Introductory Chapter: Transgender Health - Advances and New Perspectives

1. Introduction

Transvestites, transsexuals, and transgender (Trans) people require specific particularities regarding their health care. That is why it is important to know and understand these needs in order to provide them with adequate and quality health care [1, 2].

The recognition of gender identity as a fundamental human right, the State must guarantee, in the field of health, that all health benefits are contemplated in the law of each country. Then, recognizing people as active subjects of law, especially in relation to personal decisions, such as self-perception of gender and body modifications, care will be provided according to specific needs [3].

Respect without prejudice and without discrimination must be valued in policies as a basis for the humanization, promotion, protection, care, and health care of Trans people [4]. In this way, facing all types of discrimination and social exclusion implies promoting the construction of citizenship and, at the same time, requires expanding the participation of health teams as mobilizers of defense, the right to health, and sexual and reproductive rights as a fundamental component of the health of al [5, 6, 7].

2. Health in Trans people

Despite the fact that this group constitutes a quantitatively and qualitatively relevant social group in our country, sexual orientation and gender identity are not included in most national health statistics and studies, so little is known about the specific needs, problems, and health inequalities of the Trans population around the world [8].

Despite the fact that in many countries the legislation protects the right to non-discrimination and, more specifically, to that based on sex and sexual orientation, as well as the right to life, liberty, and security of the LGBT community, many National and international organizations have highlighted the existence of numerous incidents of discrimination and violence against these people throughout the world, as well as episodes of discrimination from health services [9, 10].

Although the scientific evidence is still limited, studies conducted in other settings suggest that LGBT people face inequities in health and, compared to the heterosexual population, this group has a higher prevalence of certain health problems related to social stigma and denial of their rights. The lack of personal, family, and social acceptance in relation to non-normative sexual orientation and gender identity can affect the mental health and the safety and well-being of Trans people [11, 12].

The discrimination suffered by these people has been associated with high rates of psychiatric illness, substance abuse, suicide, and victimization. These negative experiences can produce lasting psychosocial consequences both in the people who suffer them directly and in the rest of the group. Undoubtedly, prejudice and hatred towards this group play a crucial role in this health problem, added to the emotional, psychological, and physical damage caused by stigmatization, isolation, humiliation, harassment, and verbal and physical [13].

Usually, the specific health needs of the Trans population are insufficiently known or even ignored by health authorities and health professionals. According to the limited literature available, this population has higher rates of mental health disorders, such as depression, anxiety, and suicide, as well as substance abuse, such as tobacco, alcohol, and other recreational drugs. The approach to this matter is complex since within each identity there are different problems [14].

Likewise, the health needs and problems of Trans people are different throughout the life cycle: for example, during adolescence and early youth, there is a greater risk of suicide and being homeless. In adulthood, the Trans population has higher rates of tobacco, alcohol, and drug abuse, and in old age, they often face other health barriers due to social isolation and lack of culturally competent health and social services [15].

In order to guarantee that Trans can enjoy a long and disease-free life, it is necessary to eliminate the health inequalities of this group. This requires a specific approach from the services and administrations in charge of public health, as well as specific health care, which contains a gender and human rights perspective [13, 15].

The benefits of improving their health and reducing these inequities include reduced health costs from avoidable health problems, increased longevity and well-being, both physical and psychological, and, as a positive externality, increased social welfare, and creative capacity, reducing inequalities in access to the labor market and increasing labor productivity [16].

Although there are several advances in terms of regulations and acceptance, there are still several barriers, to improve the quality of life of this population.

3. Conclusion

Any action aimed at addressing the health of Trans people must be carried out from a model that has a gender perspective, human rights, and respect for diversity, with the participation of the LGBT+ community, based on the principles of voluntariness and self-definition of people who agree to participate and respecting the privacy and confidentiality that these data require, without arbitrary interference in their private life.

Conflict of interest

The authors declare no conflict of interest.