Transgender Health Myths

The health and well-being of a transgender person, though quite important, has many aspects that are very private and personal. In addition, there are also a few misconceptions within and outside the transgender community. So here we go busting up some myths.

Myth #1: Surgery is a Top Priority for All Transgender People

Surgery is not a top priority for all transgender people but it is impolite to invade the transgender person’s privacy by seeking to find out if they have had any surgeries. As we explore and promote transgender health and well-being, it’s important to keep in mind that though there is boundless curiousity, there are some things that are not open for conversation, unless the transgender person chooses to discuss it. The anatomical makeup and genital configuration is one such topic that is very personal.

Myth #2: Providing Transgender-Inclusive Benefits is Prohibitively Expensive for Companies. 

Jamaica is not at the stage yet where trans-inclusive healthcare is available from employers. However, it’s important to state here that providing such coverage is not expensive to companies. Trans-inclusive healthcare should be covered under the basic healthcare coverage afforded to all employees. Transgender health benefits are critical to well-being and productiveness of the transgender person, and therefore beneficial to the success of the workforce.

Myth #3 – My Child is Too Young to Know They’re Transgender

As parents and guardians, it’s important to listen to your child in all matters that concern them. The exploration of gender identity is no different. Children are by nature curious: they seek to know more about themselves and the world they live in. If a child has questions about their gender identity or gender expression, then caregivers need to be open to discussing these topics. The child’s emotional health and well-being should be what’s most important and a non-judgmental, loving and open conversation can go a long way towards the long-term success of the child.

Myth#4: Transgender Healthcare is ‘Special Care’

Transgender healthcare is NOT ‘Special Care. The transgender community is no different from the larger community that they exist in. Transgender people are a subset of the population and need healthcare just as all other persons do. Everyone’s medical needs are not the same. It is very important within our Jamaican context that healthcare coverage includes the needs of the transgender population so that the community can access services specific to their needs. Everyone has healthcare needs that are specific to their own needs, and the transgender community is no different. The mandate of the medical profession is to provide ‘special care’ to all. The acknowledgement of the transgender community and their needs is important in order to provide services for ALL Jamaicans.

Trans Profile – Jessica

(This is part one of a two part series. Part one focuses on Jessica’s personal journey to becoming the “ultimate” her. Part two focus on health care issues facing transgender persons in Jamaica and how she plans to change it. This interview was edited for length and clarity.)

Hi Jessica! Thanks so much for being a part of TransWave’s Transgender Profile Series. After meeting you, and watching a video of you at the Larry Chang Human Rights symposium, I knew we had to feature you on the site. Could you share with us a bit about your family background?

Thank you. Okay..let me take a deep breath. I was born in Kingston & St. Andrew. I was raised in a Christian family: father, Jehovah Witness, and mother, Pentecostal. Growing up as a very poor family but [we] try to mek ends meet, and all of that. I attended school when we had money.

Any siblings?

Yes, they were bigger than me. I was the youngest.

When did you first start to identify as female? Do you remember or was it just a gradual thing?

As far back as I can remember when I was two…two to three…playing with dolls. I knew within myself that I was different from everybody else. At first I think that everybody was one until you do things like purple touch. I saw that she act effeminate but then she has an organ that is different from mine. As kids even when you bathe together…you realise that she has a different organ but I could relate to her…whereas with boys their gender expression was different from mine.

Was there a moment that you decided to accept yourself as a woman or did the difficulties in that respect spring more from without than within?

I lived my life pleasing other persons. Even when I identified [I hid it] because the idea of being transgender is recent. We never knew about those things back then. If you’re effeminate you’re gay. When I started to go out and meet other members of the LGBT community and I act effeminate, they’d say, “So why you have to act so girly? Why you can’t be more masculine, why you can’t act more masculine?” I didn’t understand so I tried to accommodate them.

I remember a time there was this house lyme and they bluntly told me not to come because my gesticulations, how I am, would cause tension. When I said I wanted to get married and have children, they were saying, “Why you want fi change how God made you?”

Gay men, specifically, said this?

Yes. The community also had a journey to make [to accept transgender persons] and it hadn’t crossed that bridge yet. They didn’t understand.

The first time I found someone I could relate to was when I saw Laura. When I saw her I said, “Look at that nice lady.” Someone turned to me and replied, “No, she was a man.” They didn’t understand either because at that time people didn’t know the right terminology to use. I found out she was biologically male and transitioned to female. I could relate to her. Each time I saw her I asked her how she did it. I wasn’t in that capacity as yet. You have to know your surroundings before you start. If you want to cross [transition] but you don’t have the support network , the finances, it doesn’t make any sense. You have to wish and pray that one day you can become the ultimate you.

