Ten Things Transgender Persons Should Discuss with Their Healthcare Provider
1. Access to Healthcare
It is not easy to find a healthcare provider who knows how to treat transgender individuals. Even if one is found, insurance may not pay for the treatment. Ask providers if costs will be covered by insurance. If not, ask if they will reduce the bill so you can pay.
2. Health History
It’s important to trust a healthcare provider. Tell them about the medicines taken and the surgeries that may have happened in the past. If the healthcare provider knows what has happened in the past, they will be better able to give the best treatment today.
Talk with the provider about hormone treatment. If starting hormones for the first time, ask about the things to watch out for while taking these medicines. As a transgender woman, ask about estrogen and blood clots, swelling, high or low blood pressure and high blood sugar. As a transgender man, ask about the blood tests needed to be sure the testosterone dose is safe. Be sure and take only the hormones prescribed by the provider.
4. Cardiovascular Health
Transgender persons may be at increased risk for heart attack or stroke, not only from hormone use but from increased cigarette smoking, being overweight, high blood pressure and diabetes. For example, transgender women may fear that their provider may make them stop estrogen if they develop heart trouble, and so they may not report feelings such as chest pain or trouble breathing. Be sure to tell a healthcare provider if you do have these feelings.
It is very rare to develop cancer due to hormone treatment, but a healthcare provider will evaluate this possibility when he or she sees patients for check-ups. He or she will also check for possible cancer of sex organs, if they have not been removed. Again this is very rare but it should be checked along with the rest of a physical examination.
6. Sexually Transmitted Diseases and Safe Sex
Transgender people, particularly young transgender people, may be engaging in sexual activity. Just like anyone else, transgender people may get a sexually transmitted disease. It is very important to practice safe sex and discuss safe sex practices with a healthcare provider.
7. Alcohol and Tobacco
Alcohol and hormones may be more dangerous when taken together. Many transgender people smoke cigarettes. This increases their risk of heart and lung disease, especially in persons taking hormones. Transgender persons who care about their health should not smoke, and they should drink only small amounts, if at all.
Even after transition, depression can still be a problem. Talk with a provider or therapist about your feelings and tell him or her if depression feels like an accurate diagnosis. Many good treatments are available for depression.
9. Injectable Silicone
Some transgender women want to look feminine and beautiful without having to wait for the effects of estrogen. They expect injections of silicone to give them “instant curves.” The silicone, sold at “pumping parties” by non-medical persons, may move around in the tissues and cause ugly scars years later. It is usually not medical grade, may be contaminated and is often injected using a shared needle.
A healthy diet and a frequent exercise routine are just as important for transgender persons as for anyone else. If a surgery is planned for the future, the surgeon will want to be sure the individual is in good physical condition to do well during and after surgery.
*Informed by statistics from the Gay and Lesbian Medical Association (now known as Health Professionals Advancing LGBT Equality), PRIDE Institute of Minneapolis, and Substance Abuse and Mental Health Services Administration
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