LGBTQIA+ information for patients

LGBTQIA+

We at PhillyHealthCares believe that LGBTQIA+ individuals deserve equal access to affirming and inclusive healthcare. We believe that LGBTQIA+ healthcare is a fundamental right.

"LGBTQIA+ is an acronym that brings together many different gender and sexual identities that often face marginalization across society. The acronym stands for lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, and the + holds space for the expanding and new understanding of different parts of the very diverse gender and sexual identities.” -Gender Sexuality Resource Center

A GUIDE TO GENDER IDENTITY TERMS

Sex

Refers to a person's biological status and is typically assigned at birth, usually on the basis of external anatomy. Sex is typically categorized as male, female or intersex.

Gender

Gender is a complex set of social constructs made up of norms, cues, and expectations.

Gender identity

An individual’s own sense of their gender is called their gender identity, which is often labeled as male, female, or nonbinary. For most people, their gender identity aligns with the sex they were assigned at birth, however this is not always the case.

Gender expression

Gender expression is how an individual chooses to present their gender identity to others outwardly through behavior, clothing, voice, etc. Society identifies these cues along a spectrum of masculinity, femininity, and androgyny. It is important to note that one’s gender expression will not always align with what society expects of their gender identity (a man may present femininely and a woman may present masculinely), though these instances of gender non-conformity do not invalidate these individuals’ gender identity.

Cisgender

Cisgender (cis) is an adjective that describes a person whose gender identity aligns with the sex they were assigned at birth.

Transgender

Transgender (trans) is an adjective used to describe someone whose gender identity differs from the sex assigned at birth. A transgender man, for example, is someone who was listed as female at birth but whose gender identity is male.

Nonbinary

Nonbinary is an umbrella term that can be used by people who do not describe themselves or their genders as fitting into the categories of man or woman. A range of terms are used to refer to these experiences like genderqueer, gender fluid, or demigender, but these terms all fall under the nonbinary umbrella.

Intersex

Intersex is an umbrella term used to describe people with differences in reproductive anatomy, chromosomes or hormones that don't fit typical definitions of male and female.

Intersex can refer to a number of natural variations. Being intersex is not the same as being nonbinary or transgender, which are terms typically related to gender identity.

Gender dysphoria

Gender dysphoria refers to psychological distress that results from an incongruence between one's sex assigned at birth and one's gender identity. Not all trans people experience dysphoria, and those who do may experience it at varying levels of intensity. Dysphoria is not necessarily a requisite to be trans. Gender dysphoria is a diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders. There is currently debate over whether the term incorrectly pathologizes the trans experience or if it is a helpful term to use throughout the transition process.

Reference: https://www.npr.org/2021/06/02/996319297/gender-identity-pronouns-expression-guide-lgbtq

PRONOUNS

Pronouns can be an important part of affirming and respecting a person’s gender identity. In fact, The Trevor Project found that transgender and nonbinary youth who reported having their pronouns respected by all or most of the people in their lives attempted suicide at half the rate of those who did not have their pronouns respected. Respecting pronouns can have a profound impact on a person’s well-being and health. The Trevor Project also found that LGBTQIA+ youth who report having at least one accepting adult in their lives were 40% less likely to report a suicide attempt in the past year. If you have questions about pronouns or how to respond when you witness them being misused, https://pronouns.org/ is a resource you can explore.

SEXUAL ORIENTATION

Sexual orientation refers to the physical, romantic and/or emotional attraction to members of the same and/or other genders. Labels for sexual orientation include lesbian, gay, bisexual, straight, and many more.

People don't need to have had specific sexual experiences to know their own sexual orientation. They need not have had any sexual experience at all. They need not be in a relationship, dating or partnered with anyone for their sexual orientation to be validated. For example, if a bisexual woman is partnered with a man, that does not mean she is not still bisexual.

Sexual orientation is separate and often unentangled from gender identity. Both cis and trans people can be straight, gay, bisexual, etc. A woman who transitions from male to female and remains attracted to only men is straight while a man who transitions from female to male and is attracted to only men is gay.

GENDER AFFIRMING CARE

Gender affirming care encompasses a wide range of social, psychological, behavioral, and medical interventions designed to support and affirm an individual’s gender identity. The interventions help transgender people align various aspects of their lives — emotional, interpersonal, and biological — with their gender identity.

These interventions fall along a continuum. Gender affirming care can include anything from counseling to personal care to medical intervention such as hormone replacement therapy. The gender affirming care that a trans person seeks out can vary based on a number of circumstances like level of gender dysphoria or personal health.

For children in particular, the timing of the interventions is based on several factors, including cognitive and physical development as well as parental consent.

GENDER AFFIRMING HORMONE THERAPY

Puberty blockers

Transgender youths who have not started or completed puberty can receive “puberty blocker” medication, which suppresses the release of sex hormones, including testosterone and estrogen. In patients assigned male at birth, these medications inhibit growth of body hair, prevent the voice from deepening, and limit the growth of genitalia. For those identified as female at birth, they stop or limit breast development and prevent menstruation.

One purpose of puberty blockers is to allow a young person time to fully determine their gender identity and how far they wish to transition before the onset of permanent sex characteristics. If puberty blockers are stopped during puberty, usual hormone development resumes until the end of that child’s puberty. This kind of early yet reversible intervention can allow a trans child to experiment with their gender identity while sparing them the distress of going through the puberty of their sex assigned at birth.

These medications are also sometimes used in adult patients when additional hormone blocking is required.

Hormone Therapy

Older youths (usually in mid-adolescence) and adults can receive hormone therapy to increase their levels of estrogen or testosterone so that they develop sex characteristics more closely aligned with their gender identity. These include more hair growth and increased muscle mass for those transitioning to a more masculine presentation, and breast development and testicular atrophy for those transitioning to a more feminine presentation.

GENDER AFFIRMING SURGERY

Gender affirming surgery includes a wide range of procedures such as plastic surgery to change features in the face to be more typically masculine or feminine, “top surgery” to make changes to the chest or torso, or “bottom surgery” to make changes to genitals. None of these surgical procedures are unique to transgender people. They are the same procedures that have safely and effectively been given to cisgender and intersex people for decades, for a host of cosmetic and medical reasons.

Prior research shows gender affirming surgeries are both safe and positively received by patients. Post-surgical complication rates are similarly low among transgender and cisgender people receiving the same type of surgery — if not lower among transgender people. Satisfaction with gender affirming surgeries is high, including for chest/top surgery, bottom/genital surgery, and facial surgery.

Gender affirming surgeries usually require the patient to undergo a lengthy screening process.

More information can be found here

WHERE CAN I ACCESS LGBTQIA+ FRIENDLY CARE

Coming Soon

CAN I ACCESS GENDER AFFIRMING CARE THROUGH TELEHEALTH?

Yes! Links Coming Soon.

DOES HEALTH INSURANCE COVER GENDER AFFIRMING CARE?

In Pennsylvania, the state Medicaid policy explicitly covers transition-related care. Many major insurance companies do cover gender affirming surgery.

A helpful link to choosing health insurance can be found here.