As a trans physician, I support bettering the health of other trans people. The most frequent criticism I encounter from neuroscientists is,” What does being trans have to do with neurology, the branch of medicine focused on the nervous program?” as I present my research studies to professional organizations and health institutions across the United States.
I can see why they’re perplexed. Trans health care is not covered in the necessary education at the American Board of Psychiatry and Neurology, which certifies psychiatrists in medical skills. Hence, it should come as no surprise that, according to a 2019 study, almost half of members of the American Academy of Neurology thought that gender identity had no bearing on how neurological conditions were managed.
This stage is frequently overlooked by proponents of transgender health care as well. Clinical management recommendations for the care of transgender people are developed by the World Professional Association for Transgenden Health ( WPATH). Some common neurological problems and their care are not covered in the most recent version, which was released in 2022. When these absences are taken into account, it is understandable why neurologists find it difficult to treat a transgender man who has just had their stroke, arrest, or migraine headache.
To address these problems, my coworkers and I have been publishing case reports and reviews. We have identified a complex heath care issue in the process. There are significant gaps in the capacity of psychiatrists to completely interact with, instruct, or research transgender people. A small percentage of writers of academic studies and publications are transgender clinicians or researchers who work in the public eye. As a result, language and terminology used to describe the transgender community in papers published in neuroscience journals are frequently out-of-date or unpleasant.
However, over the past ten years, medical research has shown that being transgender can have a significant impact on the health of the mind and the rest of your nervous system. Stress, discrimination, and the subtle effects of physiological medications that numerous, though not all, transgender people use as part of their health transition process are all at play in this complex interplay. Simply put, the cerebral area needs to better understand the unique risks and treatment requirements that transgender people face.
Studies involving transgender people, for instance, show a pattern in which cultural stressors like discrimination, shame, bias, violence, and rejection severely harm the body. Long-term exposure to elevated stress causes biological changes, such as an increased fight-or-flight response, with many negative effects, including damage to the blood vessels that provide the brain with oxygen.
More than 800 people of different genders with problems were followed by a study that was published last year, about half of whom were diagnosed with nausea. According to this study, participants who had suffered from trauma and prejudice had greater illness as a result of their migraine headaches. In fact, the degree of prejudice a person experience may cause pain disorders like migraines to get worse. This connection may help to explain why one study found that among Medicare recipients, transgender people experienced three times higher rates of seizures and migraine than did cigget people. According to a connection made by the American Heart Association, social factors can also have an impact on trans people’s cardio health. This connection reflects the natural effects of social stressors associated with gender.
Research identifies many flaws in the treatment that transgender people receive in addition to increased health risks. Treatment for those who have suffered a strokes serves as an effective illustration. Getting to the hospital as soon as possible after having a stroke can preserve both their life and the functioning of their head. Transgender people frequently postpone or evade seeking health care, according to surveys conducted in a number of nations, however, due to prior unfavorable interactions with the healthcare system. Furthermore, it is unknown whether trans people respond differently to stroke treatments used in an emergency environment, such as clot-busting medications, because sex is frequently not assessed in serious stroke trials.
Hormone therapy is yet another crucial element. The risk of blood clots, injury, and migraine may be raised by some affirming hormonal drugs given to transgender people, such as the extreme drug estradiol. Given these connections, a physician may stop administering hormone therapy to patients who have persistent headaches or strokes. However, doing so could be detrimental to that person’s mental health because hormone therapy, for instance, lowers depression and unhappiness in transgender people who seek this kind of gender-affirming care. Thus, neurologists should ask patients for their knowledgeable consent and talk to their testosterone prescriber about a patient’s preferences. This cooperative strategy may result in a different prescription, such as low-dose estradiol, or an alternative remedy.
There are many good changes being made for the neural treatment of transgender people, moving away from the current healthcare restrictions. As neuroscience advocacy efforts advance, the picture of transgender patients and healthcare providers is increasing. In the book Stroke earlier this year, a number of neurologists argued that stroke care providers need to understand the significance of reducing inherent and widespread biases in healthcare settings. For modifications might enhance treatment for trans individuals.
However, many transgender people wo n’t have access to the necessary medical care until more neurologists recognize and deepen their understanding of these problems. I personally find it difficult to find another transgender neurologists to supply my private medical care as a trans person. There is no niche category for neurologists in WPATH’s list of gender-affirming health care providers. The country may be on the verge of a public health problems as the number of trans people in America rises, especially among children and teenagers. This is due to the fact that more people of younger years are transgendered.
There have been reports of bias and discrimination in the workplace and healthcare settings, including mine and the few formally acknowledged trans psychiatrists. Discussions with deidentified doctors and medical employees have revealed related problems. A good litmus test for how well we health professionals handle trans patients is how we treat our colleagues. I contend that our transgender patients are not at the forefront of our thinking when we provide neurological health care because there are n’t enough publicly available neurologists. In the end, my detractors ‘ query,” What does being transgender have to do with neurosurgery?” is sufficient justification for the need to advance transgendered health care, education, and research in the field.
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