I considered for a long time whether or not I would just be a woman and not transition. It wasn’t until I did a training workshop in 2014 with Latoya that I learnt about transgender[ism]. We did the gender and sexuality talk. When I mapped myself it came back to transgender. I ripped up the paper, throw it away, did it again, throw it away…I got so frustrated until I decided to accept it. It was just really time to be myself, to evolve.

Now that I’ve started the transition, I’ve realised how stigmatised you can be. [Being seen as] gay, is one discrimination. Then being HIV positive. You get it from the wider society and within the LGBT community because no one wants to get involved with you because you are positive. If you’re doing sex work, that’s another thing. And now transitioning is another! Sometimes I am even afraid of those within the community. I went to a KFC once when an employee there recognised me. She told all her coworkers that I was a man. I was so disappointed. She was putting my life at risk. But I just stood my ground. Other times, they pass me on the street and bawl out, “Jermaaaaaaine!”

That might just be an inadvertent slip. It can take time to make that transition, too, into treating you as Jessica.

Yes.

Is it easier, in that sense, to move around in the wider society because they accept you based on your gender expression, whereas, those who knew you from before have to adjust to how you are now?

Yes. The first will see me and pass and go bout dem business. When I do my business at the bank, or with various companies when doing my bills, they would have known me as Jermaine. I’m okay with that. When I interact with their employees and they address me as Jermaine, I say, “No, my name is Jessica.” It’s a challenge for them so I have to educate them. They’ll say, “You don’t look the same as your ID photo. We have to call you by the name on the ID.” I tell them, “No, I’m giving you permission to address me as Jessica. It doesn’t matter what’s on the ID — I’m telling you what to call me.”

How long have you been out as transgender?

I took my time. You have different steps. If someone asked me how long I’ve been a transgender, I could say from I was a child. How long have I been living the life of a transgender? Not just identifying as transgender but living it: dressing as a woman, using the female bathroom…it’s two different things. I always tell persons it’s like learning to drive: moving the gear stick is one thing, but going on the road, keeping the vehicle steady, it’s another. It’s very difficult. I’ve been living the life for two months. The actual wearing of female clothing and so on, is about two weeks.

It takes a lot of courage. It’s not something where you wake up one day and say, “Today, I’m gonna put on female clothing!” You have to start off gradually. Maybe you start by wearing panties, then you start wearing shorts, you start dressing unisex, you know? I would advise other transgender persons to take their time and do it properly. Sometimes people rush. I’ve spoken with transgender persons living overseas. Maybe they’re in an environment that is more enabling so they rush and do the sexual reassignment surgery. But they didn’t start with hormones, they didn’t start to use the female bathroom. Maybe they didn’t go to a qualified surgeon. Some hear the word “transgender” and think it means you have to transition, when you don’t. They go through with the surgery then later regret it.

For Jamaicans, I say, take your time. Think about it. Jamaica is not an enabling environment. If you rush it you may have to leave your family, your community, and end up marooned in a place from which you can’t move. Fortunately, I am at a level where I am capable of managing it. I am blessed because I can wear female clothes to work and I can use the female bathroom at work. In my own right, by being me, I am an advocate. I educate: sitting down in my female clothing, talking and commanding persons. I say, “Listen, my name is Jessica, not Jermaine.” Then they go home and tell their families, their children, “I have a transgender at work.” [chuckles]

Part Two continues here.

In the News – Turning the Spotlight on Transgender People

Source – Jamaica Gleaner

Published:Thursday | June 18, 2015      Jaevion Nelson, Contributer. 

There has been a lot of talk over the last few weeks, especially in social and mainstream media, about transgender(ism), which is an umbrella term referring to persons whose gender identity is different from their biological sex. Biological sex is determined by an individual’s anatomical, hormonal and chromosomal make-up and is not the same gender (we’ll get to this later).

Kudos to 63-year-old Caitlyn Jenner who recently announced her transition as a transgender woman and appeared on the cover of Vanity Fair. For those who don’t know, Jenner is an American television personality and former Olympic track and field champion. As a teenager, Jenner has had to deal with gender dysphoria, which describes the discontent one experiences with their biological sex (male, female or intersex) and gender (man, woman or genderqueer). She has also done some amount of hormone replacement therapy to change the balance of her sex hormones in an individual’s body before she took the bold and courageous step to announce to the world that she is a woman.

