LGBTQ+ health
Sexuality
It might seem weird to you that a doctor wants to know who you are attracted to and who you share sexual activity with. In fact, sometimes it can feel pretty awkward…
“Are you sexually active? With males, females or both? Oral sex? Anal sex? Vaginal sex?”
But the reason that doctors want to know, and the reason that we want you to feel comfortable sharing, is all about your health. Mental and physical health. First, different types of sex carry different risks — so we want to make sure you’re using the right kind of protection and getting the right kind of testing. Second, experiencing a sexuality that is different than societal norms can be very challenging. Doctors want to make sure that you are feeling comfortable and safe in your own skin.
If you aren’t quite ready to start sharing with a doctor or your family, consider looking to other communities for acceptance and guidance.
Gender identity
Most modern societies have a weird relationship with gender, but it doesn’t have to be so confusing. From a medical standpoint, there are male and female body parts, but those body parts do not necessarily have to match up with the gender that someone identifies with. Furthermore, gender identity does not have to be a forever state. If you feel more male or female (or both or neither) later in life, it’s your right to embody that gender.
Many individuals, places of employment and communities are getting in the habit of sharing or asking folks to share their “gender pronouns” (which simply means if you prefer to be referred to as “he/him/his,” “she/her/hers” or “they/them/theirs”). If your doctor doesn’t ask, you have the right to share this with them and ask that they respect your gender identity with your preferred pronouns. They can also provide assistance if you would like more mental or physical support in reaching a place of comfort with your body (see next section).
What’s up with the term “gender dysphoria?”
Gender dysphoria is a clinical diagnosis given to you if your gender identity is different than that which was assigned at birth AND, because of this discrepancy, you experience significant stress and anxiety. It is considered a “disorder” which is in-and-of-itself problematic, but it is also a required diagnosis in order to medically qualify for insurance coverage of some gender reassignment measures.
To break it down, a “gender dysphoria” diagnosis requires:
a gender identity that is different than your assigned gender at birth, and
distress as a result of your gender identity.
The implication here is that you need to feel angst because of your gender in order to receive medical intervention. Hopefully, as our society and the medical community catch up with new ways to define and accept gender identity we will do away with the “dysphoria” altogether. Until then, don’t let the diagnosis define you. Seek support and affection from those that accept you for who you are, and ask a doctor if you want to discuss ways to feel more comfortable with your gender identity.
Transgender care
The medical process of gender affirmation varies depending on your age. The three basic steps are puberty suppression, hormone therapy and surgery. None of these steps is essential to helping you live as your identified gender, but the purpose is to help you feel more comfortable in your own body. So let’s break these steps down.
Puberty suppression is typically only offered if puberty has started but has not yet finished. For many, this is around the ages of 11 to 13. It’s in the form of a medicine that halts puberty where it’s at, basically preventing continued maturation into a gender you don’t feel comfortable with. This step is also considered to be entirely reversible, meaning once you stop the medicine puberty will continue. Puberty suppression is generally continued for a few years until you decide to proceed with hormone therapy or stop the medical gender affirmation process.
Hormone therapy is what it sounds like — taking hormones of your identified gender. For male-to-female affirmation the hormone is estrogen. For female-to-male affirmation the hormone is testosterone. In most situations hormone therapy is reserved for ages 15 and up and can continue throughout the rest of your life. It’s also worth mentioning that if you have a uterus you will likely menstruate regardless of testosterone therapy. If you would like to stop your period, there are additional medications that can be administered (such as Depo).
The final step of gender affirmation is surgery. This is typically offered to adults only but there are a variety of surgeries that CAN be done to help you reach your desired level of gender expression (though no surgery is necessary if not desired).