Breaking Down Barriers: Who gets to decide MY identity?

Co-researchers shared the impact of heteronormativity within the medical care system on the experiences of trans individuals, specifically trans-femme co-researchers. This work describes how the co-researchers observed and experienced prejudice-motivated refusal of care, where medical professionals would determine whether or not to provide care based on the appearance of the patient. This prejudiced decision-making process resulted in a lack of trust between trans individuals and healthcare service providers.

The co-researchers also highlighted the pressure faced to present themselves as feminine in order to receive proper care. While visibly femme trans individuals who easily pass as female may face fewer challenges, those who do not pass as female or choose not to present themselves as feminine still encounter difficulties in accessing appropriate healthcare. This dynamic creates an additional burden for individuals who may have to invest time, effort, and expenses to conform to societal expectations just to receive necessary hormone therapy.

The term "gatekeeping" is used by the co-researchers to describe the prejudice-motivated refusal of care based on the judgment of medical professionals. This gatekeeping practice not only reduces the level of trust between trans individuals and healthcare providers but can also lead some individuals to resort to self-medication as an alternative.

Jane says, On the day I was going to my crappy family doctor to get a recommendation for endocrinology, I had to put full make-up on, curl my hair, wear a full-on dress with my titties, cleavage hanging out to show that I'm a 'real' woman. And I've heard so many cases, so many instances of other trans girls, trans men, and nonbinary people who are getting wrongful treatment because they don't look like what doctors think that we should look like. Like I know of someone who is non-binary who doesn't identify either man and a woman and who uses 'them' pronouns, who like feminine clothes because they think it looks cute and pretty. Your gender expression of how you dress has no relationship with gender identity. Some people like to wear specific gender clothing, and that has nothing to do with their gender identity. But when you're going to these doctors, you have to play by that role in order to get what you need (proper medication and treatment). You want the doctors to trust you instead of doubting."

Furthermore, the results acknowledge that dysphoria, a profound sense of unease or dissatisfaction with one's gender, varies among individuals. The co-researchers mentioned specific types of dysphoria, such as chest dysphoria, reproductive dysphoria, and bottom dysphoria, emphasizing that each person's experience of dysphoria is unique.

Overall, this work sheds light on the challenges faced by trans-femme individuals within the medical care system due to heteronormativity, prejudice-motivated refusal of care, and the need to conform to societal expectations. It emphasizes the importance of addressing these issues to improve the healthcare experiences and overall well-being of transgender individuals.

Towards a More Inclusive Future

We must address these systemic issues within the medical care system to uplift the experiences and well-being of transgender individuals. Healthcare providers need education and sensitivity training to eliminate prejudice and provide equitable care for all. Let's break down these barriers together and create a world where trans individuals receive the respect and support they deserve.