Non-Binary+&+Transgender+Identities-+FTM+in+the+United+States

= = toc =What it Means to be FTM= FTM (Female to Male) transgender or [|trans men] are individuals who were born biologically female, but whose [|gender identity] is male (Kenagy & Hsieh, 2005). Many experience a transition process in order to identify outwardly with their 'maleness.' This may include dressing like men, cutting their hair short, taking hormones, or receiving gender/[|sex reassignment surgery]. FTM transgenders are one of the least studied groups among sexual minority populations in the United States (Forshee, 2008). Most of the research focuses on the transition process and the discrimination and oppression many FTM transgenders experience in United States culture. =Transitioning= For those identifying as FTM, transitioning can take form in many ways. While many identified FTM's desire reassignment surgery, others live their lives without a surgical intervention (Forshee, 2008). Many FTM transgenders may not be able to economically afford surgery, or even hormone treatment. United States private health insurance usually does not cover hormone treatment or surgery because they are considered cosmetic (Newfield, Hart, Dibble, & Kohler, 2006). For those who cannot afford hormones or surgery, they may use less costly body modifications such as [|breast binders] or [|prosthetic genitalia.]All of these methods help FTM transgendered individuals live in the gender they identify (Meier, Pardo, Labuski, & Babcock, 2013).

Hormones
For many trans men, they may see hormones as necessary in order to "[|pass]or successfully live in the male gender" (Steinle, 2011). Hormone treatment has two purposes: reducing female [|secondary sex characteristics], including eliminating menstruation; and generating male secondary sex characteristics. The United States has eligibility and readiness criteria for FTM transgenders regarding hormone therapy. For eligibility, individuals must be at least 18, know the risks and benefits of the hormones, and either have real-life experience as a male for at least 3 months, or experience a period of [|psychotherapy]. The readiness criteria includes a consolidation of gender identity, progress in understanding methods used for improving and stabilizing the patient's mental health, and evidence that the patient will take the hormones in a responsible manner (Steinle, 2011).

[|Testosterone injections] is the most common hormone used by trans men. This transitional method is often used before other transition-related methods (Forshee, 2008). Testosterone may cause the deepening of the voice and a cessation of menstruation quite quickly, but the maximum effect of the hormone may take upwards of two years of continuous treatment (Steinle, 2011). Two different studies found a better quality of life for trans men who received hormonal treatment compared to those who did not (Motmans, Meier, Ponnet, & T'Sjoen, 2012; Newfield, Hart, Dibble, & Kohler, 2006).

Surgery
Surgeries for trans men include both top and bottom surgeries. [|Mastectomies] involve chest reconstruction. A [|hysterectomy] involves the removal of the uterus, and [|bilateral salpingo-oophorectomy (BSO)] involves the removal of the ovaries and fallopian tube. [|Phalloplasty]involves constructing an artificial penis. Gender affirmation or reassignment surgeries may be economically unavailable to FTM transgendered individuals as they can range from $3,000 to $100,000 (Meier et al., 2013). According to the [|Hudson's Guide to FTM surgeries], the phalloplasty procedure tends to be the most expensive, ranging from $50,000-$150,000. This may explain why more trans men get top surgery rather than bottom (Siebler, 2012). In a study by Forshee (2008), 43% of the FTM respondents had completed a double mastectomy, while only 18% had completed some sort of bottom surgery. More than half of the participants who did not receive bottom surgery claimed cost was a barrier to completing the procedure.

[|The Standards of Care for the Treatment of Gender Identity Disorders] lists criteria for those FTM transgenders wishing to obtain top or bottom surgery. These include: being at least 18, having 12 months of hormone therapy, having 12 months of real life experience as the preferred gender, and completing a psychological evaluation by two mental health professionals (Rachlin, Hansbury, & Pardo, 2010).