Yes, Dr Garth Rattray, those ‘hot chicks’ are ‘chicks’! A biological female does not have a monopoly on who gets to identify as a woman because of her genitalia. Gender identity refers to one’s personal, individual, internal experience of attitudes, feelings and behaviours associated with their own, or a different biological sex. The American Psychological Association has provided an excellent online resource atapa.org/topics/lgbt/transgender.aspx for our edification.

The trans-community has much to celebrate. I am delighted that we are now talking about such an important issue one that has traditionally not been spoken of enough when we discuss the rights of lesbian, gay, bisexual and transgender (LGBT) persons. I wish, though, that within the hoorah about Caitlyn Jenner, we would pay attention to something profound that she said. Her experience as a rich white and popular trans-woman will be much different from the vast majority of women and men like her. Transgender people face many challenges. They require specialised medical, psychological and social services that are not available in the vast majority of countries. They are often unable to find decent work and pay and, like the ‘Gully Queens’, often end up being displaced or permanently homeless. The experiences of the trans-community are not homogeneous.

‘IT’ IS UNACCEPTABLE

In addition to homelessness and displacement, unemployment and underemployment, and inadequate access to health care, locally transgender persons are physically and verbally abused almost on a daily basis. Transgender persons are often denigrated and dehumanised, with little to no regard for their personhood.

It is against this background that I am concerned that Talia Soares, the host of TVJ’s pre-recorded entertainment programme, ‘Intense’, and Miss Jamaica World contestant, found it acceptable to refer to Caitlyn Jenner as ‘it’ and that the producers allowed such a highly offensive and dehumanising reference to be made about a person on national television.

Perhaps Talia did not mean to disparage Caitlyn and other trans-people, but she has to recognise ‘it’ was problematic and offensive. I am going to assume Talia didn’t understand how this might make transgender persons feel ‘less than’ or subhuman, and how it might make fans of the programme believe it is acceptable to refer to people as ‘it’.

Talia, may I suggest that you speak with human-rights defenders or transgender women like Tiana Miller who understand these issues and would be willing to have a conversation with you. You might also want to consider issuing a public apology and underscore the fact that it is unacceptable to refer to a fellow human being as ‘it’.

Admittedly, transgender issues are complex. It’s not easy to understand, and somewhat new for us in Jamaica. Despite this fact, let us all commit to being respectful of each other and using appropriate terms that celebrate our dignity and humanity regardless of who we are, how we express ourselves, who we love, the type of work we do, where we live, who we vote for or where we worship.

– Jaevion Nelson is a youth development, HIV and human rights advocate.

Trans Profile – James*

A riveting interview that shares the life experience of a queer transsexual Afro-Trinidadian. 

Hi James*, can you tell us a little about yourself?

I am a married, Afro-Trinidadian man in his 30s and lives on the east coast of the United States. I was born, bred and fed in Trinidad and Tobago and left at age 20 to study at the tertiary level. I have a doctorate and work full-time. Both of my parents are alive and well and are happily married. I have two siblings, both of whom no longer live in Trinidad. I am also a queer transsexual man. I use the word transsexual (as opposed to transgender) intentionally because it describes how I see myself; I am changing my sex characteristics and female aspects of my body. I am a man, regardless of what packaging I may or may not have. I identify as queer because I am attracted to all types of people, regardless of their gender identity.

How did you identify in your childhood/teenage years?

As a child, I didn’t think much about my gender or sexual identity. I was assigned female at birth so my family raised me as a girl. I didn’t have to question it much because I was a tomboy who was sometimes allowed to do whatever stereotypically boyish things I wanted (except when it came to formal events like church, family parties, etc. Had to rock a dress, ribbons, baubles, frilly socks and shiny shoes). I hated the name my parents gave me because I found it too “girly” and not reflective of how I saw myself.So, I made my friends call me “Sam” or “Alex;” those names followed me into secondary school and my best friend even used to buy me stickers with my preferred names. As I approached puberty, I had a more difficult time with my body and the changes I experienced. I think I started menstruating at age 10 but didn’t tell my mother (she found out two years later). I was angry and confused because I had to start wearing training bras and started getting puberty talks in school. This was when I had to confront my gender and “accept” that I was a girl. Everyone started having their primary school crushes and I was no different; my first crush was at 8 but I found myself attracted to an older girl who was one of the lead sopranos in my school’s choir. I knew that it was “wrong” to like another girl so I didn’t talk to anyone about it. I made up these imaginary boyfriends to fit in with my peers and convinced myself that because I spent so much time playing with this one boy, I must like him.

