Why Trans Visibility Matters

Today, March 31st, is the International Transgender Day of Visibility. It’s not for me to decide how to mark this day, anymore than it’s for me to decide what someone’s gender identity is. But it is my responsibility as a doctor to speak out.

There are about three million trans people in the US. They’ve always been here. It’s not a new thing, it’s not a fad. They’ve existed as long as gay and straight people. The only thing that has changed is how we as a society treat them. And we are failing our trans friends, neighbors, and relatives.

It is understandable that someone might feel negatively toward trans people—just like sexism, racism, antisemitism, and other societal sins, anti-trans sentiment is built into our culture. But it doesn’t have to be that way. Just a couple of decades ago it was unimaginable that people of the same sex could marry, and yet here we are—same sex marriage has been around for years and it hasn’t hurt anyone; in fact it’s widely accepted across political party lines.

Violence against transgender people is growing. It’s not really a mystery as to why this should be so. The history of genocide and other mass violence against specific groups shows us that dehumanization is one of the key steps in making violence against a group of people “acceptable”. And dehumanization of trans people has become our government’s policy. This statement has been placed on the top of CDC pages that address trans health:

This is the literal erasure of over 3 million Americans, and it is both morally biologically incorrect. In addition to the dehumanization—which always leads to violence—it has a direct impact on health. The CDC will no longer be collecting data that helps us care for trans people. We (health care providers) won’t have the data to tell us how to best care for trans patients.

Whether you consider yourself an ally of trans people or you still have the biases that all of us grew up with, you should know some important data. In addition to the societal challenges trans people face, there’s good news. Medical treatment of trans people, according to their needs and wishes, helps. For example, trans people who choose gender-affirming surgeries essentially never regret it. Data tell us that, “Gender-affirmation procedures have been demonstrated to decrease rates of gender dysphoria, depression, and significantly improve quality-of-life measures and mental health outcomes.” Not all trans people choose surgery. Every trans person has their own path. It is possible to lead a fulfilling life as long as society doesn’t get in the way, preventing us from using all the tools at our disposal to help people live the lives they want and need.

There are many healthcare professionals who know how to care for trans patients—and many who don’t. What we do know is that when we listen to patients, identify them as they want to be identified, and offer them whatever evidence-based gender affirming care they want and need, they just do better. They live better lives.

Is that too much to ask?

-pal

(NB: I will not debate the essential dignity and rights of trans people. However, if any trans person feels I’ve addressed things incorrectly, please contact me.)