Each year, folks around the world commemorate Transgender Day of Remembrance on November 20. It is often a somber event—one that pays tribute to the trans men and women who are victims of transphobic violence, especially trans women of color.
However, it has also turned into a day of action and one of empowerment. Since 1999, TDOR has created a platform to discuss and demand trans rights and visibility.
At Apicha CHC, our trans patients matter, and their needs are important to us. In an effort to support and participate in TDOR, we asked several of our own Trans/GNC staff to talk about their experiences and sentiments on trans health care.
What kind of obstacles do you think transgender folks face when receiving health care?
Tara, Care Manager for Health Home: There are an exhausting number of barriers to getting competent trans health care, but let’s start with the unequal access to health care. If you grew up in a smaller town or city like I did, you would have to travel into the big city to find a health provider who appreciated the fact that trans people existed, and surprisingly, may need medical care, no less find one who took your insurance, and was competent in providing that care (did not persistently misgender you, understood that trans women still had prostates, knew how to appropriately prescribe and monitor your hormones, and did not treat every ailment as an invention of your imagination).
Misty, Trans Health Patient Navigator: There are many obstacles we as trans folks face when it comes to health care. The most common being mis-gendered (even if you have all your legal documents changed), not receiving proper medical attention because the provider doesn’t want to deal with “our kind,” and humiliation being put on display as a freak show by staff members that find your trans identity very humorous.
Daniela, Trans Health Care Coordinator: In order to receive appropriate medical services, Trans/GNC people very often find themselves in a strange and uncomfortable position when medical providers are not well trained to better serve us. My major worry is that some community members are at high risk of serious medical complications. The lack of understanding of the unique needs of this community makes accessibility harder. Many patients will try to avoid navigating the entire health care system, which is often challenging their gender identities and expression. In addition, it is emotionally and physically exhausting trying to educate health care staff all the time.
What are the most important things you look for in a health care provider?
Tara: I feel that like most people, trans folks come in with different histories, levels of understanding, and insight into what their needs are, and ideally any provider should be able to provide the same level of initial care and guide them along to improved wellness. So, I feel it’s essential that providers know how to help trans people feel affirmed, consistent with the way they see themselves, and safe not only in that intimate space they’re sharing with you, but ultimately, also in their own bodies. Most of the time, if I’m disclosing my trans history to you, I’m pretty much willing to disclose anything to you, and I need to feel like I can trust you with that knowledge, and as a medical provider, that you know what to do with it. When it comes down to it, I just want the best care possible.
Daniela: A health provider must show the capacity of administering professional care while maintaining a good rapport with their Trans/Gender Non-conforming patients. This could be achieved by showing at least a minimal level of respect by getting to know who their patient is including their gender identity and preferred pronouns. In my opinion, the problematic of the mistrust in the relationship doctor/patient is more than just a face to face issue. Unfortunately, across the board we are experiencing that less medical providers want to take care of the most vulnerable and that less and less time is being allocated for each patient’s visits; therefore, increasing the number of patients who give up on the system altogether.
Calie, Trans Health Patient Navigator: One of the most important qualities I try to find from my health care provider is that they are knowledgeable about my body and my needs. I would prefer that they are respectful of myself as an individual and what’s important to me. I’d like if they have an overall friendly disposition when communicating with me and not be so sterile and clinical.
What are your biggest concerns regarding receiving health care?
Sylver Guadalupe, Trans Health Patient Navigator: Some concerns I have when it comes to health care is that there is a lack of understanding. When it comes to the trans community, we need to be treated with a little more understanding and respect. Something that I experienced a while ago, was disclosing to a provider that I am gender non-conforming and they respond with responses like “is that a phase” or “that’s something millennials are doing.” More providers need to educate themselves and separate their personal feelings and do what they worked all those years to get a degree for.
Calie: My biggest concern and fear is having something very serious with my health not being diagnosed. Another concern is how insurance carriers have lack of services approved for transition medical needs. They refuse to cover real needs. They also lack in coverage and in approval for necessary medications and procedures.
Tara: Small secret about trans care in the US – there has historically been precious little research on how to best support the medical transitions of trans people. Most if not all hormones and blockers were originally tested for conditions such menopause, prostate cancer, and hypertension, but have found to be beneficial in supporting the medical transition of trans folks, and are used off-label. A lot of trans people willingly take those unstudied risks because for many, it is a matter of survival. And when you work with a population that is generally willing to take those risks, having a competent provider who KNOWS trans care, both in terms of holistically caring for the person, as well as knowing the science, and can be a guide and advocate, is important. My concern is that providers are constantly asked to do more with less nowadays. Trans people can be easy to give up on when things get complicated and outside a provider’s comfort level.
What kind of stigma and stereotypes have you experienced, or think trans people experience?
Daniela: Trans people are perceived as deceitful, mentally ill, and unstable. Over the years we have been considered an extension of the “sexual orientation” spectrum when in reality many of us would consider ourselves straight. It is great to be a part of a bigger community (LGBTQ), but I feel it is time to go beyond our understanding of diversity and start embracing all the types of gender identities that exist. We need more than just empathy, we need more Trans/GNC people occupying important roles, specially providing care to our own. We need allies who genuinely see who we are as human beings and believe us when we disclose our gender identity.
Sylver: Being told what I am, who I should be, and what I need without asking me. Being told what we want without speaking to community is something that a lot of organizations do. Comparing trans needs to MSM (men who have sex with men) needs, is something that is constantly happening. When placed with these stereotypes it discourages individuals to disclose things to providers that maybe vital information. We are coming from all walks of life and providers need to be ok with that even if the road isn’t familiar to them.
How do you think transgender folks and allies can break stigmas against the trans community?
Tara: Diverse representations in the media would go a long way to normalizing and humanizing our existences. I think that will naturally help overcome some of the engrained stereotypes we have about trans people. We also need allies in positions of power to support us and our communities, and provide us with more than just token roles, and actual, meaningful opportunities to contribute in making our world a better place. Also a reminder to allies - if you make a mistake, learn from it, apologize, and don’t dwell on it. And also allow others to do the same. No one’s perfect, and with all the right answers, all the time.
Calie: By creating stronger relationships within all organizations and projecting optimistic and strong representations of what a trans person is. We are slowly making greater strides in the last 10 years, but we still have much more to do. Suicide and living in the closet in shame is a terrible feeling for any human. In the future, hopefully society's perceptions and view of transgender individuals will be enlightened and much more embraced.
Daniela: I think that critical issues affecting the lives of Trans/GNC people need to be debated and discussed even when this means to have uncomfortable conversations, because the demand for better services is huge and cause a lot of detrimental conditions among the community. The approach needs to provide ample space and voices for those who fall in the intersection of the most affected populations.
Apicha CHC Trans Health Clinic
At least twice a month, Apicha CHC offers a Trans Orientation Sessions for trans* folk to come in and learn about Apicha CHC’s Trans Health Clinic.
This clinic is for the specific needs of transgender, gender non-conforming, gender variant, genderqueer, and any individual who falls within the gender spectrum but doesn’t feel aligned with the gender assigned at birth.
Our Trans Health services include:
- Personalized Primary Care
- Routine Check-Up and Immunization
- Initiation and Maintenance of Hormone Therapy
- Short-Term Mental Health Services
- Care Management
- Trans Groups
Please feel free to request an appointment to attend a Trans Orientation Session to learn more about trans health and Apicha CHC's Trans Health Clinic.