Transgender and People

The prevalence of transsexuals varies across countries, it is speculated that cultural factors and social convention play an important role in determining the number of transsexuals who choose to themselves and be counted. In Singapore, the prevalence of transsexuals is 1:2900 for male to female and 1:8300 whereas in Netherlands, it is 1:11,900 for male to female and 1:30,400 for female to male. (Cuypere, Hemelrijck, Michael, Carael, Heylens, Rubens, Hoebeke, Monstrey; 2006)

Transsexuals suffer from legal discrimination in many part of Asia. While it is possible for post operative transsexuals to legally change their sex in Philippines and some part of China, it is not possible in Hong Kong. Post operative transsexuals are transsexuals who have undergone a sex reassignment surgery. Currently the United Kingdom has been hailed as the leader in human rights for transsexuals and transgender people with the passage of the Gender Recognition Act in 2004. The law legislates that sex reassignment surgery and hormonal therapy are not required before one can legally change their sex in the United Kingdom. (Sharpe, 2009) Currently in Canada, gender identity and gender expression are not explicitly protected from discrimination on a federal level as well as in Ontario. (Xtra, May 17, 2010) In 2008, the Ontario government reinstated public funding for sex reassignment surgery for an average of 8 to 10 people per year; British Columbia, Manitoba, Newfoundland and Labrador, and Saskatchewan also provide public funding for sex reassignment surgery. (Bird, The Ottawa Citizen, 2008) According to the Journal of Association of nurses in AIDS Care, Trans is an umbrella term that includes transsexuals transitioned, transgender, gender queer people and two spirited people, encompassing a diverse group of people whose gender identity or expression not normally expected. (Bauer, Hammond, Travers, Kaay, Hohenadel and Boyce, 2009) Gender identity is unrelated to sexual orientation, transsexuals are people whose identified gender is in contrast with their biological sex assigned at birth. (American Psychological Association, 2009) The World Professional Association for Transgender Health is responsible for developing the Standards of Care for hormonal and surgical sex reassignment of Gender Dysphonic persons. The guidelines is still regularly updated to serve the evolving psychological, medical and surgical needs for individuals with GID. The guidelines allow youths with parental consent to undertake reversible medical intervention to masculine or feminize their body before the onset of puberty; sex reassignment surgeries are recommended for those who have at least reached the age of 18 and have lived in their identified gender role for two years. (Beh & Pietsch, 2004)

Transsexuals can change their body through all , any or none of the following: sex hormones, electrolysis , plastic surgery, or sexual reassignment. (Transproud, 2009)) Grossman, D` Augellli, and Salter (2006) reported that the mean age of which transgender youth become aware of their gender identity is 10.4 year. Transgender youth often face victimization, and experience verbal and physical harm by peers, siblings, parents and or stepparents; as a result, many face homelessness, sexual exploitation and substance abuses. (Grossman et al., 2006) Transgender youths are also particularly at risks for high rates of daily stressors, substance abuse, unprotected anal intercourse, needle sharing, risk of migrating silicon and sexual victimization. (Garofalo et al., 2006) Trans adults face severe marginalization, and often experience unstable employment and housing, as well as `` a disproportionately high rates of violence, harassment, and discrimination in workplaces, schools and child welfare system.`` An estimated of 27.6 percent of trans women in North America is infected with HIV according to a recent meta analysis (Herbst et al., 2008) and another 65 percent of trans people have contemplated suicide from one of the largest trans focused studies done so far. (Xavier et al., 2007) The Trans PULSE project, which has been approved by the research ethics board at the University of Western Ontario, seeks to gather information about the health of trans people in Ontario, it is divided into three phases with the last phase yet to be completed. The conclusion drawn from the project so far concluded that there trans people and their experience are often rendered invisible by health care services and providers due to the assumption that everyone is non trans and the lack of knowledge and willingness to acquire and incorporate information about trans people in research studies , textbooks and resources. (Bauer, Hammond, Travers, Kaay, Hohenadel and Boyce, 2009) According to an assessment study on behalf of the AIDS Committee of Toronto, many members of the trans community face many difficulties, such as the high rate of HIV, lack of access to medically prescribed hormones¸ lack of safer sex materials, insufficient health care and social services, as well as both intentional and unintentional misuse of pronoun and social marginalization. (Bauer, Hammond, Travers, Kaay, Hohenadel and Boyce, 2009) According to the research team at Trans PULSE, their objective is to give
”the most statistically accurate picture of trans people possible in Ontario.” (Bauer, Boyce, Coleman, Kaay, Scanlon, Travers, 2010) One of the key findings of Trans PULSE is that there is almost an equal ratio of male to female individuals and female to male individuals; another key finding is that while a high percentage of research participants, 36 percent, have a university or college degree, only a total of 7 percent earned over 80,000 dollar annually while most are living below poverty line, with 50 percent of participants making less than 15,000 and 21 percent making between 15,000 to 29,999. (Bauer, Boyce, Coleman, Kaay, Scanlon, Travers, 2010) In terms of the diversity of the participants, 433 trans people took part in the study, with 21 percent identified with an ethnic group other than white, American or European. Interestingly, the participants involving MTFs are found to be less ethnoracially diverse, older and less likely to be living with their parents when compared to FTMs. (Bauer, Boyce, Coleman, Kaay, Scanlon, Travers, 2010) By Casey Yau

