Transsexual/Transgender (ts/tg) Health Matters

Transsexual/transgender persons can face a myriad of health related issues. Stigma and discrimination can affect even the most basic healthcare visits and even the fear of this stigma can make ts/tg persons less willing to access healthcare. There is also the role that stigma and discrimination play in the advancement of knowledge and the provision/access of trans-related medical interventions. It is unfortunate, but ts/tg persons are forced to be their own medical advocates (for those who are able to speak out/up) and to educate their own healthcare providers. While this is not OK. It is reality.

We, the editor's of Qlinks.ca, want this space to be a great resource for all transsexual and transgender people in our community, as well as for those that provide service to you. We have tried our best to be respectful and inclusive. We know that we have just barely broken the surface.  If you are offended or don't see yourself in this section, we apologise. Please send us your ideas (click the 'give feedback' link on any page) and your criticism -- we are very interested in learning more. If you are interested in getting more involved, we are looking for someone who is transsexual or transgender identified to be the volunteer editor of the ts/tg sections (we are all volunteers!). Check out the Get Involved link! (you don't have to be that computer savvy, we promise!).

We hope you enjoy this and we look forward to hearing how we can make it better!

For a comprehensive trans health website, visit www.trans-health.com and http://www.transgendercare.com/

For an excellent personal story and introduction to the issue: the costs of trans healthcare in Canada

A Boy's Life. An award-winning feature piece on transgender youth that is beuatifully written and informative. Discusses the use of anti-puberty hormones among trans youth.

For local trans related information and resources visit the Transexual Menace (Toronto)

Local Trans-Specific HealthcareSherbourne Health Centre in Toronto, ON

At Sherbourne Health Centre, we provide responsive, respectful programs and services for the Transgendered and Transsexual (Trans) community. We understand the issues you are facing because we developed our approach to care in consultation with knowledgeable healthcare providers and people like you - members of the Trans community. We believe this approach reduces many of the traditional barriers to care that Trans people and others questioning their gender identity often experience.

Programs and Services for Trans People

If you are dealing with gender identity issues, we can help you with primary medical care and other services such as:

• Mental health counselling for issues such as transitioning, gender identity, harassment or violence, isolation, and substance abuse
• Support groups for Trans people
• Hormone therapy
• Workshops and links to community groups
• Trans specific resources and information

 Hormone Therapy

Hormone Therapy is a key health service for anyone wanting to transition from one gender to another. If you are considering cross-sex hormones for the first time or re-initiating hormone treatment, it is best you do so with the help of a knowledgeable, experienced physician and health care team.

At Sherbourne Health Centre, our health care team works with you to develop a clearly outlined treatment plan – “a care contract” - that fits your unique requirements and delivers the best health outcome for you. Your provider ensures you fully understand what changes to expect and all the possible health risks involved in hormone therapy. Together, you agree on the best treatment option in a professional relationship based on mutual respect and trust.

Accessing Hormone Therapy

Before any decisions are made about prescribing hormones, your provider must assess your particular situation and medical history. This assessment usually takes place over a three-month preparatory period. During this period you will make at least five visits to the Centre to see your provider(s).

Preparing for Hormone Therapy

Not everyone who seeks hormone therapy automatically qualifies. Much depends on your medical history and other important factors. However, your provider discusses all possible options with you and makes every effort to provide supportive care to help you improve your health.

Other Inquiries

• Frequently Asked Questions – LGBTT Primary Health Care
• How to make an appointment
• Clinic Hours
• How to find us
• Interpreters
• Special needs
• Privacy
• Electronic Health Records

Some Important Health Issues for Trans Men

Hormone Therapy

Age, family and personal health risk factors, organ systems present and other medications will affect how your body responds to testosterone. Taking testosterone will also influence how general medical conditions are managed. Testosterone may cause acne, balding, increased fat around abdomen, cancers of liver and reproductive organs, high blood pressure, increases in red blood cell levels, high cholesterol, liver problems, infertility or high levels of calcium in the blood. It may also aggravate polycystic ovaries and uterine fibroids. If you are taking hormones without medical supervision, it is important that you see a health care provider and discuss the hormones you are taking. Talk to your provider about initiating or maintaining hormone therapy

Contraception/Pregnancy

It is possible to get pregnant while on testosterone, although infertility occurs after continued use. Taking testosterone before or during pregnancy may cause birth defects. Consider using contraception to reduce the risk of pregnancy if you have penetrative vaginal sex with a non-transgender man. Talk to your provider about contraception.

Sexual Health

There is not much information available to Trans people in general that is specific to their sexual health. The document, “Primed: The Back Pocket Guide for Transmen and the Men Who Dig Them, was created by the Gay/Bi/Queer Transmen Working Group, a part of the Ontario Gay Men’s HIV Prevention Strategy. It is available to download at www.queertransmen.org . It is an excellent resource.

Pelvic and Breast/Chest Health

All body parts need care! Make sure to get yearly pelvic and breast/chest exams if you still have those parts. It's important to remember that chest (top) surgery does not remove 100% of breast tissue, so a cancer risk still exists, and a monthly breast/chest self-exam is recommended. An estimated 25% of trans men may be affected by polycystic ovary syndrome (PCOS) and people with PCOS are at increased risk for breast cancer, endometrial cancer, and endometrial hyperplasia (overgrowth of the lining of the uterus). All transgender men with intact cervixes should receive regular pap test screening. Talk to your provider about pelvic and chest exams and appropriate diagnostic tests.

Some Important Issues for Trans Women

Hormone Therapy

Hormone therapy involves taking estrogen and sometimes an anti-androgen to promote breast development, soften skin, lighten body and facial hair, decrease fat in the belly and increase fat in the hips and thighs. It is not risk-free, and you should not take estrogen without medical supervision and regular blood tests. If you are taking hormones without medical supervision, it is important that you see a health care provider and discuss the hormones you are taking. Talk with your provider about initiating or maintaining hormone therapy.

Breast Health

Once breast growth occurs as the result of hormone therapy, it is important that you learn how to do a breast self-examination and that you do one every month. You should also get an annual breast exam and an annual mammogram after five years of taking estrogen. Talk with your provider about mammograms and other screenings for breast cancer.

HPV Prevention

A Pap test can detect pre-cancerous and cancerous cells on the cervix. Regular Pap testing and careful medical follow-up, with treatment if necessary, can help ensure that pre-cancerous changes in the cervix caused by HPV infection do not develop into life threatening cervical cancer. All post-operative transsexual women should receive regular pap test screening. Talk with your provider about screening and treatment for HPV.

Prostate Health