-“Doctor…You don’t have a f…… clue of how I’m feeling, do you?”

I did not. Maria X. was a transgender patient that I had been treating for severe Migraine headaches with mixed therapeutic results. Frustrated that I did not offer her a cure, she never came back to my office. I occasionally remember her with a little remorse.

At the time, I was ignorant of the particular needs of transgender people and, I must confess, prejudiced enough to dismiss her as a “nuts case” that needed psychiatric care.

For the first time in its prestigious history, The Lancet is publishing a series of articles dedicated to transgender health issues. Its editorial admits “the very word transgender initially evoked surprising and varied responses, ranging from curiosity to dismissal as a ‘mere’ psychiatric disease. Other concerns were raised: the invisibility of transgender people because of lack of global recognition; the inability to account for health risks and disease burdens in transgender people because of inadequate population approaches; and stigma which keeps individuals out of health services.”

The transgender community is not homogeneous; it is surprisingly varied. It includes people that put up with their gender incongruence without making the transition; some others make a social transition without any gender-affirming health care; others do not have gender identity disorders or gender dysphoria, as they do not accept a simple binary division to identify their complex identities. We, the Cis, still have a lot to learn.

Sari Reisner says that the “situated vulnerabilities” that deprive transgender people of respect, opportunities and dignity in the health cares system can precipitate or exacerbate depression, anxiety and even suicidal behavior. Many of the transgender people suffer from a state of emotional frustration that affects their labor, family and social realms.

The anxiety of gender incongruence often leads to inappropriate psychiatric diagnoses that are clinically irrelevant and potentially harmful for their care. The World Health Organization (WHO) is proposing to relocate the relevant diagnoses for children, adolescents and adults in a new chapter of “sexual health” in the International Classification of Diseases Code (ICD)-11. Local medical societies must stop blocking the classification change and modernize their institutional stance on this social issue.

What do you think? Please tell us.

Don’t leave me alone.

3 thoughts on “The Trans also exist

  1. There’s no room whatsoever for petty prejudices that can cloud our professional judgement and impair the patients’ equitable access to good and efficient medical care. Please keep reading our blogs and enlightening us with your wisdom. Au revoir.

  2. Well written and addresses the current scenario. The free expression of sexuality and gender identity has become a defining characteristic of tolerant, pluralistic, and democratic societies in the 21st century. The challenges confronting the LGBT and human rights movements are no longer only national or regional. They are influenced by a multitude of factors at the global level. Socially cohesive societies require targeted investments in many areas, such as democratic institutions, families and communities, social justice; education and employment, housing, and protection from hate crimes and bullying

    1. Dear Dr. Vijay: good afternoon and thank you very much for your pointed commentary. I appreciate thevinput from a renowned expert in Global Health like yourself that has had a hands on aporoach to the health care issues of “different people” in different parts of the planet. In our pluralistic and democratic societies there’ s no oom whatsoever for petty prejudices

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