Gender, Work, and Health for Trans Health Providers: A Focus on Transmen

Abstract

Well-documented health research points to trans people's vulnerability to health inequities that are linked to deeply embedded structural and social determinants of health. Gender and work, as social determinants of health for trans people, both shape and are shaped by multiple factors such as support networks, social environments, income and social status, shelter, and personal health practices. There is a gap in the nursing literature in regards to research on work and health for diverse trans people and a virtual silence on the particular issues of trans-identified health providers. This qualitative study used comparative life history methodology and purposeful sampling to examine links among work, career, and health for transmen who are health providers. Semistructured interviews were completed with four Canadian transmen involved in health care professional and/or practice contexts with diverse professions, age, work, and transitioning experiences. Critical gender analysis showed that unique and gender-related critical events and influences shape continuities and discontinuities in their careerlives. This strength-based approach foregrounds how resilience and growth emerged through participants' articulation with everyday gender dynamics. These findings have implications for nursing research, education, and practice that include an understanding of how trans providers “do transgender work” and supporting them in that process.

Listen carefully: transgender voices in the workplace

“…This result is consistent with qualitative work demonstrating that for many MtF individuals, becoming a woman was often associated with a loss of authority in the workplace, harassment on the job, and termination; for FtM individuals, becoming a man was frequently associated with an increase in respect and authority (Dozier, 2005;Schilt, 2006 Roberts (2013) One of MacDonnell and Grigorovich's (2012) interviewees opined that 'Being trans gives me a unique position in the world and … I want that to be known' (p. 7).…”

“…Smaller-scale, qualitative research demonstrates that disclosure can engender employer questions about trans employees' credibility, maturity, mental health, and fitness for the profession (MacDonnell & Grigorovich, 2012). When transgender employees are dismissed following their gender transition in the workplace, employers often attribute termination to economic factors such as budget cuts; the transgender employees affected perceive that their transition was actually the motivating factor (Budge, Tebbe, & Howard, 2010).…”

“…Trans individuals may also be prone to professional isolation, and consequent mental distress, triggered by moving jobs or careers in an effort to avoid disclosing a stigmatized identity (MacDonnell & Grigorovich, 2012).…”

“…As a result, too many organisations still have no specific transgender policy, and many of those that do are focused exclusively on gender affirmation surgery, which not all trans employees will undergo. Even for those trans individuals who do undergo medical gender affirmation procedures, exploratory research suggests that their concerns are with ongoing transitions without a set endpoint: the daily challenges of living and working in one's affirmed gender, and the significance of one's profession as it relates to an individual's trans identity (MacDonnell & Grigorovich, 2012). An organizational policy with a broader emphasis on respect for employees' affirmed gender identity, whether that be male, female, or a more fluid interpretation of gender altogether, may be more effective in signalling inclusiveness for transgender individuals.…”

Adulthood transitions in health and welfare; a literature review

“…It also contained life-cycle transitions, such as those from childhood to adulthood (Lee, Courtney, & Hook, 2012;Serracant, 2012) or from adolescence to adulthood (Allen & Williams, 2012) and life role transitions, such as the transition to parenthood (Behague, Goncalves, Gigante, & Kirkwood, 2012;Wardrop & Popadiuk, 2013) or grandparenthood (McKinley, Brown, & Caldwell, 2012;Taubman -Ben-Ari, Findler, & Shlomo, 2013). Yet another type of developemental transition was the gender transition (Brown et al, 2013;Macdonnell & Grigorovich, 2012). A "situational transition" (Meleis, 1985;Schumacher & Meleis, 1994) was described as a transition from one state to another, such as an employment transition (Butterworth et al, 2011;Cook, 2012), transition to retirement (Calvo, Sarkisian, & Tamborini, 2013;Oksanen et al, 2011) or marriage (Hewitt, Turrell, & Giskes, 2012;Robards, Evandrou, Falkingham, & Vlachantoni, 2012) and educational transitions (Perry, 2012;Salmela-Aro, 2012).…”