Tuesday, November 29, 2022

Health problems for trans people

 Before someone with gender dysphoria decides he needs to be a she to solve his problems, he might take a look at the health problems, either before or after, listed by Cleveland Clinic Transgender Health Services.  To the casual observer, it would seem the first step is to fix the problem before cutting off body parts. And after all that "screening" is finished (see below), then what? 

Metabolic conditions: These conditions, such as high blood pressure (hypertension), diabetes (glucose intolerance), liver dysfunction, and high cholesterol (dyslipidemia), can develop as a result of long-term hormone therapy (both estrogen and testosterone).

Obesity and heart disease: Transgender men and women have a slightly higher rate of obesity. Compounded with their long-term hormone use and higher rate of tobacco use, routine screening for heart disease is necessary.

Cancer: Transgender women (male-to-female) should have cancer screening for cancers of the breast, prostate, and anus. Screening for cancer of the reproductive organs should also be done for all symptomatic transgender men. Transgender men (female-to-male) should also need cancer screening for cancers of the breast, cervix, and anus, depending upon anatomy and stage of transition.

Alcohol and illicit substance abuse: Population studies have shown that the rate of substance abuse is higher in the transgender community than in the general population, and patients should routinely be screened for alcohol and illicit substance abuse. As such, patients should also be offered counseling and education regarding substance abuse and risk-taking behaviors.

Tobacco use: Population studies also show that transgender men and women have higher rates of tobacco use than the general population, and patients should be screened for this and provided with counseling and education about smoking cessation.

Depression, anxiety disorders, and post-traumatic stress disorder (PTSD): These medical illnesses occur at higher rates among transgender and non-binary individuals, often because of poor social supports, trauma, and challenges accessing affirming and knowledgeable providers. These conditions should be screened for regularly and be addressed by medical providers.

Sexually transmitted infections (STIs), including HIV and AIDS: Individuals who use drugs and other substances and have condomless sex are at risk for sexually transmitted infections, including HIV and AIDS. Patients who present with these risk factors should be screened for these infections and offered HIV Pre-Exposure Prophylaxis (PrEP) if medically appropriate.

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