Access to Healthcare for Transgendered People

Saturday, 29 July 2017

Hatice Kaya, PhD
Yeliz Culha
Nuray Turan, PhD
Gulsun Ozdemir Aydin
Aysel Ozsaban, MSc
Department of Fundamentals of Nursing, Istanbul University, Florence Nightingale Nursing Faculty, Istanbul, Turkey

Purpose: Transgendered people are more vulnerable and at risk in terms of certain diseases. These people are more hesitant on health protection and cannot benefit from health care services for various reasons.

Methods:  In this article, the relevant literature and research findings on transgendered people's attitudes to protect their health and the responsibilities of the nurses in this regard were examined and discussed, and application-oriented suggestions were offered.

Results:  The concept of transgenderism was firstly addressed in the Diagnostic and Statistical Manual DSM III under the heading of psychosexual disorder. transgenderism is person's rejection of anatomic gender and desire to have the primary and secondary sex characteristics of the opposite sex. The incidence of male and female transsexualism is not completely known in the world and in our country. According to the World Professional Association for Transgender Health (WPATH), the ratio of female transgenders has been stated between 1/30.400 and 1/200.000, and the ratio of male transgenders has been stated between 1/11.900 and 1/45.000. Transgendered people have a transition period to physical appearance or gender expression specific to the gender they perceive. Hormone replacement therapy or surgical operation is widely used in this period. There are risks associated with hormone therapy such as venous thromboembolism, cardiovascular disorders, diabetes mellitus, cancer and osteoporosis. Transgendered people are at increased risk for HIV, sexual violence and mental health problems, depression, anxiety and suicide. In these people, risky health behaviors such as smoking, alcohol and substance abuse also increase the incidence of these diseases. To understand the health risks of transgendered people is important and ensures the effective provision of health care. However, it was seen that there was a strong relationship between access to health care services of these people experiencing stigma and othering in the society and its consequences. In the study carried out by Yılmaz and Göçmen (2015) with lesbian, gay and transgendered people, 7.6 percent of the people who participated in the study stated that they did not receive treatment and delayed their treatment for the fear that they would be exposed to discrimination. Nurses have an important position in the protection and development of the health of this group and in increasing the quality of care they receive.

Conclusion: Nurses should raise these people's awareness on hormone usage, the ways of protection from sexually transmitted diseases, the importance of early diagnosis in the prevention of cancer, the prevention of risky behaviors such as smoking, alcohol and substance use, and the ways of protection from depression by taking part in awareness-raising trainings related to the health of transgendered people. Nurses should help to improve the quality of life of the people by making them feel that they are away from prejudice during the entire care process.