Transgender health care
[12] Some studies posit that treating gender variance as a medical condition has negative effects on the health of transgender people and claim that assumptions of coexisting psychiatric symptoms should be avoided.
The informed consent model is an alternative to the standard WPATH approach which does not require a person seeking transition related medical treatment to undergo formal assessment of their mental health or gender dysphoria.
[19] While the WPATH standards of care generally require the patient to have reached the age of majority, they include a separate section devoted to children and adolescents.
After puberty, some medical intervention is available for adolescents depending on specific criteria for gender incongruence diagnosis, capacity for informed consent, and mental and physical health.
According to UCSF Transgender Care, "The primary class of estrogen used for feminizing therapy is 17-beta estradiol, which is a 'bioidentical' hormone in that it is chemically identical to that from a human ovary.
This therapy induces breast formation, reduces male hair pattern growth, and changes fat distribution, also leading to a decreased testicular size and erectile function.
[17] On July 1, 2022, the FDA issued an update that gonadotropin-releasing hormone agonists, drugs that are approved for treating precocious puberty, may be a risk factor for developing pseudotumor cerebri.
As evidence has shown that trans women tend to have lower motile sperm compared to their cisgender counterparts,[36] fertility preservation can be important for individuals anticipating having biological children in the future.
Transgender Law Center expand their work to multiple important areas, including but not limited to, healthcare access, education, employment and housing.
GLMA provides resources along with edcational programs to help healthcare professionals gain the knowledge and skills in giving appropriate care to LGBTQ patients whilst hosting conferences and workshops to foster the environment for discussion of the latest research or emerging issues in the field.
[60] Specifically, in resource-constrained settings where non-discriminatory policies may be limited or not enforced, transgender people may encounter high rates of stigma and violence which are associated with poor health outcomes.
As noted by a systematic review conducted by researchers at James Cook University, evidence reports that 75.3% of respondents have negative experiences during physician visits when seeking gender identity-based care.
[96] In the studies conducted by researchers, transgender participants reported experiencing stigma, prejudice, barriers and discrimination resulting to avoidance or delaying of health care.
[97] According to the systematic review conducted by Hermaszewska and colleagues, "some transgender people are forced to migrate to countries that offer them better legal protection and wider social acceptance.
[122] Additionally, the typical lack of access to transition options that comes as a result of gatekeeping is compounded by the relatively limited knowledge of transgender topics among psychiatrists and psychologists in South Africa.
Multiple interdisciplinary clinics exist in Spain to cater specifically to diagnosing and treating transgender patients, including the Andalusian Gender Team.
[135] In 1972, Sweden introduced a law that made it possible to change a person's legal gender, but in order to do that, transgender individuals were required to be sterilized and were not allowed to save any sperm or eggs.
The activists demanded that their voices be heard regarding the way the country, healthcare, and the National Board of Health and Welfare mistreat transgender and intersex individuals.
[146] Sweden's Karolinska Institute, administrator of the second-largest hospital system in the country, announced in March 2021 that it would discontinue providing puberty blockers or cross-sex hormones to children under 16.
Additionally, the Karolinska Institute changed its policy to cease providing puberty blockers or cross-sex hormones to teenagers 16–18, outside of approved clinical trials.
The Dutch Ministry of Health, Welfare and Sport publishes guidelines recommending the use of puberty blockers in transgender adolescents of at least Tanner Stage II with informed consent and approval of an endocrinologist.
[154][155] The ruling means that it is illegal for any health authority in England or Wales to put a blanket ban on gender-affirming surgery relating to transgender people.
[157] In 2018 Stonewall described UK transgender healthcare as having "significant barriers to accessing treatment, including waiting times that stretch into years, far exceeding the maximums set by law for NHS patients".
[159] As of May 2024, prescription of puberty blockers to new patients under 18 for the treatment of gender dysphoria is banned for both private medical practices (by a law in parliament in May[160][161]) and the official state healthcare National Health Service (NHS) which stopped their use earlier, in the aftermath of the Cass Review except for use in clinical research trials.
[178] Minister for Public Health Maree Todd has stated that the Scottish Government wants to reduce "unacceptable waits to access gender identity services".
[189] According to the Canadian Pediatric Society, "Current evidence shows puberty blockers to be safe when used appropriately, and they remain an option to be considered within a wider view of the patient's mental and psychosocial health.
In addition to the guidelines, multiple Mexican states have modified their civil codes to recognize gender-affirming healthcare as a right for transgender people under the age of eighteen.
[1] Various factors play a role in creating the limited access to care, such as insurance coverage issues related to their legal gender identity status.
The mental effects of GnRH modifiers are positive with treatment associated with significant improvements in multiple psychological measures, including global functioning, depression, and overall behavioral and/or emotional problems.
[205] In a two-year study published in January 2023, Chen et al. found that gender-affirming hormones for transgender and non-binary youth "improved appearance congruence and psychosocial functioning".