1. See Maggert v. Hanks, 131 F.3d 670 (7th Cir. 1997) (recognizing that sex reassignment is the only effective treatment for transsexual prisoners, but holding that it is permissible to withhold treatment from transsexual prisoners in light of fact that neither public nor private health insurance programs will pay for sex reassignment); Long v. Nix, 86 F. 3d 761 (8th Cir. 1996) (holding that prisoner diagnosed with gender identity disorder had no right to cross-dress or to estrogen therapy); Brown v. Zavaras, 63 F.3d 967 (10th Cir. 1995) (rejecting equal protection claim brought by pre-operative male-to-female transsexual based on evidence that Colorado provided hormone therapy to non-transsexual prisoners with low hormone levels and to post-operative male-to-female transsexuals); White v. Farrier, 849 F.2d 322 (8th Cir. 1988) (holding that male-to-female transsexual prisoner is not entitled to cross-dress or wear cosmetics and does not have a constitutional right to hormone therapy); Meriwether v. Faulkner, 821 F.2d 408 (7th Cir. 1987), cert. denied, 484 U.S. 935 (1987) (holding that transsexual prisoner is constitutionally entitled to some type of medical treatment for diagnosed condition of transsexualism, but she “does not have a right to any particular type of treatment, such as estrogen therapy”); Jones v. Flannigan, 1991 U.S. App. LEXIS 29606 (7th Cir. 1991) (same); Supre v. Ricketts, 792 F.2d 958 (10th Cir. 1986) (same); Lamb v. Maschner, 633 F. Supp. 351 (D. Kansas 1986) (holding that transsexual prisoner had no right to hormone therapy). See also Cuoco v. Mortisugo, 222 F.3d 99 (2nd Cir. 2000) (holding officials entitled to immunity against claim by transsexual pre-trial detainee who was denied hornomes).

2. See South v. Gomez, 211 F.2d 1275, 2000 WL 222611 (9th Cir. 2000) (finding 8th Amendment violation where a prisoner’s course of hormone treatment was abruptly cut off after being transferred to a new prison). Cf. Kosilek v. Nelson, 2000 WL 1346898, at * 3 (D. Mass. 2000) (assuming without deciding that transsexualism is a serious medical need, but finding insufficient evidence of deliberate indifference). Cf. Wolf v. Horn, 130 F. Supp. 2d 648 (D. Pa. 2001) (noting that abrupt termination of prescribed hormonal treatment by a prison official with no understanding of Wolfe’s condition, and failure to treat her severe withdrawal symptoms or after-effects, could constitute “deliberate indifference”).

3. See also Phillips v. Michigan Department of Corrections, 731 F. Supp. 792 (W.D. Mich. 1990), aff’d, 932 F.2d 969 (6th Cir. 1991) (granting preliminary injunction directing prison officials to provide estrogen therapy to a pre-operative transsexual woman who had been taking estrogen for several years prior to her transfer to a new prison and distinguishing failure “to provide an inmate with care that would improve his or her medical state, such as refusing to provide sex reassignment surgery” from “[t]aking measures which actually reverse the effects of years of healing medical treatment”).

By Joe Lunievicz
From Body Positive
November 1996
Perception is everything. Are you a boy or a girl? Blue or pink? People view you as male or female, and this view is crucial to the way our society thinks, identifies, categorizes and defines each other. It's woven into the fabric of our daily existence, and God help anyone who challenges this two-party, male/female system. History has shown that you will be beaten verbally, spiritually, emotionally and/or physically if you challenge it.
4. Rosalyne Blumenstein, Director of the Gender Identity Project (GIP) at the Lesbian and Gay Community Services Center, and a female of transgender experience remembers, "When I was a child, I was told boys don't play with dolls and to stop crying like a girl. I thought the way I was, was wrong. Most transgenders experience a sense of difference at a very early age, and that this difference is wrong. If you don't fit into your category (boy or girl), you're going to internalize that there's something wrong with you."
5. Some transgender people defy categorization. This tends to disorient people who need to neatly define the world. According to Rosalyne, many people ask transgenders why they aren't either a man or a woman, and if they are unhappy with their gender, why they don't just have a sex change? When a transgender has a sex change, people then say, "but you're not a real woman or man." Nora Molina, a peer educator at GIP and a self-identified Hispanic transexual woman adds, "We are looked at as neither female nor male . . . we are treated like a foreign entity, a freak of nature." (Note: Rosalyne explained that one "s" in the word transsexual has been dropped to depathologize the word, and to empower and embrace the community).
GIP, along with many other service providers, uses the term transgender as an umbrella term encompassing a diversity of gender expression including drag queens and kings, bi-genders, crossdressers, transgender people and transexuals.
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1. Transexuals are defined as people who find their gender identity -- their sense of themselves as male or female -- in conflict with their anatomical sex. Some transexuals may live part-time in their self-defined gender. Many desire to live fully in their self-identified gender. Some undergo hormone therapy and sex reassignment surgery.
2.