The transgender population became visible at the end of the twentieth century when more and more people started openly reveal their gender identity as well as address healthcare professionals with quite specific issues. Transgender people can be defined as individuals “whose gender identity or expression differs from their sex designated at birth (Stanton, Ali, & Chaudhuri, 2016, p. 34). The modern society is starting to accept diversity in different aspects of people’s identity.
Nevertheless, people pertaining to the LGBT community still face a societal stigma. Transgender individuals are specifically prone to rejection, stigma, and discrimination. These people have various barriers to receiving high-quality healthcare services, which has adverse effects on their physical, psychological, and emotional well-being (Stanton et al., 2016). This paper examines some of the central barriers to high-quality health care and includes practices employed to address the issue, as well as some recommendations concerning possible improvements.
The transgender population has to deal with various issues when addressing a healthcare professional or visiting a healthcare facility. These concerns often depend on the nature of services needed. Some of the primary services used by this group are HIV tests and treatment (Sevelius, Patouhas, Keatley, & Johnson, 2013). Transgender people are often involved in the sex industry, which is associated with high risks of being infected.
Moreover, this population often faces violence. Stanton et al. (2016) also state that transgender individuals often provide sexual services for housing. As for the issues associated with HIV tests and treatment, the target population is often reluctant to do regular tests due to their concerns about confidentiality. These people are afraid to meet people they know or to be seen by anyone (Sevelius et al., 2013).
Another significant issue related to transgender individuals’ HIV status is the nature of treatment. Transgender people are reluctant to receive HIV treatment as they fear that it will interfere with their hormone therapy (Stanton et al., 2016). Moreover, HIV treatment is rather time-consuming as patients often have to receive medication in different health-related facilities. However, many transgender individuals see waiting in lines for their medication as a waste of time as they have to work to pay for housing, food, hormone therapy, and so on (Sevelius et al., 2013). Irrespective of increased risks, this population chooses not to receive HIV treatment or associated services.
Furthermore, transgender people are often reluctant to address healthcare professionals due to their previous experiences. Transgender individuals seek for understanding and acceptance of their identities, so when they are treated like the rest of people, they feel frustrated and depressed. For instance, transgender patients may leave a healthcare facility if they are called by their ID name rather than the name they provide (Sevelius et al., 2013). They also choose not to receive healthcare services rather than be treated in certain ways.
It is noteworthy that transgender people tend to avoid any communication with healthcare professionals due to the lack of competence or discrimination healthcare staff reveals. For instance, Lim, Brown, and Justin Kim (2014) provide results of a study that revealed quite alarming results as 19% of the participants were denied health care due to their gender identity. Ethnic minorities face an even greater degree of discrimination.
Another study shows that 28% of transgender people were verbally harassed when they tried to receive healthcare services (Roberts & Fantz, 2014). As to the lack of competence, as well as structural resources, healthcare professionals tend to lack skills and knowledge concerning the use of hormone therapy and HIV treatment, particular needs of the target population, and so on. Healthcare facilities still do not have information systems that could reflect gender status of people as patients are divided into two gender groups, males, and females.
All these barriers have a considerable negative effect on this population’s health and well-being. Transgender people become prone to the development of severe forms of various infections as they do not have regular tests or checkups. These people may also suffer from complications associated with an inappropriate use of hormones due to the lack of knowledge and lack of access to high-quality consultancy (Roberts & Fantz, 2014). Clearly, these issues can have a larger impact on the entire transgender and LGBT community. It can have negative consequences if the issues remain unsolved.
As for the practices existing to address the situation, various healthcare facilities and health-related organizations have contributed to the development of numerous effective programs. For instance, Fenway Health, a health center in Boston, Massachusetts, provides various healthcare services that address transgender population’s needs (Reisner et al., 2015). The effectiveness of the program designed for transgender patients is obvious as the number of patients increased from eight in 1997 to 90 people in 2006. In 2014, the number of transgender patients of this healthcare center grew up to 1200 patients.
