An open letter to WHO: On World Mental Health Day, don’t forget trans people
This is important because even in relatively trans-friendly states in the United States, a diagnosis of gender dysphoria can save the lives of trans people – as it is required to access gender-confirming surgeries. Mental health professionals play a key controlling role for people in transition. (Whether Assurance will cover the surgeries is a whole other question.)
Things are generally worse in states ruled by Republican governments, which increasingly embrace open hostility to trans people. in law. In contrast, in strong democratic states, access to hormone replacement therapy is often much easier to obtain than in the UK, for example, and it is also usually much easier to change your name and gender on the Internet. legal documents.
Because trans people are marginalized and stigmatized, we also have higher rates of mental illness and suicide than the general population. The COVID-19 pandemic and its tensions have exacerbated these problems, as has the current crisis in the affordability of mental health care.
Finding a therapist can be a difficult and demoralizing process, especially for those who already suffer from depression. I know this from personal experience. I have been repeatedly shut off or ghosted by care providers, both in my search for a regular and long term therapist, and even in trying to make a single appointment for the assessment needed to get that coveted diagnosis of gender dysphoria – without which I can’t even schedule a consultation with a surgeon.
Doctors Susan Hata and Thalia Krakower recently made a passionate appeal to the American Medical Association to declare a national mental health emergency, quoting systemic issues that lead “many mental health providers to choose private practices, where high fees put services beyond the reach of many.” They describe how American patients often have to “hunt, one phone call at a time, for an available and affordable provider who calls back – a process known to be rife with racial and class bias.”
These problems affect many people. Hata and Krakower cite a US national study showing that “55% of participants contacted a psychiatrist only to learn that the doctor was not accepting new patients, and 33% could not find a single mental health care provider who accept their insurance “.
I appreciate that WHO’s action plan for mental health highlights the LGBTQ community, among other marginalized groups, whose needs should be met through community-based services. And although many of us continue to slip through the cracks, I am aware that there are many community organizations whose heroic staff and volunteers are doing rescue work locally across the United States.
In the future, I hope the WHO will focus more on access to health care for transgender and LGBTQ communities at large – access that in the United States is threatened by systemic problems in the community. how care is provided, as well as by the pursuit by the right of religious exemptions this amounts to discrimination by conservative Christians against trans and queer people.