Transgender EuroStudy – Legal Survey and Focus ... - ILGA Europe

51 April 2008
There is very little published research concerning the issues facing trans people
when accessing healthcare in the EU but from the available research it is clear
that the issues facing trans people in accessing good quality healthcare are
markedly similar from country to country. The second problem in terms of the
paucity of research is that much of the research conducted subsumes trans
people under the umbrella of ‘LGBT’ or ‘GLBT’ (for example The Medical
Foundation 1997; Clark et al 2001), where data on trans issues is regrettably
acknowledged as not available (Bell 2002; Quinn 2006). Some of the barriers for
trans people accessing healthcare discussed below are similar to the LGBT
community – for example lack of awareness by healthcare providers of the needs
of these communities. There are, however, issues which are trans–specific which
may not be addressed while under the ‘LGBT/GLBT’ umbrella – LGB people, for
example, do not require a diagnosis from a medical professional in order to
realise their identities. Moreover, the disadvantage of trans being incorporated
under this ‘umbrella’ is that it may paradoxically maintain the erroneous view
held by some practitioners that trans is an extreme form of homosexuality (as
evidenced by Solymar 2006).
The available research on the issues for trans people accessing healthcare focusses on the
barriers experienced by trans people. These are access to health insurance; the type and quality of
provision of trans-related healthcare in one country; the knowledge and the skills of practitioners on
trans-specific clinical healthcare needs; as well as awareness and understanding of trans issues in
general.
It is documented that the treatment of gender dysphoria through gender reassignment has a
very successful outcome in terms of quality of life. It is generally agreed by professionals working in
the field that gender dysphoria cannot be alleviated by psychiatric treatment – for example drugs or
therapy. The most comprehensive review of gender reassignment spanning over 30 years, 13 countries
and over 2000 patients concluded that gender reassignment treatment was generally effective in
relieving gender dysphoria, and that its positive results greatly outweighed any negative
consequences gender reassignment yielded for patients with gender dysphoria (Pflafflin and Junge
1998). Pfafflin and Junge looked at the specific beneficial effects of gender reassignment in four areas:
subjective satisfaction, mental stability, socio-economic functioning, and partnership and sexual
experience. The most important area they identified was subjective satisfaction, which they noted was
a demonstrated outcome in all the studies they reviewed.
Studies on the quality of life of trans people undergoing treatment have also found that early
diagnosis and intervention do reduce the symptoms and increase quality of life (Nakane and Ozawa
2005) in particular the first stage – hormone treatment (Newfield et al 2006). Yet, the research on trans
issues and access to healthcare suggests that much healthcare provision fails in the treatment of trans