Wed. May 18th, 2022

Medical students should often pledge “no harm, first,” but in Baltimore, transgender residents and lawyers say the care provided by reproductive health professionals can be extremely harmful.

T. Irwin Pak Noonin, a 27-year-old non-binary artist, said reproductive health care facilities in the city have pressured her to give up treatment on several occasions because providers are “uncomfortable treating someone like me.” They were ten. “

Nunn’s experience is not unique. Many Baltimore transgender people express such an undesirable feeling from the healthcare system that many people are reluctant to have access to professional reproductive care. Noonan said he had personally heard numerous “horror stories” from other members of the local trans community.

“I’m afraid to talk to my providers about my gender identity, and I haven’t had reproductive health care in almost two years,” he said.

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Nunn added that providers in large parts of Baltimore have “so little knowledge” about treating patients with gender inequality that they are more interested in providers’ research and education than treating them as a single patient. What time is it

Research shows that Nunn’s negative competition with the healthcare system is common among trans people.

In a June 2020 study by the Center for American Progress (CAP), nearly half of transgender respondents جن including 68% of transgender people اطلاع reported abuse of healthcare providers in the past year. Twenty-eight percent of trans participants said fear of discrimination forced them to avoid or postpone essential medical care during the same period.

The CAP results were similar to the 2015 US Transgender Study, the largest national survey focusing on documenting the experiences of transgender people in the United States. The anonymous online survey, conducted by the National Center for Transgender Equality, collected data from more than 27,715 trans adults in all 50 states, as well as from District of Columbia, American Samoa, Guam, Puerto Rico, and U.S. military bases abroad. ۔

Nearly one-third of Maryland respondents who met with a healthcare provider last year reported that their gender identity led to at least one negative experience, including refusal of treatment, verbally. They need to be harassed, or physically or sexually assaulted, or educated. Providers about trans people to get proper care.

Go nowhere

Lee Blinder, executive director of Trans Maryland, a nonprofit organization focused on connecting trans and non-binary residents to local resources, as well as guiding them through the legal process related to transfers. For the infamous time is considered undesirable.

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Blinder said only a handful of Maryland-based trans residents rely on providing reproductive health care. If a resident is also black, disabled, or in need of trauma-aware care – Blinder noted the intersections are common in the trans community – “Options, already thin, are diminishing.”

“The more care we get, or the more gender the care is, the more problems we see,” Blinder said. Abortion care is one of the most specialized and gendered forms of health care.

Jessica Blum, a 40-year-old Trans resident, works from home as an administrative assistant in Harford County, 25 miles from Baltimore. When it comes to finding safe abortion care, she said, linking all the barriers women already facing, “a trans man has to go through only if he has a cold” Creates the chances of the individual being safe. Abortion care “in single digits.”

In her hometown, Blum said she would “not even know where to go or who to call for an abortion.”

Fighting “mass misinformation”

Moss Forum, aka Moss de Dola, is the only trans-dola practitioner in Baltimore. For the past three years, they have been providing sex verification pregnancy, labor, and birth services, including postpartum and abortion support.

The forum explained how healthcare providers in Baltimore – even those who market themselves as LGBTQ + friendly – continue to spread “massive misinformation.” For example, Froome said that many trans patients are told by their doctors that taking testosterone can prevent pregnancy – a view that does not support scientific research.

“People get pregnant accidentally because their healthcare providers tell them it won’t happen,” she said.

Medical providers also believe that taking testosterone can cause problems if someone decides to try to get pregnant later, Froome said. He added that, on the contrary, “a lot of incidental evidence” suggests that a person can get rid of testosterone “perfectly” and have a healthy pregnancy.

A landmark 2019 study of Boston IVF, an international trailblazer in fertility care, supports the forum’s claim. Based on eight years of patient data, the study concluded that “[assisted reproductive technology] The results can be excellent even if testosterone therapy has already been started.

Breastfeeding is another area where misinformation continues. Surgeons often tell people who undergo top sex-confirming surgery that the breast tissue needed for breastfeeding will be completely removed. “That’s not true,” Froome said.

Chest swelling is common during pregnancy, even in people who have had surgery, according to a 2021 poll by the American College of Obstetricians and Gynecologists under the Committee on Gynecological Practice and the Committee on Health Care. Froome said the experiment could lead to significant gender dysphoria for trans patients, especially if they are not fully informed by their doctor.

Sometimes supplier assumptions can be directly contradictory. Nunn recalls her experience of trying to control a birth several years ago at a prominent Baltimore supplier who “immediately assumed I wouldn’t want reproductive services because I’m trans,” and here It turned out that Noonan’s trans identity was a “product”. Trauma and it must be treated. “

“This treatment makes it difficult to rely on any reproductive care in the area,” Noonan said.

Facing “Strong Barriers”

The fear of discrimination described by Noonan is something that customers face all the time, Froome said. “People will avoid care if they know they will be sexually assaulted or not verified,” he said.

Forum has seen this fear create a “dangerous environment” in the local trans community, especially when it comes to access to abortion. In a peer-reviewed study first published in the journal March 2021 BMJ Sexual and Reproductive HealthA high percentage of transgender and non-binary participants reported considering or attempting to terminate their pregnancy without medical supervision.

“Some people talked about inserting needles into their vagina, hitting their uterus with a hammer – severe trauma to the abdomen,” said Dr. Heidi Mossison, the study’s lead author. He also described the alleged use of drugs, alcohol and other chemicals for abortion.

Moseson, an epidemiologist with Ibis Reproductive Health whose research examines issues related to the reproductive health care needs of trans and non-binary people, has written more than 35 peer-reviewed publications. Ibis is a 20-year-old nonprofit research center based in Massachusetts that focuses on compiling sexual and reproductive health data to better inform advocacy efforts.

Mussison’s team designed a survey of sexual and reproductive health care experiences that it gave to more than 5,000 participants nationwide, including approximately 1,700 trans and non-binary people. The study’s authors concluded that the results of the survey may reflect the presence of “significant barriers to the care of facilitated abortion” for trans people.

The survey also included questions about what respondents thought clinics could do to make abortion care accessible. The answers suggested a number of simple changes, such as gestures, photography, and intake forms, Mussen said. “It’s really a low hanging fruit,” he said.

Although the medical field is slowly beginning to recognize the need for gender-confirmed healthcare, there is still much work to be done, Mussen said.

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