My teen years are mostly a blur but from what I remember, I really struggled. Everyone was growing out of their “tomboy” stage and my masculinity was becoming more pronounced and solidified. At 13, I came out as bisexual to my secondary school best friend (with whom I was madly in love) and really started to shy away from thinking of myself as a teenage girl. For some reason, being a teenage girl did not fit with my self-concept and I was having a hard time liking myself. I spent a lot of time in online chatrooms as an escape and found out about testosterone patches and their side effects (e.g., increased body & facial hair, increased muscle mass, deeper voice). Something clicked and I knew that that’s what I wanted my body to experience. For the first time, I felt like something made sense but there was no way I could explore this or access testosterone in Trinidad. So, I went through adolescence with the secret of being attracted to women, feeling less and less like a woman as I aged, and pretending to be feminine so people would stop treating me differently and teasing me. It wasn’t until I left secondary school that I embraced my masculinity and attraction to women. At that point, I was labelled a gay woman but that still did not feel right. I gave up on trying to make sense of my identity and spent a year of partying hard, drinking heavily, and smoking to numb my pain. I didn’t think about my gender when I was drunk so I just functioned like a machine.

What was it like growing up in Trinidad and Tobago?

I always think of growing up in Trinidad and Tobago as a love/hate story; the education I received was phenomenal and laid the foundation for me to thrive during my tertiary years. I enjoyed time spent with my family and friends, the cultural experiences of Christmas, Carnival, Easter and sometimes, the ritual of church (I was raised Roman Catholic). I was loved and respected because I was a solid student (when I wanted to be), a musician, a writer, a footballer, a cricketer. But I hated growing up there because I learned that there were aspects of who I was that were not accepted or celebrated. How could I love a country so much that didn’t fully love me back? It felt abusive and one-sided. I felt disingenuous living in Trinidad and felt like I was in a fog for most of it. I knew being a girl did not fit but there was no way I could question it, particularly when Trinidad was even more conservative when I lived there. Also, there was no language related to gender identity; you were either gay or straight. I grew up hearing anti-LGBTQ songs like “Boom bye bye” and “Bun out the chi chi,” listened to family members and friends ridicule gay people, and for years, I internalized those negative messages. I found myself disgusted and feeling unlovable throughout adolescence and my early 20’s because I was similar to those people they hated. I kept my mouth shut about my gender expression and decided that if I felt this tortured by age 25, I was going to kill myself.

Throughout school, I was teased by some of my peers for “acting like a boy.” I confided in one of my friends that I wanted to cut my hair and start openly “tracking girls.” When she threatened to tell my mother about my “nastiness,” I pretended that I was joking. After that experience, I created this person who would fit in with other girls. I had boyfriends who were more my friends rather than romantic partners. I would purposely dress in hyper-feminine ways but felt ugly and exposed whenever I did. When I completed secondary school and started working, some of my coworkers had the same reaction as my school friends; I wasn’t womanly enough and was “weird.” On the other hand, it was the first time that some of my male coworkers started treating me like one of the boys and that felt…natural. It was at this job that I had my first girlfriend. Our relationship was a secret to all but a handful of people who we told after being together for over a year. Even with the secrecy, I felt liberated because I was finally living part of my truth. But living your truth comes with a major price, which for me, was my extended family.

My family knew I dated women when I lived in Trinidad but no one talked about it; they just started treating and speaking to me differently. And I was okay with that because it made it easier to distance myself and feel less ashamed of who I was. While living in the US, I came out as a transsexual man and that caused major rupture in my family system. My parents accepted me as a person but they did not understand. My siblings were in disbelief and my brother said I would always be his sister. Those are the reactions that I was able to handle. My extended family’s vitriol, however, really cut me deep. My aunts, uncles and cousins verbally attacked me and said the most vile things about me, and my parents’ child-rearing; they told me that I was going to hell and that my parents should have beaten it out of me. They do not care about what I’ve accomplished over the years and I do feel sorry that they would never know how great of a person I am.

What were some of the challenges you faced while living in Trinidad and Tobago?

