Transforming Trans Health and Community: Prioritizing Gender-Affirming Care for Prevention and Substance Use Support
June 27, 20224
by Lu Orona (he/they),
We Breathe Communications Intern
In a world where only a limited number of spaces are well-prepared to support the needs and well-being of Transgender, Gender-Diverse, and Intersex (TGI) individuals, accessing affirming care can be a daunting task due to high demand and limited availability. The dilemma of whether to see my primary doctor now or wait an estimated three months to consult with a doctor who specializes in LGBTQ+ and trans* inclusive care is one that many transgender individuals, myself included, grapple with.
The hurdles to accessing care can feel unattainable for many trans* folx, particularly amidst prevailing political and social struggles. This hurdle is exacerbated when overcoming addictions such as tobacco use, which is 5 times higher amongst trans* folx in comparison to cis-gender usage. The path to seeking and continuing recovery becomes even more daunting in the absence of educated, supportive, and affirming healthcare providers who are able to address the unique needs of the TGI community.
According to the most recent study conducted by the National Center for Transgender Equality, nearly one-quarter of TGI folx did not see a doctor when they needed to due to fear of mistreatment, and almost half of the respondents experienced at least one negative incident in healthcare the past year alone. These instances range from being denied healthcare due to their gender identity to having a provider be abusive during treatment. These statistics underscore a profound failure in our medical institutions to cultivate inclusive and affirming spaces, further increasing hesitation to seek assistance against issues like tobacco use or receive preventative care such as regular check-up exams and pap smears.
Moreover, the dearth of safe spaces extends beyond healthcare settings and infiltrates our own communities. Recent years have witnessed pushback against TGI and queer folx from within the LGB community. This lack of solidarity leaves trans* individuals feeling unsupported precisely when they need it most, exacerbating feelings of alienation and unworthiness of a healthy and happy life. Trans people need a world worth living and thriving for, and it’s hard to do so when systems in place that were meant to help you, communities raised to uplift you, and a country meant to grant you “Life, Liberty and the pursuit of Happiness” are consistently striving to erase, limit, and criminalize you. This only further encourages TGI communities to succumb to what is wanted of us by transphobes: early death, endless struggle, and the failure to feel empowered over those who think they have control, and the best way to do that is through increased usage of harmful products like tobacco use and limited access and comfortability to seek aid against harms like it.
This is not a new phenomenon; it harks back to the struggles of pioneers like Marsha P. Johnson and Sylvia Rivera, who fought tirelessly for the freedoms we enjoy today as the LGBTQ+ community. Yet, despite their dedication, both Johnson and Rivera were often shunned away from the spaces they built. Both, unfortunately, would pass from the kind of death we still see today within our communities; Johnson would be left as a cold case, and Rivera would pass from liver cancer. To this day, the TGI community continues to face backlash and systemic obstacles that deter them from seeking the care and community support we deserve.
So, how do we chart a path forward? Organizations like We Breathe and the California LGBTQ HHS Network work to reduce LGBTQ+ disparities in issues like tobacco-prevention work and improve standards of care to best serve TGI individuals. By providing a safe space and eliminating the barriers in access to health care and community tools that are necessary to combat tobacco use, TGI folx can feel accepted, encouraged, and supported without fear of judgment or discrimination.
As a current intern for the Network’s We Breathe program, I can attest to the transformative power of such inclusive environments. Here, I have found not only solace but also the resources and camaraderie necessary to navigate life as a trans* individual. It’s a sanctuary where I can focus on my journey without constantly having to justify my existence or fend off bigotry.
From healthcare facilities to community spaces, we need to foster environments where TGI folx are not just tolerated but fully embraced and supported. Only then can we begin to dismantle the barriers that stand between TGI folx and the healthy, fulfilling lives we deserve.
