While any data citing the number of individuals in our community who identify themselves as transgender and gender nonconforming is likely understated, one University of California researcher, Gary Gates, a LGBT demographer suggests the figure might amount to 700,000 people in the United States. What is clear, however, is that important social and health disparities exist throughout the lesbian, gay, bisexual and transgender (LGBT) community in our country. Further, and frighteningly, surveys completed by individuals who identify as transgender and gender nonconforming indicate that these youth and adults face a much higher suicide risk than the general population. According to the U.S. Centers for Disease Control and Prevention (CDC), suicide was the tenth leading cause of death for all ages in 2013.
The Suicide Fact Sheet of the CDC reports:
“There were 41,149 suicides in 2013 in the United States—a rate of 12.6 per 100 is equal to 113 suicides each day or one every 13 minutes.”
So while one may think being a person who identifies as transgender and gender nonconforming is strictly a social issue, it is not this alone. It is an important health issue for our society too.
One Colorado and Denver Health presented the findings of a report originally released in November 2014 titled, “Transparent: The State of Transgender Health in Colorado,” at the 2015 Public Health in the Rockies conference in Vail last week. Partners involved in the publication of this report also included the center, the Colorado Dept. of Public Health & Environment, and the University of Colorado at Denver’s Anschutz Medical Campus. One Colorado and Denver Health asked attendees to consider how the report can inform the work of public health professionals as individuals and of local public health departments in our state. It was explained that transgender and gender nonconforming individuals include persons both who participate in hormone therapy, as well gender confirmation surgeries, as well as those persons who chose not to. Summarizing not only the findings from the Colorado Transgender Health Survey, the report helpfully points out striking economic data, as well as identifying important transgender health resources that are worth sharing widely.
As stated in the Transparent: the State of Transgender Health in Colorado report,
“From societal issues of stigma and discrimination to practical barriers such as finding a health care provider, transgender and gender nonconforming people face a complex set of barriers to living healthy lives and financial stability.”
Only 48% of the Colorado Transgender Health Survey respondents reported being employed for wages. Many also reported delayed or avoided medical care, due to cost, fear of discrimination, or inability to find an appropriate health care provider.
The report’s key findings continue, “While the physical health of transgender Coloradans may be similar to the general Colorado population, the mental health outcomes are drastically different. Transgender Coloradans report alarmingly high rates of depression, thoughts about committing suicide, and suicide attempts.
Among the steps that can be taken to address the report’s findings are to advocate for increased use of gender-sensitive best practices training and professional development opportunities for physicians, registered nurses and physician assistants in our state, as part of their credentialing process. A major indicator, it turns out, for the health and well-being of transgender Coloradans, according to the report, is having access to a transgender-inclusive provider.
Addressing the social and health disparities that exist throughout the transgender and gender nonconforming community is not just a local issue. It is critical enough to merit the attention of the President of the United States in his January 2015 State of the Union address. As reported by Danielle Paquette in the Washington Post on January 22, 2015, President Obama states in his address:
“As Americans, we respect human dignity…” Obama declared. “That’s why we defend free speech, and advocate for political prisoners, and condemn the persecution of women, or religious minorities, or people who are lesbian, gay, bisexual, or transgender.”
More recently, on September 3, 2015, Ricardo Alonso-Zaldivar of PBS.org reported,
“Mirroring a shift in society, the Obama administration proposed Thursday to ban discrimination against transgender people throughout the health care system.
Once the proposed regulations are final, they should expand insurance coverage for gender transition and prohibit health care facilities from denying transgender people access to restrooms that match their individual gender identity.
The new protections are part of a broader rule from the Department of Health and Human Services to carry out anti-bias provisions of President Barack Obama’s health care law. In a first, the law specified that sex discrimination is prohibited in health care, and the regulation carries it a step further, clarifying that ‘gender identity’ is included under that protective umbrella.”
Alonso-Zaldivar continued in his article titled, “Obama administration plan protects transgender community’s access to healthcare,”
“The new transgender policy comes as social attitudes about sexuality and gender are undergoing major changes. The Supreme Court recognized a constitutional right for same-sex couples to marry, and the gender transition of Olympian Bruce Jenner from male to female — Caitlyn — has brought new awareness about a group often ostracized by society.”
At a time when mental health is at the forefront of the news, it must be acknowledged that the drastic differences in mental health for transgender Coloradans are unacceptable. Of the Colorado Transgender Health Survey respondents, 36% reported contemplating suicide in the past year, compared with 4% of all Coloradans who did the same thing.
I will also apologize up front that this article may do an inadequate job of offering comprehensive transgender and nonconforming gender health resources and data, however I did try feature the beginning of a foundation of resources to establish a starting point.
This said, to become a better ally of transgender and gender nonconforming people in our state, learn more about the resources that are available to you and your neighbors. These include joining the advocacy and education efforts of One Colorado, as well as learning more about the legal rights of transgender and gender nonconforming people. For example, in May 2014, the U.S. Dept. of Health and Human Services (HHS) issued a decision that overturned a long-standing exclusion of transition-related care, including many gender confirmation surgeries. This sets a precedent for other public coverage programs such as Medicaid to move toward addressing transgender health disparities, especially in health care coverage.
If you are a health care professional, One Colorado and Denver Health invite you to check out the 2013 training resource from the Colorado Medical Society called, “Health and Health Care for the LGBT Community: Identifying and Minimizing Disparities.” Another advocacy group to learn more about is the National Coalition for LGBT Health.