2015 was an unprecedented year in the recognition of transgender rights in some high-income countries. However, as a new Series published in The Lancet today reveals, public recognition has yet to translate to a concerted effort to support and improve the health of transgender people across the world.
The Series, launched on Monday 20th June at the World Professional Association for Transgender Health (WPATH) 24th Biennial Scientific Symposium held this year in Amsterdam 1, was compiled with input of members of the transgender community and provides an assessment of the health of transgender people worldwide. While the study points to major gaps in our understanding of transgender health because of a failure to recognise gender diversity in public health efforts, the authors say there is enough information about this marginalised group to act now.
Estimates suggest there are around 25 million transgender people worldwide 2. Routinely denied their rights, transgender people often face stigma, discrimination and abuse leading to marginalisation which has further damaging effects on their physical and mental health (paper 1, figure). As a result of this social and legal context, transgender people have high rates of depression (reported up to 60%). Often excluded from families or the workplace, transgender people are at greater risk of engaging in risky behaviour (sex work or drug use for instance) and studies have shown transgender people are at almost 50 times greater risk of HIV than the general population (paper 3). Violence against transgender people is widespread and in between 2008 and 2016, there were 2115 documented killings of transgender people across the world, with many other murders likely going unreported or misreported (paper 1).
“Many of the health challenges faced by transgender people are exacerbated by laws and policies that deny them gender recognition. In no other community is the link between rights and health so clearly visible as in the transgender community,” says one of the lead authors for the Series, Associate Professor Sam Winter, Curtin University, Australia. “Faced with stigma, discrimination and abuse, transgender people are pushed to the margins of society, excluded from the workplace, their families and health care. Many are drawn into risky situations or behaviours, such as unsafe sex or substance abuse, which leave them at risk of further ill health.” 3