Grant: CIHR Café Scientifique Program

Gender identity represents the sense one has of being male or female. A significant incongruence between gender identity and physical appearance is known as gender identity disorder leading often to depression and social outcast. Manifestations of gender identity issues range from simply living as a member of the opposite sex to partial or maximal physical adaptation through hormonal and surgical treatment. Social rejection, discrimination and violence exacerbate the risk of sexual transmitted infection including HIV in these transsexual persons. The number of persons seeking help for gender identity disorder in Canada has recently increased based in part on the change of legislation, cultural values, hormonal therapy and surgical techniques. Persons undergoing sex reassignment can be reassured that serious short-term complications of cross-sex hormonal treatment appear to be uncommon. However, long-term effects on risk of cardiovascular disease, diabetes, and cancer are not well known. We will address a historical perspective on transsexual positive actions and on the criss-crossing forms of marginalization that include sexual stigma, transphobia, HIV-related issues in the context of community and social norms in Quebec . We will provide a frame-work to promote health equity and optimal medical management for these persons.