Nov. 14 – 20 of this year (2015) is Transgender Awareness Week; and one major issue facing those in the trans community is the process of accessing healthcare that is inclusive, respectful, and knowledgeable of non-binary gender identities. (Yahoo Health)
Cazembe Jackson of Atlanta, Georgia, has lived one of the most difficult, traumatic iterations of needing healthcare as a trans person. While a junior in college, and out as a gender non-conforming person, Cazembe was raped, became pregnant – and quickly found himself in the acutely painful situation of being someone other than a woman in need of abortion care.
Cazembe ultimately found the care he needed at a Planned Parenthood health center.
“More than the accessibility was the name Planned Parenthood. It’s a trusted name,” notes Cazembe, who now identifies as a trans man. “I knew I could go there and be safe. As a trans, gender non-conforming person seeking healthcare – especially abortion, which is thought of as something that only women do – the thing about Planned Parenthood is that when you go in for treatment, it’s about treating you. It’s about making sure that what you need to get done is done and that the services you need are provided to you. You feel safe enough to say, These are the services I need and you know you can go there and have it done without judgment or preaching. It’s just about taking care of you.”
Cazembe’s experience at Planned Parenthood is, sadly, not one that is par for the course when it comes to the trans community accessing important healthcare services.
“We talk a lot about coming out in the LGBT community,” Brooke Baxa of Denver, Colorado tells Yahoo Health, “But you don’t want to have to come out to your healthcare providers, your insurance company.”
“When I go to the doctor, a lot of them assume my sexual orientation and gender and start using pronouns and don’t actively ask what kind of sex I’m having and make assumptions – so I feel like there isn’t the space available to me to bring up these kinds of things,” Dakota David of Baltimore, Maryland tells Yahoo Health. “So instead of seeking out healthcare when I need it, I try to research and take care of things on my own. This is really common in transgender communities.”
“The biggest challenge for me in seeking healthcare is finding a doctor that is not only trans-friendly,” says Cazembe, “but also knows trans bodies. When you go to the doctor … and not having to use your legal name versus your preferred name – it’s the small things like that [can make for] a space safe at a doctor’s office.”
Thus, Planned Parenthood health centers often become a place where transgender and gender non-conforming individuals can safely receive medical care, from annual physicals to hormones related to physical transitioning.
“It was no question for me to seek care from Planned Parenthood,” says Brooke regarding their decision to use Planned Parenthood for administration of hormones related to their physically transitioning. “I use my Planned Parenthood health center as my primary care doctor, to make sure I’m healthy. I’m lucky enough to not have any big medical issues, but if I just want to go to the doctor for a check-up, get myself tested, and have someone who respects my pronouns and takes my insurance.”
Dakota David also receives healthcare at Planned Parenthood. While most “mainstream” healthcare experiences involve “assumptions about who I am, who I have sex with, and how I have sex,” Planned Parenthood practitioners, “are not afraid to ask those questions,” Dakota says. “They actively ask. The nurses I spoke with at Planned Parenthood didn’t assume my pronouns, they asked me. I rely pretty heavily, if not exclusively, on Planned Parenthood for my healthcare services because of how open they are.”
Another critical facet of providing comprehensive healthcare to the transgender community is recognition of healthcare issues that might exist outside of the presumed gender binary. That is, not all health issues are uniquely “male” or uniquely “female.”
“A trans man may want to have a hysterectomy,” explains Cazembe. “A lot of times they say that taking testosterone along with having ovaries can lead to osteoporosis or ovarian cancer. So a lot of us will have hysterectomies. But for insurance to cover that, it’s set up so that to have a hysterectomy, you need to have a female gender marker. But for a trans person, they may have had their gender marker changed already. There is so much gate-keeping – so many hoops to jump through to just get the services you need for your own self.”
Cazembe continues, “I’m a trans man, so when I go to the doctor, much of the time, they want to treat my body the way they would treat a non-trans woman’s body. But it’s not the same. I’ve been on hormones for almost a year. It’s not the same. And it make for a really uncomfortable time, having to explain and then being misgendered. It happens all the time.”
The trans experience, says Cazembe, is “often framed in medical terms: getting hormone therapy, surgical options – and this is great for the people who want it, but it doesn’t mean it comprises the whole trans experience. To be trans doesn’t mean to seek out those medical transitions. You may not match your assigned gender at birth without seeking those modifying medical procedures. Trans people are still people – our medical needs are just one aspect of being trans. We are so much more than just our lack of healthcare coverage and our healthcare needs.”
Brooke explains that while they are taking testosterone, they “still identify as gender queer. It is mind-blowing to people that I don’t identify as going from girl to boy. I think when most folks think about what it is to be transgender, they only think about the transition itself and the surgeries. The first thing people who don’t know what it is to be transgender ask me is, ‘When are you scheduling your surgery?’ And I’m like, I don’t know if I am going to do that. And that’s just mind-blowing for folks who don’t understand what being trans is like. There is so much pressure to have to pass as a certain gender.”
Which is why many people feel that the word “trans” isn’t always the best way to describe themselves and their experiences.
“I call it a gender journey,” Brooke says. “I don’t like the phrase transitioning because it denotes a beginning and an end. Our relationship with gender, even for cis people, evolves over time. With trans people – well, it’s just more in your face. This is my gender journey.”