Access to gender-affirming healthcare can be life-saving for people of different genders.

The care that is gender-affirming is about affirming the gender identity of the person. It wants to make sure that the person is not a disorder.

People who surpass traditional expectations of gender identity or expression may be referred to as tranny.

Discrimination, ignorance, and systemic biases can lead to health disparity for trans people.

Little gender-affirming healthcare existed until recently. Research shows that limiting gender-affirming medical care can have negative effects on health.

The healthcare of a trans person is patient-centered and works to align their physical characteristics with their gender identity. It may include a variety of services.

As of 2022, this type of healthcare is coded in the 11th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-11) under the term, or diagnostic category, “gender incongruence” in the chapter “conditions related to sexual health.”

It’s now clearer that gender incongruence isn’t a mental disorder, but with a substantial need for gender-affirming healthcare, the World Health Organization decided there are needs that can best be met if gender incongruence remains coded under the ICD-11.

Hormone therapy

For adults who were assigned female at birth, testosterone hormones can be used, as well as estrogen hormones and testosterone blockers. It is prescribed to help a person gain the characteristics that match their gender identity.

“This involves using hormones to temporarily stop puberty in children who haven’t gone through puberty. Puberty blockers allow more time to explore gender identity before puberty starts.”

During this time, individuals can decide if they want to pursue less-reversible gender-affirming medical interventions, such as hormone therapy or surgery.

If puberty is allowed to continue, more surgeries might be needed to reverse the development of breasts, facial hair, and body hair.

Surgery

There are few surgical options that are suitable for the situation. Not every person who is trans will want gender-affirming surgery. There are surgical options.

  • Top surgery. Also known as chest reconstruction, this surgery creates either a male-typical chest shape or enhances breasts.
  • Bottom surgery. This is gender-affirming surgery on the genitals or reproductive organs.
  • Facial feminization. This involves a range of procedures that change masculine facial features into feminine features. It may include hairline reconstruction, cheek augmentation, jawline reduction surgery, and rhinoplasty (aka a “nose job”), among other procedures.

Social affirmation

“Social affirming includes clothing, hair, and name aligning, and use of facilities with a person’s gender identity.”

“For many people, pronouns are a way to affirm an aspect of their gender that is not in line with other people’s assumptions. Pronouns can help affirm a person’s existence.”

Misgendering is when a pronoun or gendered word is used to refer to someone. These pronouns are gender-neutral. Examples include:

  • He/him/his.
  • She/her/hers.
  • They/ theirs.
  • Z/zir/zirs
  • ze/hir/hirs

Before a child can be eligible for medical and surgical interventions, they need to be listened to and respected for their identity.

Francis Kuehnle MSN, RN-BC (They/ theirs.), a lecturer at the University of Iowa College of Nursing, clarifies that, “Gender-affirming care for children is accepting them where they are at and listening to how they feel about their bodies.”

Mx. Kuehnle, who is trans and has experience working with trans patients as a nurse, describes spending a lot of time with the parent to make them feel better about their child being trans.

Nonsurgical options

There are non- surgical options for aligning certain physical aspects of gender identity.

  • Name and gender marker changes.
  • To create more masculine or feminine frames.
  • There is hair and makeup.
  • Speech therapy can help match vocal characteristics.
  • Laser treatment, electrolysis, or waxing are used for hair removal.
  • The chest is binding.
  • There is breast padding.
  • The genitals are tucked.
  • Stand-to-pee devices.
  • The buttocks or hips have padding.

The mental health and well-being of gender-diverse people are improved by gender-affirming healthcare. It is important to realize that gender-affirming care is life-saving.

Trans individuals have physical and psychological benefits from gender-affirming healthcare. The benefits are inextricably linked.

Physical

Trans individuals can align their physical attributes more closely with their gender if healthcare is gender-affirming. The physical changes lead to improved body image.

In one 2022 study, participants who accessed gender-affirming healthcare at an earlier age also had lower rates of binge drinking and drug use, suggesting an overall healthier lifestyle.

