In recent years, transgender individuals have become increasingly visible in American society. While the transgender experience is beginning to be considered by both the media and the community at large, trans men and women still face major hurdles in their daily lives, including a number of health and social inequities. According to an Institute of Medicine (IOM) survey, people who identify as transgender are more likely than other groups to face discrimination and harassment, both within the healthcare system and elsewhere. In fact, 63% of transgender individuals report that they have been openly harassed, discriminated against, or have been the victims of violence within their communities, due to their gender status.
At the International Center for Transgender Care, we believe that greater understanding can lead to greater acceptance, which in turn can result in an improved quality of life for transgender individuals. That’s why, in addition to providing high-quality, compassionate clinical services for our patients, we aim to become the de facto source for transgender research and publication in the international community. Our mission is to advance the existing body of scientific research in order to better understand the causes of transgenderism, as well as to enhance and improve the treatment options available for transitioning patients. We offer a truly holistic approach to transgender care, incorporating psychotherapy, treatment, and research.
In the United States, it is estimated that approximately 0.6% of the population identifies as transgender. Trans people are a diverse group with a range of life experiences, encompassing individuals from every race, ethnicity, age group, and social background. At the Trans Center, we recognize this diversity and strive to provide care that is individualized to the unique needs of each patient that we serve. However, there are certain challenges that tend to be common amongst transgender individuals. In particular, research suggests that access to healthcare can be a major hurdle for many trans people. 19% of transgender individuals surveyed report that they have been denied healthcare based on their gender status. Additionally, transgender patients are very likely to encounter healthcare providers who lack knowledge on gender diversity; 50% of transgender patients report that they have had to educate their physicians about transgender health issues.
According to the American Medical Association, gender transition services are considered medically necessary procedures. Still, individuals seeking to obtain these services often face a number of roadblocks on their transition journey. Locating competent, knowledgeable, and compassionate providers of gender transition services can often be a challenge. And while these services are now covered by some health insurance plans, transgender individuals are less likely to be insured than are their cisgender counterparts. Combined, these factors mean that transgender individuals may face difficulties related to obtaining hormones, surgery, and other gender-affirming treatments.
Mental health is a particularly relevant issue for transgender individuals. Minority stress theory suggests that the constant, daily stress that results from being a member of a minority group with a stigmatized social identity can lead to a number of adverse health outcomes. For transgender individuals, these outcomes often manifest as mental health issues. Researchers have found that trans men and women are more likely to experience depression, anxiety, and substance abuse disorders than are members of the general population. A study conducted by researchers in Boston found that more than 50% of young adults who identified as transgender suffered from depression, compared with 20% of their cisgender peers. Furthermore, 17% of these transgender young adults reported that they had attempted suicide at least once in the past. Clearly, a need for additional research into the mental health needs of transgender individuals exists.
There is a growing body of research on gender-affirming therapies available to transgender individuals; these therapies typically include treatment with hormones and surgery. Hormone therapy has been particularly well-studied, and results confirm that both masculinizing (testosterone) and feminizing (estrogen) hormones are generally safe, well-tolerated, and effective in trans men and women. Recent studies also suggest that hormone therapy may result in positive changes in the psychological functioning of transgender people. In a 2016 study, researchers from Harvard and Yale universities determined that transgender individuals experienced decreased levels of depression and anxiety, as well as improved quality of life, after undergoing hormone therapy. Although additional research is needed, these positive effects may be due to a reduction in gender dysphoria related to the results of hormone therapy.
According to the American Psychological Association, gender dysphoria is defined as persistent distress related to the feeling that one’s body is not congruent with their perceived gender. Simply put, gender dysphoria occurs when the way a person looks on the outside doesn’t match the gender they feel on the inside. Gender dysphoria is actually a relatively new diagnosis. It replaced “gender identity disorder” in 2013, in a move intended to underscore the fact that being transgender is not an illness or a disorder—only individuals who experience distress related to their gender status require mental health treatment. Research suggests that a number of factors can help to reduce the levels of distress and psychological dysfunction related to being transgender. In addition to psychotherapy with an empathetic provider who is well-versed in transgender issues, interventions that increase family, peer, and community acceptance can go a long way towards improving outcomes and quality of life for transgender men and women.
Emerging research suggests a natural, biological origin for the transgender experience. Notably, many transgender individuals report that they have felt out of harmony with their assigned gender since early childhood. Because the brains of males and females are structured differently, a number of studies have attempted to determine whether the brains of transgender individuals align most closely with their experienced or assigned gender. Researchers in Spain performed MRI scans on a group of trans men, and concluded that their brain structure resembled that of cis males, rather than cis females—strongly suggesting a biological basis for transgenderism. Research conducted on twins has provided further evidence for this theory. The authors of a 2013 study surveyed a group of transgender participants who also happened to be twins. They found that one third of the identical twin sibling pairs in their sample were both transgender, compared to just over 2% of the fraternal twin siblings. These results strongly suggest that being transgender has a biological, genetic basis, rooted in nature.
The International Center for Transgender Care is the first in the country dedicated to both understanding and treating the many aspects of transgender care. Utilizing a rigorous, methodologically-sound scientific process in a respectful, compassionate environment, our expert physicians will examine the biological causes and consequences of transgenderism and gender dysphoria, while also exploring the effectiveness of various therapies. Through our work in the clinical research division, we hope to positively impact the lives of transgender patients. We believe that additional research into this area of the human experience is essential to facilitate greater access to healthcare and health insurance benefits for transgender patients, to decrease the rates of depression and suicide in the transgender community, to provide education to the general public, and to ensure that transgender individuals are afforded appropriate options for treatment. In essence, we hope to foster an enhanced understanding, acceptance, and quality of life for the transgender patients that we serve.