26 November 2012

Healthcare And The Transgender Lost Generation

How many people would take advice from someone who was deemed mentally ill?

And, what would you do if you suffered some sort of disease but no one who has suffered it would talk to you?

Those two questions, I believe, sum up at least one part of the reason why there is the lost generation of transgender pepople I've mentioned in earlier posts.  

In addition to discrimination and other problems, trans people of the 1950's, and even the 1980's, faced the stigma of being classified as mentally ill.  What this meant is that, in some places, they were subjected to treatment much like the kind suffered in some of this country's worst mental institutions.    Or they were referred to the wrong kinds of medical or pyschiatric practitioners for their difficulties.  That is not to mention, of course, all of the jobs that were unavailable to them, no matter their qualifications.

This belief that trans people are mentally ill is one reason why so much emphasis was placed on "going stealth".   Doing so also could prevent a trans person from experiencing discrimination in workplaces, schools, social service agencies and other ares.  

The hostility they faced also deterred many from getting the health care they needed.  This, of course, cut more than a few trans people's lives short:  Such was the story of a few older trans people I knew.  Not that I used the past tense:   They are no longer in this world.

I discovered another effect of what I've just described in 2005-2006, when I was writing a pamphlet on how to access health care for the Transgender Legal Defense and Education Fund .  Although I knew a fair number of trans people by that time, it was difficult to find older trans people with whom I could discuss such things as long-term health issues trans people experience as they age--or, for that matter, the issues they faced in getting the healthcare they needed.  Of course, I could--and did--talk to the health care providers.  But providers can talk mainly about treatments and therapies; only someone who has experienced those things can talk about coping with the effects of treatments and medications, or about some of the emotional and mental issues someone who's in the process of a gender transition might face.

What the experience also taught me is that trans people of that time didn't have others with whom they could share the wisdom borne of their experiences.  Part of the reason for this is in going "stealth", they could not disclose much about the issues--including discrimination and, in a few cases, outright hostility, they might have faced.  So, in not passing their knowledge and wisdom onto their "children"--because those "children" weren't there--the new generation of trans people I was seeing had no one from whom they could learn.  Thus, in the middle of the last decade, the level of healthcare (excluding surgeries) available to most trans people, and their level of sophistication in accessing it, was really not much (if at all) better than they were two or even three decades earlier.

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