I truly struggled reconciling my religious beliefs with my understanding of my gender and sexual identity. I wanted to explore my identity but couldn’t because I learned that in my faith, acting on any sexual feelings toward someone of the same gender was sinful. But my challenges were not limited to sexual attraction; I was in a society that had no framework for transsexualism other than sex workers. I struggled with my appearance; what I wanted to wear, what I wanted my body to look like, the sound of my voice, my mannerisms…all of these contradicted the expectations family, friends and society had of me. The older I got, the more harassment and violence I experienced. I had people threaten to beat me up or offer to “show me how to be a woman.” I had police officers ridicule me as I was minding my business and walking through the street. One time, I went on a boat ride and they divided patrons into men and women. I went into the women’s line and had people loudly ask, “What that is? That look like a man. Wam to it boy?” I had security guards not want to touch me or let me into venues because of my appearance. I frequently went to well-known gay club in Woodbrook and one night, we had the pleasure of people throwing bottles into the venue and screaming homophobic epithets. People hated me for assuming I was gay but I knew they would hate me more if I told them I was a boy. When I left the country at 20, I felt broken. I am fortunate that I have never experienced serious physical violence due to my gender expression; trans women in the Caribbean are not that lucky.

Did you find it difficult accessing healthcare while in Trinidad?

Yes and no. I did not medically transition until I left Trinidad therefore, I have no experience with healthcare in Trinidad. However, I was sexually involved with women when I lived there and never once disclosed my sexual history to my doctor (who had been my physician all my life). I lied and said I was not sexually active because I could not deal with the stigma of being a woman who slept with women. My first girlfriend encouraged me to go to a particular gynecologist, as she knew him to be open-minded. When discussing sexual history, I disclosed that I had sex with women and he automatically said, “Oh. So you’re a lesbian?” I replied, “I didn’t say that. I said I have sex with women.” Again, I did not have the language to say “I’m a transsexual man” but to me, the distinction made sense.

How has your identity, sexual orientation and sexual expression changed or progressed through your adult-life?

The biggest change was not feeling like I have to play pretend any more. I lived two lives for a long time; there was the side of me that was the tomboy who lied to family and friends about not wanting to date because I was so focused on school. Then the other side of me was the Trini living in America who dated women, wore whatever I wanted, and started to do research on gender identity. This back and forth became exhausting and painful because it felt like constantly putting on a mask. I was miserable and immersed myself in my studies. I figured if I were the best student, when people eventually found out that I was a transsexual man, they wouldn’t care because the content of my character would be established by my academic and professional successes. After coming out to my extended family and being rejected by most of them, I realize how faulty that line of thinking is.

I am still attracted to women (and married to one!) but I no longer feel ashamed to admit that I also find men attractive. For me, asserting my manhood meant adopting really toxic aspects of masculinity, like internalized homophobia. “Real men can’t like men” or “Real men like sports.” Well, I am a real man who likes men and most sports are still boring to me. My version of manhood is not based in this stereotypical hyper-masculine trope often seen in Caribbean men and I’m okay with that.

How has your access to healthcare changed since living in the USA?

The only reason I have been able to medically transition (i.e., be on hormones, have gender affirmation surgery) is because I left Trinidad. Being in the US has helped me obtain resources that were not available to me when living in Trinidad. From what I gather, more people are aware that trans people exist in the Caribbean but they mistakenly think it’s the same thing as being gay so there are no health initiatives for people like me. Hormones and surgery are medically necessary for trans people and should be something that is incorporated in health care.

What are some of the changes you wish to see regarding the accessibility to healthcare for transgender men and women in the Caribbean?

First off, I want there to be a campaign to explain the difference between the LGB and T in the acronym. Trans people are not some hybrid or morphed form of gay and our medical issues are different. I want medical professionals to receive training to increase their awareness and enhance cultural competence, while learning how to keep their religious and moral beliefs out of their clinical practice. I want medical professionals to receive training on evidence-based practices with the trans population (e.g., hormone replacement therapy) and I want to see initiatives that create safe spaces for trans people. Look at what is happening in Jamaica with the trans women who are forced to live in the gullies and can only engage in sex work to survive. We are quick to mistreat our own countrymen who do not fit in these restrictive categories.

What advice would you give to transgender men and women living in the Caribbean?

Most people may not understand what it means to be trans but that does not mean your existence is any less valid. Find at least one ally who may not understand what being trans is but still sees and honours your humanity.

Live in your affirmed gender but be safe and strategic.

Always remember your value; no matter what external voices say, you know who you are. Do not let other people try to convince you otherwise.

Being trans isn’t “abnormal;” it is simply less common. Uncommon things are not automatically bad. Embrace your difference.

*Name changed upon request.