=Cultural Experience: Discrimination and Stigma= Most transgender individuals face oppression and discrimination resulting from social stigmas regarding their gender 'nonconformity' (Bockting et al., 2013). In the United States, transgender individuals experience prejudice and discrimination in all facets of life including: housing, employment, governmental policies, and access to health care and insurance coverage (Forshee, 2008). They may also experience discrimination from people who should be a support system: family members, friends, and partners (Dispenza, Watson, Barry, & Brack, 2012). As a result of this discrimination, many transgendered individuals are prone to experience low self-esteem, depression, anxiety, loneliness, and substance use problems. This can lead to issues like dropping out of school or losing jobs (Dispenza et al., 2012). A study by Newfield discovered a significantly lower quality of life in FTM transgenders when compared to [|cisgendered]male and female populations (Motmans et al., 2012). A lot of the research focuses on areas of discrimination regarding healthcare providers and services.

Health Care
In the United States, transgendered individuals typically experience discrimination and provider insensitivity when trying to access healthcare services. Many primary care physicians are unfamiliar with transgender treatment protocol. Not being able to rely on a supportive healthcare system can be attributed to a lower quality of life. (Newfield et al., 2006). A needs assessment of FTM individuals conducted in Los Angeles found 42% of the participants cited difficulty accessing healthcare, 53% of participants claimed being denied services because of their transgender status, and overall, 70% were unsatisfied with their provider's knowledge surrounding transgender issues (Rachlin, Green, & Lombardi, 2008). The documentary film, [|Southern Comfort], follows the last year in the life of Robert Eads, an FTM identified individual. He died of [|ovarian cancer] when he was unable to find a medical provider who would treat a transgendered patient (Rachlin et al., 2008).

=Suggestions for Researchers and Communities= In terms of conducting research, Forshee (2008) suggests avoiding generalizing the experiences of trans men to the broader transgender population. It should not be assumed that these individuals share a common history, perspective, or transitional experience. In terms of communities, unisex bathrooms should be constructed, and representatives with training in transgender issues should be employed in workplaces and health centers (Dispenza et al., 2012).

media type="custom" key="25750836" This is a video depicting the 5 year change experienced by an FTM individual taking testosterone. =References= Bockting, W.O., Miner, M.H., Romine, R.E.S., Hamilton, A., & Coleman, E. (2013). [|Stigma, mental health, and resilience in an online sample of the US transgender population]. //American Journal of Public Health, 103//(5), 943-951. doi:10.2105/AJPH.2013.301241

Dispenza, F., Watson, L.B., Barry Chung, Y., & Brack, G. (2012). [|Experience of career-related discrimination for female-to-male transgender persons: A qualitative study]. //Career Development Quarterly, 60//(1), 65-81. Retrieved from http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=548c4bb9-aaa6-4efb-ac2b-3f0f13bce6a7%40sessionmgr4004&vid=2&hid=4212

Forshee, A.S. (2008).[| Transgender men: A demographic snapshot]. //Journal of Gay & Lesbian Social Services: Issues in Practice, Policy & Research, 20//(3), 221-236. Retrieved from http://0-www.tandfonline.com.libcat.widener.edu/doi/full/10.1080/10538720802235229#tabModule

Kenagy, G.P., & Hsieh, C. (2005). [|The risk less known: Female-to-male transgender persons' vulnerability to HIV infection]. //AIDS Care, 17//(2), 195-207. doi: 10.1080/19540120512331325680

Meier, S., Pardo, S., Labuski, C., & Babcock, J. (2013). [|Measure of clinical health among female-to-male transgender persons as a function of sexual orientation.] //Archives of Sexual Behavior, 42//(3), 463-474. doi:10.1007/s10508-012-0052-2

Motmans, J., Meier, P., Ponnet, K., & T'Sjoen, G. (2012). [|Female and male transgender quality of life: Socioeconomic and medical differences]. //Journal of Sexual Medicine, 9//(3), 743-750. doi:10.1111/j.1743-6109.2011.02569.x

Newfield, E., Hart, S., Dibble, S., & Kohler, L. (2006). [|Female-to-male transgender quality of life]. //Quality of Life Research, 15//(9), 1447-1457. doi:10.1007/s11136-006-0002-3