Trans* - PowerPoint Presentation

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Trans*

Population in a health context * Transgender and Gender Nonconforming (TGNC) CommunitiesSlide2

TRANS*

POPULATION IN A HEALTH CONTEXTREACTIONS TO TRANS Migth reflect: Stigma within the medical communityMisunderstanding, generating some discomfort or lack of tactHealthcare provider’s lack of knowledge (specificities and needs) whichmay affect their access to carePervasive stigma and discrimination attached to gender nonconformityaffect the

health and

wellbeing of Trans people across their

lifespan

Must be taken into account:

The trans-identity diversity and mainly the individual’s self-genderdefinitionIntersectionality: biological sex, type of TGNC identity, sexualpreference, ethnicity, geographical localizationSlide3

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POPULATION IN A HEALTH CONTEXT TRANS REACTIONS Healthcare impactsReluctances: to find and to remain in a healthcare service; to talk about sexual health and proctologic, urologic, gynecologicdisorders or body transformationsto disclose their non conformed gender identity/their HIV statusLeads to:

Delayed

access to

care

Resort to non-

professional care (e.g., silicon pump parties)

Self-medication

drugs

(

hormones, corticoids, benzodiazepines antibiotics, etc) in the various galenic forms and frequently in high concentrations, leads to undesirable and drugs interactions effectsSlide4

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POPULATION IN A HEALTH CONTEXTRISKS OF… CROSS-SEX HORMONES THERAPYHigh concentrations, self-medication or inadequate medical prescription (with or without ART) for TSWPsychiatric/ psychological evaluation/ screening neuro-cognitive disorderImplants of soft tissue fillers (industrial silicone) without medical supervisionchest binding

SEX REASSIGNEMENT SURGERY (

SRS)

BAD OBSERVANCE OF POSTOPERATIVE

INSTRUCTIONS MAY LEAD TO:

Infectious complicationsFistulisationsNeovagina’s canal stricture/obstruction and/or urethral strictureSlide5

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POPULATION IN A HEALTH CONTEXTRISKS OF TRANSMISSION HIV / STI / VIRAL HEPATITIS Screening: Tb, syphilis, gonorrhoea, HPV, chlamydia, HCV, HBV et HAV. Barriers to optimal health outcomes among HIV patients with multiple comorbidities include:Being diagnosed with HIV infection late in the course of the disease Lack of a social and

emotional support à e.g., increases STI

Polypharmacy

Physical

limitationsThe hiv status increases health disparities:Lack of insurance or underinsurance for health services

Lack of knowledge among health care providers and support staff

Insensitivity

,

hostility and discrimination Non-observance of ART Transgender SW women are more concerned Slide6

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POPULATION IN A HEALTH CONTEXTRISKS OF CONSUMPTION… OF TOBACCO, ALCOHOL, PA Substances Smoking tobacco/cannabis PLHIV increases≈13X the lung cancer risk• CV risks (+oestrogens)– Alcohol risks increases with oestrogens and ART interactions– Sleeping pill (BZD/opioid) over consumption– Coke may cause heart stroke without

atheroma

MENTAL HEALTH PSYCHOLOGICAL/PSYCHYATRIC SUPPORT

Take

into acount:Native language and cultural aspectsStyle and history of lifePrecariousness and

mobility

Individual

trans-identity

processSomatic comorbiditiesAvoid leaps or preconceived ideasTrans persons in prison Slide7

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POPULATION IN A HEALTH CONTEXTCHALLENGES TO CONSIDER REGARDING GENDER IDENTITY DEFINITIONS Awareness of various stakeholders: reception staff, social workers and paramedical and medical caregivers to the particularities of Trans persons in compliance expectations. Ensure proper appellation/Civil state desired by the person. Trans people, despite some stigma experienced also need to be aware of the constraints imposed by the administrative procedures, schedules and appointments. Social inclusion, awareness and tolerance to gender diversity should be effective from the early stages of life in order to mitigate the adverse effects of generated discrimination. Slide8

TRANS*

POPULATION IN A HEALTH CONTEXTINTEGRATED CAREINTER- AND PLURI-DISCIPLINARITYPrimary care:Health promotion, diseases prevention, health maintenance, counseling,patient education and empowerment.Integrated Health gender care in HIV care (vice-versa)Coordination of services across patient care continuum:Trans women population living with HIV require extensive carecoordination as consequence of complications related with gendertransition’s and other co morbidities or chronic diseases.Official survey, Evidence-based HIV prevention, education, care andtreatment intervention for TSW, inclusion of gender health in care providers’curriculum are urgently needed wSlide9

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POPULATION IN A HEALTH CONTEXTPREVENTION CAMPAINS AND RISK REDUCTIONScreening for HIV infections/viral hepatitis and STIs should be done with SUITABLE information Succinct and clear written messagesPeers must be trained and sensitized to oral dissemination of prevention and harm reduction messages in sexual transmission and use of drug equipment and sharing personal hygiene material or filler injection by HIV / Viral Hepatitis / STD• Disclosure of devices PrEP (pre-exposure prophylaxis) and PEP (post exposure prophylaxis) must be prescribed by approved/ qualified doctors and should never be used for self-medication

Active militancy against any type of

discrimination

wwSlide10

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POPULATION IN A HEALTH CONTEXTACKNOWLEDGEMENTSGAT – Portugal Grupo de Activistas em tratamentos

www.gatportugal.org

EATG

www.eatg.org www.ageingwithhiv.org

Dr

Anaenza

Maresca (Hospital Embroise Paré – Paris)Françoise Gil www.esf-editeur.fr/detail/775/prostitution---fantasmes-et-realites.html

Jo Bernardo

jobernardo@gmail.com