The New Gender Paradigm
Medical Treatment Protocols
There is an alternative. Here are medical treatment protocols that begin with the understanding that transsexuality has a biologic cause -- it's not a mental illness. Treatment doesn't require a psychiatrist's permission.
These protocols are intended for healthcare professionals, although statistics show that 50% of the time, the patient ends up teaching the doctor what to do. These protocols will help: Diagnosis is based on the patient's findings rather than their endurance. Treatment makes use of cutting edge technology, instead of obsolete left-overs from the 1960's. The protocols include nursing care and office policies.
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NOTE: I, the author, am a medical doctor (MD -- University of Colorado Medical School) licensed in Virginia, with 35 years experience in providing care to the gender community, both children and adults. I did 6 years of post-doctoral residencies and fellowships. I'm board-certified in three medical fields.
The transsexual community is divided into two groups: the haves and the have-nots. Privileged transsexuals have jobs. Their jobs offer generous healthcare benefits -- with enough money left over for cosmetic surgery (eg, facial reconstruction). When transitioning is complete, the elite pass easily in mainstream society. They're the beautiful people who are put into leadership positions in support and advocacy groups.
The have-nots lose their jobs at the first mention of "transsexuality". They live in abject poverty without adequate housing or support. Sex work is the only option for survival. Lack of access to the healthcare system forces many to take street hormones and silicone injections. Without access to a doctor, they can't obtain driver's licenses, social security cards, passports or other identification documents. HIV is rampant. Their life expectancy is short.
The laws & social policies advocated by the privileged elite serve to widen the gap between the haves and the have-nots. WPATH has created so many obstructions to healthcare that only the privileged can afford it: there are unnecessary but mandatory psychiatric evaluations and expensive psychotherapy. A mental illness diagnosis brings additional health insurance exclusions.
For the elite, maintaining the status quo is just fine.
On 1 October 2013, the Affordable Healthcare Act of 2010 went into action. The Act's goal is make healthcare more accessible to a large segment of the American population through mandatory private insurance. Unfortunately, that insurance still specifically excludes medical care for transsexuals -- who are forced to buy insurance that discriminates against them.
For more information, go HERE.
WPATH on the Warpath
WPATH is the single greatest obstacle for transsexual access to healthcare. Their Guidelines begin with mental disorder and add scores of reasons for not allowing a patient to transition--or to make that transition as difficult and expensive as possible -- or to achieve the worst possible outcome at the greatest possible risk & expense.
But there are better published treatment guidelines and even WPATH states that their Guidelines should be tailored to meet the needs of the patient. Except not in actual practice. There's enough hostility in the WPATH document to meet the needs of the most rabid transphobe. WPATH has enough name recognition that their treatment refusal is final and unanswerable.
Transsexuals can't achieve access to quality medical services without first weakening the iron grip WPATH holds on the healthcare system.
For more, see HERE.
Transsexuals depend on the health care system for their survival. Yes, they get sick, they have accidents, they get depressed -- just like anyone else. But they also have unique needs:
-- TRANSITIONING: Right-gender expression usually requires a lifetime of hormonal treatment. Surgery may be needed to correct a person's chest and/or genital appearance.
-- HEALTH MAINTENANCE SCREENING: Transsexuals have a unique schedule for screening tests such as mammograms, pap smears, prostate screening, etc.
-- HEALTH CARE RECORDS: Current society is rabidly transphobic. In order to survive successfully in mainstream society, it's necessary to hide every hint of transitioning. Outing usually leads to loss of job, family & housing; inflicts withering harassment; and may even lead to death due to hate crime violence. And the information is all there in the health care records. They must be handled with care.
For a transsexual, access to medical care is blocked at every level:
-- OUTRIGHT REFUSAL: 24% of the time, a transsexual is turned away at the clinic door. That includes Emergency Rooms turning away transsexuals suffering from appendicitis, a broken arm, cancer or any other reason. It's not just healthcare facilities sponsored by religious groups.
-- HARASSMENT: 28% of transsexuals report being verbally harassed by the medical facility staff. Wrong names & pronouns are used. A transsexual's medical status feeds the gossip mill. Wrong-gender room assignments are common.
-- FINANCIAL: 48% of the time, a transsexual won't get needed care because they can't afford it. Around 22% of transsexuals don't have any insurance; another 24% have public insurance that specifically excludes transsexual treatment. Of the remaining 54%, most have insurance that likewise excludes transsexuals from reimbursement.
You may think you have coverage, but you don't. For information about the impact of federal health care reform, go HERE.
-- INADEQUATE CARE: 50% of healthcare providers admit to being unfamiliar with the diagnosis and treatment of transsexuality. Even those that are knowledgeable use inadequate dosage amounts and dosage forms. Various treatment guidelines exist, but most use protocols that date back to the 1960's. 85% of transsexual patients have been forced to undergo unnecessary and ineffective psychotherapy in order to access healthcare.
Working for the Cure
Lives depend on specifically addressing and resolving these basic problems:
-- ACCESS, FINANCES, QUALITY --
Today's social values are the root of the trouble. Mainstream society must be convinced that transsexuals are human beings, with joys and needs common to everyone. But the greatest catastrophe of all is that healthcare providers themselves create those social values. It's physicians who ignore the science while promoting myths about mental illness. The supposed "experts" freely admit that their goal is to eliminate transsexuality rather than treat it.
The gender community must recognize the threat posed by the medical community. Trans people and their advocates can demand unbiased professionals who offer quality of care. But the current course of bowing to medical tyranny will have to stop.
Injustice at Every Turn: A Report of the National Transgender Discrimination Survey by Jaime Grant et al, National Gay & Lesbian Task Force (NGLTF) & National Center for Transgender Equality (NCTE) 2011.
© Cassandra Branch MD