Meeting the Needs of Transgender People in San Francisco: A Clinician's Perspective

BETA honors Transgender Awareness Week -- this year from November 14 to 20 -- by inviting an expert on transgender health to share his perspective on gender identity, surgery, healthcare access and the many ways to be in this world.

Individuals who identify as transgender oftentimes are confronted with insurance restrictions, safety concerns, and psychosocial barriers in order to access medically necessary gender dysphoria health care services. Barry Zevin, M.D., as clinical lead of San Francisco Department of Public Health's Transgender Health Initiative, is helping the transgender community, and the providers that serve them, navigate this complicated landscape and improve delivery of medically necessary treatments, including gender reassignment surgery, here in San Francisco.

In the last five years, at least 2,000 transgender men and women have received services at the San Francisco Department of Public Health. Zevin explained that the prevalence of people with significant gender dysphoria -- who do not identify as the gender they were assigned at birth -- is probably close to 1% in San Francisco.

Whether or not people take steps -- whether behavioral or through medical procedures -- to make changes to their gender expression is individually determined and can be influenced by cultural factors as well. As hormone replacement therapy and gender reassignment surgery become more widely-known and culturally accepted, more people are presenting to health care settings to ask about transition-related services.

Zevin said that oftentimes, he sees people who make the assumption that they need to have surgery to conform to a social idea they have of their gender identity. But that sometimes, this mindset can change when they are educated that not everyone opts for surgery.

"There are a thousand ways to be in this world. We like to ask people, 'How would the surgery change where you are?' Some people will come to the realization that, hey -- maybe I don't need to do this," explained Zevin.

Clinical staff must therefore be prepared and competently able to counsel people on their options. With increasingly better access to gender reassignment surgery by insurance providers, some transgender men and women who feel like they've been waiting all their lives for surgery are "thrown into a crisis" when they actually have the option of gender reassignment surgery.

This excerpt was cross-posted with the permission of Read the full article.