The World Health Organization, the American Psychiatric Association, the American Psychological Association, and many other medical organizations and mental health associations acknowledge the importance of gender identity in treatment. Modern mental health organizations generally recognize that gender identity is real and valid and that LGBTQ+ individuals should be able to access gender-affirming care.
Non-binary people make up around 0.5% of the population, and they experience significant levels of gender dysphoria – a condition where one experiences emotional distress due to a marked difference between the gender someone is assigned at birth and the gender they identify with. This discomfort can manifest in many ways, including depression, anxiety, and suicidal ideation.
In fact, 41% of transgender and non-binary people have attempted suicide at some point in their lives – a rate that is nine times higher than the general population. Furthermore, in the United States, transgender people are four times more likely to live in poverty than the general population, and one in five trans folks have experienced homelessness at some point in their lives.
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Despite making up a significant percentage of the population, trans and non-conforming folks often suffer from discrimination and violence. This is partly due to the fact that many people do not understand gender identity or the differences between sexual orientation and gender identity. Even fewer know what it means to be gender fluid. Western society has much to learn in supporting the LGBTQ+ community. Providing gender-affirming health care is one way we can support individuals navigating transness and/or gender transition.
What is gender-affirming care?
Gender-affirming care is essential to ensuring that gender-diverse people have opportunities to live healthy and happy lives. It is geared toward helping non-conforming individuals feel comfortable in their own skin and embrace their true selves. This type of care can involve anything from support groups and therapy to transition-related medical treatments and gender-affirming surgery. Each individual’s needs may vary.
Many gender minorities do not have access to gender-affirming care due to financial barriers, discrimination, and a lack of providers trained to provide this service. It is important that gender-affirming care is covered by insurance, as this will help to reduce financial barriers people often run into. In addition, more training is needed for medical providers, so they are better equipped to meet the community’s needs.
Non-surgical gender-affirming treatments
There are many ways to affirm someone’s gender identity without resorting to surgery. The path chosen depends exclusively on the individual’s goals and needs. Some people may need hormonal treatment to achieve gender-affirming physical changes, while others may only need a different gender pronoun or a change in their name or gender marker on legal documents. Here are some of the most common non-surgical treatments trans and non-binary people resort to in their quest to feel whole:
Laser hair removal
Laser hair removal is a common gender-affirming procedure for non-conforming individuals. It can help reduce or eliminate the appearance of gender-related features, such as facial hair or chest hair. For many, this procedure can be an important step in their transition and make them feel more comfortable in their own skin. The procedure is relatively safe and effective, but only if performed by a qualified medical professional.
Hormone therapy
Gender-affirming hormone therapy is a key part of gender-affirming care for the transgender community. The gender-affirming hormones used in therapy vary depending on the person’s gender identity and the transition they seek. For example, testosterone is often used to help people who transition to a more masculine presentation, while estrogen is used for those transitioning to a more feminine presentation.
Hormonal treatment aims to help the person’s body better align with their gender identity. This can result in changes in appearance, such as increased muscle mass or breast development. Hormone therapy can also help alleviate gender dysphoria.
Voice and communication therapy
According to the World Professional Association for Transgender Health, voice therapy is recommended for people who want to “feminize” or “masculinize” their voices. A speech and communication therapist can help transgender and non-binary people achieve a more gender-affirming voice.
Research has shown that voice therapy can be effective in helping transgender and non-binary people to feminize or masculinize their voices. A study published in the International Journal of Transgenderism found that, after 12 weeks of voice therapy, participants had a significant increase in gender-affirming vocal characteristics.
Mental health care
Transgender and gender non-binary people often experience poorer mental health outcomes than cisgender people. This is partly due to the discrimination and stigma they face from society. It is important that gender non-conforming folks have access to mental health services specifically tailored to their needs. This type of care can help address the unique challenges they face and provide them with tools to find self-acceptance and self-love.
Some mental health concerns that non-binary and trans people may experience include gender dysphoria, anxiety, depression, and eating disorders. A health care provider specializing in gender identity can help people explore their gender identity and figure out what steps they need to take to transition to an authentic gender expression. They can also provide linkage to therapy or other mental health care to reduce the risk of depression and encourage a healthy transition.
Surgical gender-affirming treatments
Gender-affirming surgical interventions are becoming more and more common as society becomes more open to transgender individuals. In a study by the Williams Institute at UCLA, it was found that gender affirmation surgery (GAS) is a safe and effective procedure for transgender people. The study looked at data from gender-affirming surgeries performed between 2000 and 2014. In that time period, there were 3,853 gender confirmation surgeries performed in the United States. Of those, only 0.3% resulted in any kind of major complication. This means that gender-affirming surgery is a very safe and effective means of transition for transgender individuals.
In addition to being safe, gender-affirming surgery can profoundly impact the quality of life for transgender people who desire it. A National Center for Transgender Equality study found that gender-affirming surgery can improve mental health, employment opportunities, and overall quality of life for transgender individuals. The study surveyed 2,000 transgender people who had undergone gender-affirming surgery and found that 77% of respondents reported an improvement in mental health after surgery. In addition, 59% of respondents said they were able to find a job after surgery that better matched their gender identity, and 64% said their overall quality of life improved after surgery.
Now, of course, nobody has to want or acquire surgery. Plenty of trans folks find they can be their best selves without it. Unfortunately, these types of surgeries can be expensive, and gender-affirming medical care is not always covered by insurance. However, they can be life-changing for transgender people who feel like their bodies do not match their gender identity. There are a variety of gender-affirming surgical treatments available for gender non-conforming individuals:
Gender affirming surgery (GAS) (AKA Gender reassignment surgery (GRS))
GAS (also called bottom surgery or genital surgery) is a surgical procedure that changes the gender of someone who identifies as transgender. This uses genital, cosmetic, and urological surgical techniques, and it can involve the removal of sexual or reproductive organs or the construction of new ones.
Chest surgery
Chest surgery (also known as top surgery) is a surgical procedure that changes the appearance of the chest for trans folks. Chest surgery is usually done to remove chest tissue in transmasc folks, or to create breasts in transgender women and transfem folks. The surgery can involve different procedures, such as breast implants, nipple grafting, and chest reconstruction.
Facial surgery
This can involve facial feminization surgery or masculinization surgery. Facial surgery is usually done to make the face look more feminine or masculine, depending on the person’s gender identity. There are a variety of facial surgeries that can be performed, depending on the individual’s needs, including rhinoplasty, brow lift, jaw contouring, and facial feminization surgery.
Gender-affirming care saves lives
Gender-affirming care is essential for transgender and gender-nonconforming individuals. For too long, transgender people have been denied the medical care they need and deserve. This has led to health disparities and high rates of depression, suicide, HIV infection, and homelessness among people with a transgender identity. Each trans person’s journey is unique, and there is no one “right” way to undergo gender affirmation, but gender-affirming care is vital for all.
According to a study by the Williams Institute, transgender people are four times more likely to attempt suicide than the cisgender population. However, when gender-affirming services are provided, that number drops to almost zero. A study by the American Foundation for Suicide Prevention found that transgender people who had undergone gender-affirming surgery were 65% less likely to attempt suicide than those who had not.
Gender affirmation and mental health access are crucial for the LGBTQ+ community in the process of social transition and gender identity development. To have a healthy, affirmed gender identity, it is important that individuals receive gender-affirming care from a health care professional who is knowledgeable and sensitive to the needs of trans and gender non-conforming people.
