The "T" in LGBT could, arguably, be the foundation of a new acronym that includes, well, any and everybody. That's because the transgender ( "T" ) community spans all genders, sexual orientations and lifestyles.
That was the subject of a meeting by the Chicago Task Force on LGBT Substance Use and Abuse ( CTFSUA ) at the City of Chicago Health Department May 19.
"The transgender community is not defined by a sexual orientation, which means it is just as diverse as the general population. Transgender people are gay, heterosexual, and bisexual. There's no definition of behavior that is unique to the transgender population," said Pamela McCann, co-chair of CTFSUA.
Specifically, the meeting focused on the unique health issues associated with the transgender community. It was attended by a handful of healthcare professionals, including Jim Belanger, HIV prevention case manager from the Haymarket Center; Aren Drehobl, staff psychotherapist from the Howard Brown Health Center; Tom Lyons, Director HIV/AIDS Policy Institute at Chicago State University; and Dr. David G. Ostrow, co-founder of Howard Brown Health Center, just to name a few.
Despite the broad and diverse nature of the transgender community, there remains much to learn about the unique health concerns therein. The reason, according to McCann and other public health officials, is because there is a "total lack" of coordinated research from the public health sector on transgender health issues.
"From the perspective of transgender people, the entire world is either 'transgender' or 'cisgender'. 'Cisgender' means that you're not transgender. It means that you're happy with your internalized identity and your physical self. Transgender refers to people who feel a disconnect between their physical body and their internal identification," McCann said.
In other words, 'cisgender' ( also called "gender normative" ) refers to how an individual identifies himself or herself in conjunction with the behavior or role considered appropriate for that person's sex. Thus, how one identifies him or herself matches one's sex, assigned at birth.
"Transgender," however, is an archetypal term that refers to individuals who feel that their gender identity and their physical body ( assigned sex at birth ) do not match. A transgender person may be born as a female ( the sex assigned at birth by a doctor ) , but feel psychologically and emotionally the opposite.
That may seem like "Gender Identity & Orientation 101," but understanding the distinction is key to understanding broader public health issues, not only within the trans community, but also the public at large.
A lack of cohort studies on trans health issues is just a piece of the puzzle. According to the National Center for Transgender Equality, transgender people experience higher rates of discrimination, even within the mainstream health community, which leads to increased rates of substance abuse, depression and suicide.
Also, transgender people are often diagnosed with gender identity disorder ( GID ) as defined by the American Psychiatric Association ( APA ) ; the primary diagnostic means to determine access to trans health services.
"From a psychiatric perspective, there's a gathering storm over language in the new Diagnostic and Statistical Manual of Mental Disorders ( DSM ) . One of the key issues is the definition of 'gender disorder'.' The language that the APA uses, 'disorder,' is somewhat of a double-edged sword," said Dr. Ostrow. "Some people are worried that the language will make it harder to get insurance payment for treatment" to trans-specific health services like hormone therapy, sexual-reassignment surgery, and mental health services.
"Others worry that the language in the new DSM, regarding transgender people, will be like how it [ the American Psychiatric Association ] treated homosexuals; that homosexuality was a disorder. So, referring to transgender people with 'disorder' associated with them, as a diagnostic term, has ramifications. It's a delicate balancing act," Ostrow said.
In related news, Chicagoland will soon host "Be-ALL," a transgender conference that aims to tackle trans-related subjects such as homelessness, substance abuse, victims of violence, STI/HIV, job discrimination, and generational and socioeconomic differences within the transgender community.
"We expect over 500 attendees at this year's conference. It's not only an important gathering for our community with great workshops, it's also a great networking opportunity," said McCann.
"Be-ALL" will be held Friday, June 4 at 2 p.m. at the Doubletree Guest & Conference Center, 2111 Butterfield, Downers Grove.
For more information about "Be-ALL" go to www.be-all.org . For more information on CTFSUA go to www. chicagoLGBTsubstance.com .