Canadian Professional Association for Transgender Health

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Erasure in health care…

Lombardi (2001), described a transgender person’s right to health or access to care in modern society as still being restrictive and constrained. This is well elucidated in a more recent article on informational and institutional erasure and its impact on health care for transgender people (Bauer et al 2009). Informational erasure encompasses the lack of knowledge regarding transgender persons, and the assumption that such knowledge does not exist. Institutional erasure involves a lack of policies that accommodate transgender persons, and the questioning of whether such policies are necessary despite evidence to the contrary. These two processes work synergistically to ‘erase’ the person as they become defined by their transgender nature, which in turn impedes their ability to navigate the health care system. For example, a transperson’s visit to the ER with a broken arm can quickly loose its focus. Staff and students may question the patient about their transistion and discuss the merits of surgical reassignement, while the real needs of the patient (pain control, x-rays, and splinting) become secondary.