November is recognized as Transgender Health Awareness Month. This is a time to reflect on the experiences of transgender and gender nonconforming individuals seeking and receiving health care. It is also an important reminder of how everyone can take action to create a more equitable health care experience for all.
Mason Bobro offered valuable insight into the importance of Transgender Health Awareness Month in an interview with NBDF's Communications team. Mason is a transgender man with Factor 10 deficiency studying biology at Robert Morris University. He has spoken at multiple Bleeding Disorders Conferences on the importance of recognizing LGBTQIA+ voices within the inheritable blood and bleeding disorders community, barriers to health care, advocacy, and more.
Watch the full interview or read a transcript of the conversation below.
Tell us a little about yourself! What is your relationship to the inheritable blood and bleeding disorders and LGBTQIA+ communities?
My name is Mason Bobro; my pronouns are he/him. I have hereditary Factor 10 deficiency, moderate to severe, and I am a transgender man. I am also queer on the sexual orientation side.
How does having a bleeding disorder affect your health care experiences as a transgender person?
It mostly has to do with my transition, more of the medical aspect of my transition than the social aspect. Because I have a bleeding disorder, there are obviously complications with surgeries. I had a hysterectomy, and that was all sorts of complicated. I had to stay in the hospital for two days after my laparoscopic hysterectomy, which is way longer than normal because of the bleeding disorder and some things that they were worried about.
Additionally, hormone interactions between hormone replacement therapy and things like Factor are not known, so who knows if that's affecting me or not, but I thought I would include it anyway.
Has being transgender affected your experiences with health care providers in general?
I'm not sure if this is because I'm young, or because I was assigned female at birth, or because I'm transgender, but I feel like I don't get taken seriously in a doctor's office. Again, it could be for any of those reasons. It's definitely palpable in a doctor's office when you walk in and they brush off your concerns and it's very frustrating.
And I've had periods of time where I felt like I needed help but I would go to the doctor and I would get nothing. I didn't want to go to the doctor anymore because I felt like it wasn't going to help me.
Why is it important to highlight health care for the trans community specifically?
There are many reasons. The first is that transgender people and non binary people are disproportionately affected by social determinants of health, like housing and food insecurity. Additionally, trans and non binary health care needs are often not covered by insurance. Or they're covered, but you have to jump through a million and one hoops to get full coverage, and get coverage you desire for a surgeon that you want, because every surgeon's results are going to be different.
Current care for trans and non binary people is lacking. Data collection on intake forms is limited a lot of the time. There's only one question asking you for your sex. And there is no question about your gender identity. Or, if they have two questions, they don't have any non binary options.
Additionally, there are very limited treatment options. When you go into the doctor's office and you tell them that you're trans and you want to medically transition, you sort of get spoon fed this, "Oh, this is the path you have to take to medically transition." And what they don't tell you is that you don't have to take that path.
You don't have to go in the order they tell you you have to go in. You don't have to get top surgery before you get bottom surgery. You don't have to get any surgeries at all. You don't even have to do any sort of medical transition at all, but it's important to highlight health care for trans and non binary people for all of those reasons.
What do you wish more health care providers took into consideration when caring for transgender patients?
The biggest thing is that we have different needs. We as transgender and non binary people have different needs from the general population, but we also as individuals have different needs from one another. For example, trans and non binary people may be less comfortable with certain subjects like nudity or in heavily gendered environments like an OBGYN office.
Additionally, due to social determinants of health, we're more at risk than the general population for certain illnesses, such as HIV. We're in social situations where certain things like sex work are more common among transgender non binary individuals than in the general population. This is particularly pertinent given the history of bleeding disorders and HIV/AIDS, though hopefully that that crisis is behind us.
And at the same time, we as individuals are different from one another. For example, what I want is not going to be the same as what someone else who is a feminine trans man is going to want in terms of our medical transitions, so we can't all be put in the same box.
Given the current political climate, how would you recommend people advocate and show support for the community?
The number one thing is that you should stay safe. Do not do anything that is going to put yourself in danger. If you're in a location where advocating is not safe, please do not do so. We've got you. But if you are in a safe place where you can advocate, protesting is a good traditional route, as are petitions.
More modern routes are being active on social media. That is a great way to make some noise about your story and have your issues be heard. Keep telling your story everywhere you go. When people ask, answer. That's the best way to advocate.
It's the best way to get people to see who we are as a community and to be more open to us. It's a shame that we have to convince them, but it's the best way to do so.
What would you like to see in the future for the inheritable blood and bleeding disorders community?
The first thing I'd like to see as far as trans and non binary inclusion goes is inclusionary language. I know that we have the very fantastic women, girls, and people who have or had the potential to menstruate acronym (WGPPM). However, we don't have an equivalent phrase for people assigned male at birth, which is a shame.
I've also noticed that this language is not used everywhere it should be used at. It's gaining traction, thankfully, but it needs to gain more. There's still a long way to go.
Additionally, I would personally like to see transgender and non binary exclusive spaces. We do have LGBTQ+ exclusive spaces, but specific trans and non binary spaces will foster community among trans and non binary people within the bleeding disorders community and will also allow us to share specific needs with the NBDF, for example. That we come up with as a collective, instead of individuals saying what their issues are.
And finally, I would personally like to see informational materials on how to navigate trans and non binary-specific issues like changing your name and gender marker for health insurance or finding health insurance or providers that can navigate both your gender identity and your bleeding disorder.
Is there anything else you’d like to add?
Thank you for the opportunity. I appreciate it very much and I appreciate the work that you and NBDF and everyone who is doing to make things more inclusive for trans and non binary people. It's come a long way, and I hope to see it grow into something more.
Mason referenced data about social determinants of health, HIV among transgender people, and the health care experiences of the trans community during his interview. To learn more, visit the articles cited below.
HRC Foundation. (n.d.). Transgender people and HIV: What we know. Human Rights Campaign.
https://www.hrc.org/resources/transgender-people-and-hiv-what-we-know
James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The report
of the 2015 U.S. transgender survey. U. S. Trans Survey. https://www.ustranssurvey.org/reports
United States Centers for Disease Control and Prevention. (2022, April 22). Issue brief: HIV and
transgender communities. https://www.cdc.gov/hiv/policies/data/transgender-issue-brief.html
United States Department of Health and Human Services. (n.d.). Social determinants of health.
Office of Disease Prevention and Health Promotion. https://health.gov/healthypeople/priority-
areas/social-determinants-health
