Intended for healthcare professionals


Comfortable in their bodies: the rise of transgender care

BMJ 2015; 350 doi: (Published 05 June 2015) Cite this as: BMJ 2015;350:h3083
  1. Bob Roehr, freelance journalist, Washington, DC, USA
  1. bobroehr{at}

Transgender people are seeking care for gender dysphoria in greater numbers than ever before, Bob Roehr finds

Driving a surge in demand for treatment for gender dysphoria are news stories about transgender people such as Laverne Cox, star of the Netflix comedy drama Orange is the New Black, and the Olympic gold medal winner Bruce Jenner (now Caitlyn Jenner). Such media coverage has helped make society more aware of gender dysphoria and eased social stigma. The culture shift has left transgender people more informed, more comfortable in their identity, and more willing to seek care, requiring providers to be more willing and able to meet their medical needs.

An equally important factor in the United States has been better access to health insurance, both public and private, and expanded insurance coverage of services that once were excluded. Many transgender people are able to access appropriate care for the first time.

The BMJ spoke with providers at clinics on both the east and west coasts of the US about these changes and caught up with the latest research findings at the Transgender Health Summit in April, organized by the University of California, San Francisco.

Defining transgender

The former GI Christine Jorgensen titillated the tabloids with her very public sex change in the early 1950s. At the time the general public’s understanding of sex and gender was a simple polarity of being male or female: a transgender person was a woman “trapped” in a man’s body or vice versa.

Today, transgender is just as likely to mean a person who resists being forced into a straitjacket of male or female traits, expectations, and behaviors that are assigned at birth. It is a universe of near infinite variation where, much like what is said of snowflakes, no two people are identical.

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