Trans Health: International Perspectives on Care for Trans Communities (Gender Studies)

Cis (or cisgender) is the term used to describe people whose gender is congruent with the sex assigned to them at birth. Cis people can be critical of and question stereotypical gender images, but subjectively they do not feel any dissonance between their gender identity and the sex assigned to them at birth. Cis-Normativity is the assumption that everyone identifies with the sex assigned to them at birth and that there are only two sexes -female and male. Due to cis-normativity, people whose gender is different from the sex assigned to them at birth encounter a variety of individual and structural barriers and discrimination in the course of their lives. The gender identity of cis people is usually not questioned, as long as their gender performance is in line with the norm. Trans and gender diverse people, on the other hand, continuously find themselves in situations where they have to justify their identity and fight for its recognition. Deadname is the first name given to a trans or gender diverse person (usually by their parents at birth) before their transition. Many trans and gender diverse people reject this name for themselves and decide to use a new name. Questions about the previous name are often considered inappropriate or invasive by trans and gender diverse persons. Gender is the socially constructed idea what it means to be a 'woman' or a 'man'. This description includes not only one's own gender identity, but also the gender roles that are perceived and reproduced in our society through language, external characteristics and behavior. The lived and performed gender does not have to match the sex assigned at birth. Transition describes the process of a trans and gender diverse person adapting to their lived gender on a social, physical and/or legal level. This affirmation takes place individually for each person and can involve one or more steps. Some trans and gender diverse people decide for themselves only one type of social transition (e.g., change of first name, pronouns, external appearancei.e., in the form of different clothing) without desiring a legal or medical transition. Others may wish to transition on various levels. It is important to note that it is only the individual person who determines what the desired steps are. There is no 'right' or 'wrong' way of a transition. Additionally, in many countries, laws exist that hinder trans and gender diverse people's ability to transition, and in some countries, trans and gender diverse people are legally and socially persecuted if they attempt to do so. Transsexuality is a term often rejected by people from the trans and gender diverse community because it was originally coined in the 1950s by cis doctors to distinguish between supposedly 'healthy' (cis) and supposedly 'sick' (trans) people. The term is therefore pathologizing since it is still associated with the diagnosis of a mental disorder. In addition, the term is criticized because the ending '-sexuality' is misleading. Being trans or gender diverse refers to the gender identity of a person and not to their sexual identity. Given the diversity of the trans community and the large number of possible identifications, some trans and gender diverse people nevertheless choose this term for themselves, as they feel it to be their own and it is often easier to convey this term. Vaginoplasty is the surgical procedure of shaping a vagina. This procedure is colloquially called bottom surgery. Contents Glossary Introduction “The law is not going to tell us how to care for the patient.” – Health Professionals and the Argentine Gender Identity Act The Context of Health for Guatemalan Trans People Access to Trans Healthcare in Russia Healthcare Access of Trans People in Rwanda Determinants of Access to Healthcare Among Trans Women in North Central Nigeria Access to Gender-Affirming Care in South Africa – A Landscape in Transition No Data, No Problem? Community-Driven Responses to Public Health: An Example from England’s HIV Sector Cultural Competency with Non-Binary and Genderqueer Individuals: Results from a Qualitative Participatory Action Research Pilot Study Trans in Practice, Transition in Sequence: Providing Medical Assistance for Gender Transitions in Trans and Gender Non-Conforming Youth The Parallel Process of Trans Mental Health Providers – The Strengths and Complexities of Working as a Trans Person in Mental Healthcare Ganda ng Transpinays: Narratives on Trans Health, Barriers to Care and Trans Sisterhood in the Philippines Dis-ease of Access: Health and Cancer Care Survey for Trans and Gender Diverse Australians Do Trans People Age Differently? Empirical Findings of International Studies on Trans Identities, Health and Age(ing) About the authors (in order of appearance in the book) Although social scientists and practitioners have shown an increased interest in the inclusion of trans persons in recent years, the current position of this group in the (medical/psychological/nursing) care system remains under-researched. Studies tend to merge the issues of gender diversity and sexual diversity, rendering the lived experiences of trans persons invisible. In addition, trans people often face a discriminatory environment in which they are pathologized and stigmatized as mentally ill. This anthology addresses trans people's access to healthcare from a transnational perspective, and offers courses of action to improve nursing, medical, therapeutic, and social care for trans persons. Most contributions of this book are written from a lived trans experience. Around the world trans and gender diverse people are marginalized and discriminated against in medical, psychological, and nursing care. This anthology is the first to address the current situation of this population in various global healthcare settings. The perspectives from 11 different countries give insight into the difficult experiences of the trans and gender diverse community when seeking healthcare, and how self-organized community structures can help to overcome barriers to often inaccessible public healthcare systems. The majority of contributions are written from a lived trans and gender diverse perspective.