Across many cultures, those who identify as lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) are alienated and experience discrimination (APA, 2005). This discrimination is prevalent in various settings, including clinical settings. Although some hospital and clinics have instituted policies that are more inclusive and supportive of LGBTQ+ individuals. These policies and support systems can be improved for the quality of life of transgender patients (Grant et al., 2011; Messinger, 2011; Stolzenberg, 2017; Woodford, et. al, 2014).
The term transgender is an umbrella term for individuals whose gender identities do not comply with the binary assumptions and for whose birth sex is different from their internal and self-expressed identification (Dugan et al., 2012). For transgender individuals, identity is important to express themselves and who they are in society. Identity can be explained as the experience of oneself as unique, with clear boundaries between self and others; stability of self-esteem; and ability to regulate, a range of emotional experiences (APA, 2013). One way an individual can express identity is through gender. Gender is the public lived role as a man or woman and interaction with social and psychological factors to gender development (APA, 2013). Sex is the biological indicator of male and female, understood in the context of reproductive capacity (APA, 2013). One’s gender identity may differ from one’s assigned sex at birth.
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When a person begins to transition it can take years to fully transition or just a couple months depending on how the individual wants to go about their process of transitioning: socially, biologically, physically, or a combination of them. If it would be socially one may getting their name and gender marker changed. It could be a biological transition when they transition socially and use hormone replacement therapy to physically appear as their gender to society. On the other hand, they may desire to physically transition by having surgeries that would be gender reassignment surgery, to correct the gender they were assigned as at birth. However, some individuals change it up and only do parts of each for their transitioning. The concept of how a transgender individual come to terms with them being transgender can take years and can be at any age. Overall, transgender individuals do not wake up one morning and be in the stage in their transition that they would like.
Gender binaries in society are usually based on the gender beliefs. Throughout history, the beliefs of the male and female, gay and straight, and now the transgender and cisgendered binaries have been controversially topics. (Drescher, 2015). Many scientific studies of homosexuality contain information and definitions that were stated clearly and in detail but also information that was implied but not plainly expressed when it comes to the binary gender beliefs. First published in 1968, DSM-II (the American classification of mental disorders) listed homosexuality as a mental disorder. There is conflicting information on where or not in 1973, the American Psychiatric Association (APA) asked all members attending its convention to vote on whether they believed homosexuality to be a mental disorder(Burton, 2015 & Drescher, 2015). 5,854 psychiatrists voted to remove homosexuality from the DSM, and 3,810 to retain it (Burton, 2015). Gender beliefs usually only allow for the existence of two sexes. To maintain this gender binary, most cultures traditionally insisted that every individual is assigned to the category of either male or female at birth and that individuals conform to the category to which they have been assigned thereafter. Gender binary beliefs and the morals that are associated with them can play a role in the meaning and theory of homosexuality, similar to the nature and nurture argument (Drescher, 2015).
When it comes to health care, transgender individuals can be denied medical coverage for gender-affirming surgery to treat gender dysphoria, even though the medical company provides coverage for the same surgical procedures for other medical conditions. Today, most of the major medical organizations recognize that such exclusions have no argument in medical science and that transition-related care is effective for the treatment of gender dysphoria. But Insurance companies still ban coverage for procedures (Professional, 2018). Individuals can be banned for medical treatment because of the Department’s regulatory ban on providing such coverage.