On Thursday, December 9th, the largest survey of transgender people ever conducted was published by The National Center for Transgender Equality. The anonymous online survey had nearly 28,000 participants and found transgender people are twice as likely to live in poverty and three times more likely to be unemployed, according to an article in TIME Magazine. Other findings included that one-third of respondents reported issues in finding healthcare and 42% reported higher rates of mistreatment by health care providers.
Fordham University Center for Ethics Education Director, Celia B. Fisher, Ph.D., lauded the recent national study highlighting the healthcare needs of transgender people in the United States. “More is needed on the health care experiences of transgender adolescents, especially their experiences with family physicians who often do not have the training to provide necessary gender affirming care,” she noted.
Fisher’s research with colleagues from Northwestern University, supported by the National Institute on Minority Health and Health Disparities (NIMHD), has highlighted the critical need for physicians who are trained and open to providing gender minority youth with not only transitioning information, but also gender and sexual orientation specific sexual health information and services to prevent HIV and related STIs.
The recently published article on doctor’s lack of expertise in treating transgender patients in The Guardian is an important step forward in highlighting current disparities in healthcare services for this population. The study, based on interviews with sample of 23 physicians and psychologists who chose to work with transgender patients, focused on current challenges in providing gender affirming care for individuals who are seeking medically supported transitioning treatments, such as hormonal replacement therapies (HRT).
The movement of the World Health Organization (WHO) to declassify transgender identity as a mental disorder is simultaneously a step forward in affirming the personhood of gender minority individuals, and a step backward in diagnoses that adequately reflect their health needs. The solutions posited by the WHO reveal the systemic influence of health insurance policies in defining not only medical disorders, but also social categories.
Currently, in the United States and abroad, in order to qualify for health insurance coverage for gender affirming surgery or hormone replacement therapy (HRT), mentally healthy transgender individuals must receive a diagnosis indicating a gender-related mental disorder based on either the WHO classification or the “gender dysphoria” diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders (DSM). In the hopes of fostering greater acceptance while still satisfying insurers, after 25 years, the WHO is considering a new diagnostic category: “Conditions related to sexual health.”
According to Dr. Celia B. Fisher, Director of the Center for Ethics Education and Professor of Psychology at Fordham University, the new terminology, while well-intentioned, “runs the risk of perpetuating stereotypes that conflate gender identity and sexual orientation and lead to continued misclassification of transgender personhood as a sexual problem.”
Apple vs. FBI is a sign of a dangerous divide Rogers and Grumet examine Apple’s decision to fight a court order to unlock an iPhone belonging to one of the terrorists involved in the San Bernardino, California, attack last year. They look at the ethical restraints on the FBI wanting software to unlock these devices.
On Monday, August 3, several organizations, including the Human Rights Campaign, the National Education Association, and the American Civil Liberties Union released “Schools in Transition: A Guide for Supporting Transgender Students in K-12 Schools.” The report, which addresses issues such as names and pronouns, dress codes, and puberty and medical transition “represents an important milestone in reducing health disparities among transgender youth, something that we are also working toward at the Fordham University Center for Ethics Education,” stated Dr. Celia Fisher, Center Director.
Today, the American College of Physicians called for action to address the entrenched disparities that LGBT people face in the healthcare system. The position paper, published in the Annals of Internal Medicine, asked medical providers, insurers, patients and others to address critical needs for members of the LGBT community, like non-discrimination protections, comprehensive healthcare coverage for transgender people, inclusive visitation policies, and research and training to better address the numerous health disparities LGBT people experience.