley, A., & Rosi, L. (2012). Development of Expertise in Mental Health Service Provision for Lesbian, Gay, Bisexual and Transgender Communities. Academic Search Premier, 46(9), 903-913.

Salisbury, M. & Dentato, M. (2016). An Exploratory Study Examining Needs, Access, and Competent Social Services for The Transgender Community In Phoenix, Arizona. Journal of Human Behavior in the Social Environment: Academic Search Premier, 26(2), 119-136.

United Nations Development Programme [UNDP]. (2016). Implementing Comprehensive HIV and STI programmes with Transgender People. New York, USA: HIV, Health, and Development Group.

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