Did you know that STI’s are on the rise all over the world? Despite all the education and safety measures we have, the cases of reported STI’s is increasing every year. Mind you this is just the reported cases, can you imagine what the numbers would look like if you took all the non-reported cases and added them in. As of 2015 the CDC estimated there were 110 million cases of STI’s with approximately another 20 million each year after in the United States. The WHO organization estimates 357 million new infections each year world wide with approximately 1 million each day.
The CDC estimates approximately 1 million adults in the United States identify as transgender. The lack of knowledge regarding transgender people, and the social stigma and discrimination that accompanies homosexuality in our culture, transgender people regularly fall into a gray area that has very real and dangerous consequences. It is common that transgender people don’t get the healthcare they need which increases their chance of transmitting an STI or HIV as well as passing it on to their partner(s). Many doctors don’t have the training, both in terms of medical knowledge and sensitivity, to provide care for transgender people, especially if they’ve undergone sex reassignment surgery.
If a transgender person contracts an STI the physician can not go about identifying the disease the same way they would with a cis-gendered individual. The doctor needs to understand that transgender people’s bodies are different from cisgendered people. Despite me being a man I still have female genitals, therefore checking me for an STI would be different than checking a cisgendered male for STI’s. This is why it is important that the healthcare system is knowledgeable about transgender healthcare in order to properly diagnose diseases as well as be respectful to the person. In practice, transgender people may avoid screening procedures and physical examinations due to fear of discrimination, encountering providers who are inadequately trained in transgender health, or personal discomfort with the visit or exam. I go to the gyno on a regular basis because I take good care of my health, but it is a very unpleasant experience for me to do, like most transmen.
The prevalence of high-risk factors that are routine for many transgender people, such as homelessness, incarceration, unprotected anal sex, and being employed in sex work, combined with the fact that the hormones used can cause erectile dysfunction and lead many transgender women to assume the receptive role during sex, contributes to the reality that transgender women have the highest risk of contracting STI’s especially HIV/AIDS of all demographics worldwide. Additionally, studies have suggested that the increased anxiety caused by societal discrimination, abandonment by family, and sexual rejection lead to a higher instance of alcohol and substance abuse in the transgender community, which is associated with a higher risk of contracting STIs and HIV. Transgender women have a very high chance of contracting HIV; about 49 times the risk than the non-transgender population. Statistically, African American transgender women have the highest number of positive STI and HIV test results in the United States. According to the CDC more than half of all transgender people who were tested for HIV and STI’s were tested outside of a healthcare facility with 99 percent of them being transgender.
More research is needed to identify and begin to tackle the issues plaguing the trans community, including the high risk of HIV infection, which in turn leads to a high risk of co-infection with other STI’s. The CDC provides support for health care and community organizations dedicated to helping transgender people. Campaigns designed to reduce the stigma associated with being transgender also help by creating a kinder, gentler environment and, hopefully, reducing the instances of physical and sexual violence against transgender individuals. As with any other demographic, getting tested for STI’s and HIV is pivotal for preventing the spread of disease. The problem in the transgender community is the lack of healthcare out there. Trying to find an educated physician who understands what transgender is, is hard to come by. Confidential STI testing can also alleviate the stress and potential mistreatment that comes with visiting a physician’s office.
The biggest factor in not contracting an STI or HIV is have protected sex and don’t reuse needles, especially from other people. Transgender people may be at a higher risk on contracting these diseases, but that doesn’t mean we can combat that and lower our risk through education and safe practices. Don’t be afraid to get checked and make sure you go to a reputable physician that hopefully is well versed in the trans community. Provide knowledge to your physician if they don’t know because the best advocates of our own healthcare is us and other people in the trans community. Stay protected out there and make sure you get tested.