The services provided include but are not confined to primary care, family planning (alternative insemination), transgender care (counseling on medication, hormone use, rights, resources, post-operative wound care), HIV care, diagnostic imaging, infectious disease care, psychological support, and so on. The healthcare facility continues developing services to meet the need of this population.
Although such a complex approach to the issue is rather rare and a few healthcare-facilities provide such transgender-oriented services, many healthcare facilities try to meet the need of this group. For instance, healthcare facilities and health-related organizations provide the corresponding training to their staff. For example, the New York City Health and Hospitals Corporation was the first healthcare organization to require “a mandatory LGBT cultural competency training” for its employees (Lim et al., 2014, p. 31). Other organizations and facilities also try to raise their employees’ awareness on issues associated with the LGBT community.
Another positive trend in this sphere is an increasing interest in the problem among researchers. Various aspects of the issue have been explored, and many gaps have been identified (Roberts & Fantz, 2014). The major areas of concern include healthcare staff’s education and training, the development of proper resources and structures within the healthcare system, the provision of particular healthcare services, raising awareness among the transgender population. Researchers and practitioners have come up with possible solutions to the problem. Nevertheless, these efforts are still insufficient, and further research is needed to address the issue.
It is possible to consider a number of solutions and programs that could improve the situation. Clearly, raising awareness among healthcare professionals and transgender individuals should be a priority. The stakeholders should know about the needs of this population, available resources, and so on. However, training programs should not be confined to groups of healthcare professionals and training for the transgender population, although this stakeholder-oriented education should also take place.
Training programs should involve healthcare staff and transgender individuals (Keuroghlian, Ard, & Makadon, 2017). Such courses will not only raise the trainees’ awareness on the subject but will help them develop proper attitudes towards each other. As has been mentioned above, transgender people do not trust the healthcare staff as well as the entire system (Sevelius et al., 2013). In their turn, healthcare professionals tend to have negative attitudes towards the transgender community (Roberts & Fantz, 2014). Bringing these people together can improve the situation.
Besides, it is essential to make sure that healthcare facilities are prepared to meet the needs of the transgender population. Health organizations should provide the corresponding services with the focus on prevention. It is also essential to pay attention to the psychological well-being of these patients. The areas to pay attention to include HIV and STD, rights and resources consultancy, psychological support, medication and treatment consultancy, and the like (Stanton et al., 2016). Finally, healthcare facilities should have the information systems that could meet the needs of the transgender community (use of preferred names rather than ID names, specifying gender identity not gender, etc.). These components can make the programs aimed at addressing the needs of transgender people effective.
In conclusion, it is necessary to note that the transgender population still faces discrimination and stigma in the sphere of healthcare. Transgender individuals often have no access to high-quality healthcare services, which has detrimental effects on their health as well as the entire community. The modern health care can be characterized by an increased attention to the needs of this group. Numerous programs and incentives help transgender populations to exercise their right to healthcare services. However, there are still various issues. Education, the development of healthcare facilities’ structures and resources, and further research can result in the development of effective solutions to the problem.
References
Keuroghlian, A., Ard, K., & Makadon, H. (2017). Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming health care environments. Sexual Health, 14(1), 119.
Lim, F., Brown, D., & Justin Kim, S. (2014). Addressing health care disparities in the lesbian, gay, bisexual, and transgender population: A review of best practices. American Journal of Nursing, 114(6), 24-34.
Reisner, S., Bradford, J., Hopwood, R., Gonzalez, A., Makadon, H., & Todisco, D., … Mayer, K. (2015). Comprehensive transgender healthcare: The gender affirming clinical and public health model of Fenway Health. Journal of Urban Health, 92(3), 584-592.
Roberts, T., & Fantz, C. (2014). Barriers to quality health care for the transgender population. Clinical Biochemistry, 47(10-11), 983-987.
Sevelius, J., Patouhas, E., Keatley, J., & Johnson, M. (2013). Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus. Annals of Behavioral Medicine, 47(1), 5-16.
Stanton, M., Ali, S., & Chaudhuri, S. (2016). Individual, social and community-level predictors of wellbeing in a US sample of transgender and gender non-conforming individuals. Culture, Health & Sexuality, 19(1), 32-49.