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For transgender people, health care is scarce, say experts

Ashley Love, the keynote speaker, at the Transgender Health Conference at Lincoln Hospital. May 13, 2011. Photo by: Linda Thrasybule.

The first step in addressing the health concerns of transgender people is to understand who they are. That was the overarching theme of the first ever health conference in the Bronx dedicated to highlighting a largely invisible community that advocates say is facing a number of challenges.

“We need to face issues of sexual violence, economic hardship and more importantly, discrimination among the transgender population,” said Catherine M. Abate, president and CEO of Community Healthcare Network, which held the conference at Lincoln Hospital on May 13 together with the Bronx Pride Center.

She urged participants to spread the word on the importance of transgender people getting quality health care in the city.

“We need to advance rights and services and make sure that providers are sensitive and understand the needs of transgender people,” she said.

Community Healthcare Network is a nonprofit organization that provides access to comprehensive community-based primary care, mental health care and social services in underserved communities.

“When you are born with a transsexual medical condition, it means that you’re neurologically intersexed, it means that your chromosomes are born different,’’ said Ashley Love, the keynote speaker. “A transsexual herself, Love, is an advocate for legal and medical protection for people born transsexual or intersex.

“Some people find out later that they have a variation of intersex, which means that they have female and male characteristics,” she said.

The term “transgender” can mean many things, including individuals making the transition from male-to-female, female-to-male, transsexuals, cross dressers and more. “A lot of different people fall under the umbrella of transgender,” said Samuel Lurie, director of Transgender Training and Advocacy, an organization that provides training for clinicians and service providers on the needs of transgender people.

“Some of them want to have medical intervention and some of them don’t,’’ he said. “Some of them want to live full-time in a gender different than what was assigned to them at birth and some of them may not.”

Lurie is a transgender male (female to male) who has trained 26,000 health care providers across the country on how to better understand and treat patients who are transgender.

Because transgender individuals do not conform to traditional gender roles, they often face stigma, discrimination and violence at some point in their lives, experts say. They also routinely lose jobs, homes and families when others find out about their gender. Even worse, complaints are never voiced by patients out of fear of rejection, ridicule or violence, Lurie said.

Little to no insurance coverage has left transgender individuals to find other ways to fund their transition. “Providers are seeing more and more transgender patients, and there is still a lack of information regarding care,” said Lurie.

The process of transition is a potentially dangerous period for transgender individuals. “It’s visible,” said Lurie. “People can know and see and can tell that you are either somebody who is gender different where they knew you before. I can’t tell you how dangerous this is. That’s how people find out. That’s how disclosure happens.”

Transition involves adjusting socially, physically, medically and legally to society. From taking cross gender hormones, deciding to have surgery to changing one’s name. “It’s a long process,” said Lurie. “It doesn’t happen overnight. It doesn’t happen over a weekend.”

The lack of access to health care has lead to serious health issues within the transgender community, advocates say. HIV/AIDS is currently an epidemic in the transgender population, in particular transgender women (male to female). Nearly 30 percent of transgender women in New York City were HIV positive, according to a 2008 Centers for Disease Control Study.

A 2011 report by the New York City Department of Health and Mental Hygiene noted that of the 206 new HIV diagnoses recorded between 2005 and 2009, 95 percent were transgender women and 5 percent were transgender men (female to male).

The report also states that out of these 206 new HIV diagnoses, close to 90 percent were black or Hispanic, which is a telling statistic on the high prevalence of HIV among minorities in the transgender community.

Since 2002, the Bronx Health Center, part of Community Healthcare Network, serves the transgender community by providing primary health care services, HIV counseling and testing, support group and weekly workshops. “We have around 180 transgender people accessing health care services at our center, said Dr. Luis Freddy Molano, vice president of HIV Programs & Services of Community Healthcare Network. “For the past three years, we’ve seen an increase this population.”

The transgender community currently has limited access to health services in the Bronx. The purpose of the conference was to reach out to other health care providers and community partners and raise awareness, said Dr. Molano. “We decided to make this effort and hopefully we’ll be able to do it again in the future.”

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