ABSTRACT
This chapter examines experiences of sexual healthcare, as well as experiences of interactions with healthcare professionals, in relation to the mental health and wellbeing of trans people. In this analysis, we draw on the findings of The Positive Life Study, a recent survey of 699 trans people conducted in Australia, as well as published research in this sphere. Trans populations are recognised to be at a high risk for both sexually transmitted infections (STIs) and blood-borne viruses (BBVs) including HIV. However, many trans people postpone sexual healthcare needs and avoid obtaining healthcare services due to their fears or previous experiences of stigmatization, with a direct result on health outcomes. Trans people who avoid healthcare because of fear of discrimination have significantly worse outcomes than those who do not delay, or delay care for other reasons, including higher rates of depression and suicidal ideation. In the Positive Life Study, participants reported feeling misunderstood, unsafe, and experiences of discrimination in interactions with healthcare professionals. We found that comfort in healthcare settings, and comfort discussing sexual health, significantly predicted self-reported mental health, suggesting mental health was better for individuals who were more comfortable discussing sexual health with HCPs. Equitable access to sexual health services is a human rights issue for trans people. Sexual and reproductive justice requires that trans people should feel safe and comfortable when seeking healthcare, and should be treated with dignity and respect by clinicians.
