13 March 2015

Trans Men Face Discrimination And Harassment In Healthcare Serviices

In this blog, when I've written of Transgender Experience rather than my own individual transgender experiences, I have concentrated on male-to-female transgenders.  After all, that is what I am, so that is the experience I know best.

But my own personal point of view isn't the only reason why my discussion of trans experience is so slanted. Turns out that most of the research on trans people--as little as there is--focuses on male-to-female trans people.  There are probably a number of reasons for that.  One that I can think of off the top of my head is the perception that we far outnumber female-to-male transgenders.

Now, since I don't know all of the research, what I am about to say is conjecture.  Here goes:  There probably are more MTFs than FTMs.  However, I don't think we outnumber FTMs as much as has been commonly assumed.  I think we don't hear as much about FTMs because there is, I believe, less stigma attached to a "woman becoming a man" than a "man becoming a woman", just as masculine females aren't ostracized as much as feminine males.  Also, I think that because the vast majority of violence against trans people is against MTFs--especially those of color--our struggles have become more visible than those of FTMs.

Still, violence and discrimination are committed against FTMs.  And the latter happens in an area in which we, MTFs, are all too familiar with it:  in health care

Wayne State University researcher Deirdre Shires and  Kim Jaffee recently co-authored a report based on a study of 1711 FTMs throughout the US in 2008-09 and recently published in the journal Health and Social Work. Most of those surveyed were aged 25 to 44 years old. Three-quarters were living full-time in their non-birth gender and a similar proportion had undergone,  or were undergoing, some medical aspect of gender transition.  

Of those surveyed, 42 percent reported some form of discrimination--ranging from verbal abuse and unequal treatment to, in a number of cases, physical assault.  The report doesn't specify which health-care professionals (doctors, nurses, technicians or others) perpetrated the discriminatory and abusive behavior against the FTMs.  

The study's authors cautioned that their findings may not apply to the entire transgender community.  Dr. Laura Erickson-Schroth, a psychiatrist with New York University may have given one reason why, though perhaps not the one the study's authors had in mind.  She says, "the sample was skewed toward white, young, college-educated people with jobs and private health insurance".  That bias is probably not the fault of the researchers, for Dr. Erickson-Schroth was describing the sort of person most likely to answer (or, in the case of the trans community, even know about) surveys like the one Shires and Jaffee conducted. 

Thus, "If 42 percent of that group is reporting discrimination, the number may be even higher for others," according to Erickson-Schroth, who edited the book, Trans Bodies, Trans Selves.

Perhaps the most disturbing finding of all is that 65 of the study's participants said they never accessed care in a doctor's office or hospital at all.  Some may do so because they don't have insurance. But a more likely explanation--and one I've heard from both FTMs and MTFs--was articulated by Shires:  "I can't help but to wonder whether they avoided care completely because they feared harassment or discrimination".  If such is the case, I can understand:  Few things feel worse than being mocked, called names or, worse, being denied care or given inappropriate care by someone who's taken a professional oath to help. I say this from a couple of experiences I had early in my transition.

The taunts and intimidation I experienced came from two nurses in a specialty hospital where I was referred. I told the receptionist I was leaving and would seek my care elsewhere.  She called a doctor, who apologized and talked encouragingly to me before performing the work for which I'd gone to that hospital.

So, my advice to any trans person who experiences discrimination or harassment is to first report it to someone in the office, clinic or hospital.  If no one is available, or no one is wiling to help, then it should be reported to an organization like the Transgender Law Center, the Transgender Legal Defense and Education Fund or the National Center for Transgender Equality.

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