Psychological/mental

Experts agree that access to gender-affirming healthcare can improve the mental health of trans individuals.

  • The rates of suicide are lower.
  • Depression, anxiety, and other mental health concerns are lower.
  • The incidence of self-injury is lower.

A large-scale 2021 study, for example, showed a significant link between access to hormone therapy and lower rates of depression, suicidal thoughts, and suicide attempts among transgender youth in the United States.

Interplay between psychological and physical

The physical changes that come with puberty can cause extreme distress for many gender non conforming teens and young adults.

Dysphoria can be difficult to function in daily life for some trans people. Kuehnle says affirming care can improve quality of life and decrease suicidal thoughts in trans people.

“It is important for a person’s psychological well-being to feel comfortable in their own skin, and physical aspects of gender-affirming healthcare can help. This is true for adolescents.”

Some people with transmasculine skin have a chest binder to help with the effects of having breasts. Keuhnle says that he wore one for years and it helped him feel more comfortable.

I was working 12-hour shifts and wore a binder for about 6 hours. I had to choose between physical or emotional pain before I had surgery.

A ripple effect

Improved access to gender-affirming healthcare for one individual can have a domino effect.

Trust is the most pervasive benefit I see in care. It is common for people in the trans community to check out a service provider before they go. You are very likely to see others come out of the woodwork when you build those relationships.

Kuehnle says it happened at a hair salon. A large portion of their clientele were members of this community.

A lack of general knowledge about best practices is one of the reasons why there are barriers to accessing healthcare for trans people.

In one 2021 study, one-third of respondents reported having at least one negative experience in a healthcare office related to being transgender. These experiences involved being verbally harassed, having to teach their doctor about transgender people to get appropriate care, or even being refused care altogether.

If a clinic provides gender-affirming care and publicly advertises and shows this, people with other concerns related to this may feel more comfortable bringing this up with their doctor.

It shows that this is a safer place to have a discussion about identity.

Different people have different meanings for nonbinary. It is a term to describe someone whose gender is not defined by the genders of woman or man.

“The term gender diversity describes various gender identities and expressions that don’t conform to the societal expectations of the male/female.”

Everyone on the gender incongruent spectrum should have access to gender-affirming healthcare. Non-binary individuals need to be able to express and explore their sense of self with their healthcare professionals in a safe environment.

Non-binary individuals may have different surgical goals, but procedures can be combined to create the body which best reflects their gender.

“Everyone’s path will be different, and doctors are beginning to realize that gender identity is a spectrum. When talking to your doctor, you should tell them about your goals and your own.”

“You shouldn’t feel rushed to make decisions because there is a lot to talk about. You should talk about the following with your doctor as you build your relationship.”

  • Your family history and medical history.
  • There are potential side effects of hormones.
  • Fertility and parenting desires are included.
  • You may need additional cancer screenings once you start hormone therapy.
  • If you are sexually active, you should know your sexual history and what you should do to reduce your risk of STDs.
  • If you are experiencing any of the above.

If you still have questions or are uncertain about your journey, you can ask your doctor for a referral to a health educator who focuses on trans health.

The following resources can be used to find a healthcare professional who is welcoming and knowledgeable of the trans community.

  • Mytranshealth, a free directory that connects trans people with qualified, culturally competent healthcare providers
  • Outcare, a nonprofit that maintains a directory of providers who identify as specialized in the care of the LGBTQ+ community.
  • Gay and Lesbian Medical Association (GLMA), a free directory of healthcare professionals with experience working within the LGBTQ+ community.

Keep in mind that current federal and state laws prohibit health insurance plans from excluding transition-related care.

With an estimated 150,000 youth and 1.4 million adults who identify as transgender in the United States today, understanding and improving the health and well-being of transgender people and other gender minorities is crucial for the trans community.

Some states are trying to take away some of the affirming care for trans and non-binary youth.

“The effects of this care can be seen in the rest of the person’s life. Without it, people with trans issues may turn to harmful coping skills.”