The healthcare needs of non-binary transgender individuals should be acknowledged, understood, and taken seriously, scientists say.
For years, many experts have considered gender to be a binary construct, with people falling into male and female categories in an “either-or” way. However, these distinct categories do not always apply.
For example, bi-gender people switch gender roles according to particular situations. An individual may be female at work but male in social situations. Or, people may be genderqueer or genderfluid, placing their gender on a continuum that isn’t 100% male or female.
In a recent Journal of Sexual Medicine study, researchers surveyed a group of 415 trans individuals in Germany to learn more about their demographics, their word choices used to describe gender, and their use of transition-related healthcare in the following four categories: mental health counseling, hormonal treatment, treatments regarding primary sex characteristics, and additional treatments not concerning primary sex characteristics. All of the participants were at least sixteen years old.
About 82% of the participants categorized themselves in binary terms, using words like female, male, trans-female, trans-male, transgender, transident, and transsexual. The remaining 18% were considered non-binary or genderqueer (NBGQ) and described themselves with words like bigender, genderfluid, genderqueer, in between, inter, and agender. Sixty-three percent of the NBGQ group used words that were not listed on the survey; the most common term was neither nor.
Seventy percent of the NBGQ group had been assigned as female at birth; in the binary group, the two birth genders were distributed more evenly, with 48% assigned female.
NBGQ participants tended to be younger than their binary counterparts, with median ages of 35 and 39, respectively. It’s possible that younger participants might have been experimenting with NBGQ roles as an adolescent transitional phase on the way to a binary gender, the authors suggested. But they added that younger people may feel more comfortable expressing gender this way than older people might.
NBGQ people also tended to live in larger cities, where they might feel more freedom to be themselves and have greater opportunities to connect with other NBGQ individuals.
NBGQ participants accessed transition-related healthcare less frequently than the binary group, perhaps because, in their view of gender, fewer treatments were needed for their transition to feel complete.
For planned treatments, the two groups were similar for all categories except treatments regarding primary sex characteristics. Forty-three percent of binary participants planned such treatments, compared to 20% of NBGQ participants.
Healthcare providers should acknowledge gender diversity among their patients, the authors noted, especially since more NBGQ individuals are expected to seek care in the future. They called for providers to “become informed about NBGQ genders and expressions to appreciate the range of genders viewed as healthy and normative.”
Providers should also consider further training on gender to learn more about their patients’ healthcare needs, the authors said.
The Journal of Sexual Medicine
Koehler, Andreas MSc, et al.
“Genders and Individual Treatment Progress in (Non-)Binary Trans Individuals”
(Full-text. Published online: December 9, 2017)