Transgender health concerns

"Transgender" is an umbrella term used to capture the spectrum of gender identity and gender-expression diversity. Gender identity is the internal sense of being male, female, neither or both. Gender expression — often an extension of gender identity — involves the expression of a person's gender identity through social roles, appearance and behaviors.

Many health concerns that transgender people face are due to minority stress, which is characterized by:

• Negative social attitudes and disapproval (social stigma) toward transgender people
• Abuse, harassment, neglect, rejection or unfair treatment (discrimination) of transgender people
• Internalization of social stigma, turning it into negative attitudes and thoughts toward one's self (internalized stigma)

For example, minority stress is linked to transgender people seeking out less preventive care and screenings than that of cisgender people of similar ages, whose gender identity and expression match the sex they were assigned at birth. This might be due to a lack of gender-related insurance coverage, being refused care, difficulty finding a doctor with expertise in transgender care or fear of discrimination in a health care setting.

In addition, because of minority stress, transgender people are at risk of:

• Emotional and psychological abuse
• Physical and sexual violence
• Sexually transmitted infections, viral hepatitis and HIV
• Substance misuse
• Mental health problems, such as depression, anxiety and suicidal thoughts