The young people we spoke to highlighted many ways in which race, culture and religion have shaped their healthcare experiences throughout their lives. Along with accounts from our participants, this summary has been informed by advisory youth panels conducted specifically with trans and gender diverse people of colour. Our participants talked about:
- Respecting cultural and religious differences
- Impact of western ideals and colonisation
- Experiences of racism and discrimination
- Representation in healthcare and information
- Finding community and activism
- Recognising and understanding privilege
Respecting cultural and religious differences
The impact that culture, heritage, and upbringing had on their experiences was discussed by the young people we spoke to. In some cases, this meant not feeling able to explore their gender until later in their lives. Max said, ‘I came from quite a strict [religious] background. I wasn’t allowed to explore [gender] at all. So I spent quite a long time just being really depressed without knowing why.’
Anderson says coming out [as a trans person of colour] and approaching your gender, culture, heritage and upbringing is a lot more to think about.
A talks about their Chinese background and the emphasis on traditional values and gender roles.
Finn says there are big differences in what’s socially acceptable and what isn’t’ according to different cultures.
Of those that we interviewed who grew up in religious households, many talked about the impact this had on their family members accepting their identity. H said in some cultures and religions ‘trans is not a thing’ because ‘however you’re born is how God or whoever made you, it’s not right to change it.’ He added that when he came out the general opinion among family and community members was “It’s not right… I don’t really understand it, but I just feel like it’s not right.”
Begam talks about the cultural differences in Pakistan and how this impacted on her parents’ approach to making sense of her gender identity.
Rahul talks about the difficulty of coming out to his Muslim parents and what this means for the community.
Cultural and religious differences also had an impact on young people’s healthcare experiences. Some participants talked about coming up against barriers, which they believed, were due to differences in beliefs. Tyra felt her doctor’s religion was a ‘highly contributing factor’ to his refusal to help her with her healthcare. The doctor told her ‘you [were] born this way and you should stay this way’.
Similarly, Jessica wondered whether the reason her doctor refused to work with her was ‘maybe due to his religion’ and ‘contrasting ideology’. Begam shared ‘it’s taken a lot of time to you know to talk to [her GP] to make him understand… but slowly in time I think he’s come to understand. However, she said that her GP has ‘commented to the bigger family that “from a religious concept, it’s only the Creator, he can help you and keep guiding you”.
Safia talks about their decision not to come out to family due to different cultural understandings of sexuality and gender.
June shares how his parents were quite involved in the church and didn’t have much exposure to queer or trans identities.
Impact of Western ideals and colonisation
Trans and gender diverse young people talked about gaps in understanding about the rich precolonial queer histories of many countries before western colonisation*. They wanted others to know about the diverse queer cultures that have existed for thousands of years. Kat said, ‘Trans people are viewed as new despite not being kind of especially new… trans people have existed in most cultures for years, forever almost’. She gave the examples of ‘Native American cultures have had two spirit trans people. In India there’s the Hijra’.
Rahul talks about the representation of the Hijra communities and the impact on his family’s understanding of trans people.
Shash talks about the stigma associated with the Hijra community and how it has affected her.
A says a lot of the queer phobia in China and Asia’ comes from the U.S and the Western world.
Our participants talked about how Western ideals of gender and sexuality influenced their experiences of passing. N talked about the differences between ‘passing in trans community and in racialised communities’. Jack said there is ‘the ideal of a trans man… that you see on social media a lot’ that is ‘very stereotypical skinny [and] white’.
June says it’s really interesting to me like how much we racialise…Asian men as effeminate inWestern culture.
Jaz talks about how the trans healthcare system is rooted in a conservative Eurocentric idea of gender.
M talks about the impact of colonisation on societies across Africa, the Americas and Asia.
Experiences of racism and discrimination
Young people talked about their experiences of racism and discrimination in relation with their healthcare experiences. N stated ‘it’s not hyperbolic to say that the healthcare system is racist or that cultural considerations are rarely factored in’. H said, ‘I feel like because I am a trans person, I’m a trans person of colour [I’m] not seen as a human. It’s easier for someone to be like, “No, fuck off,” to me, than if, if I wasn’t.’ N said, ‘there’s a starting point’ of having resources ‘made for trans people that actually acknowledges different experiences and barriers…in healthcare.’
H feels that they are less likely to be seen as a person’ as a trans person of colour.
Tyra talks about their experiences of race, class and religion and the impact on accessing healthcare.
N felt it was important to have conversations about the differing experiences of racism and the differences between ‘experiences of anti-blackness, the black experience of racism and other people of colour’s experience of racism’. They gave their own example of ‘being very light skin and the amount of privilege… that brings me and access to resources’.
M talks about their experiences of a surgeon making unhelpful assumptions about the body based on race.
Shash describes the racism in medical training a lot of [people of colour] learn to hide pain.
Part of this was because of the lack of resources aimed at people of colour. M said, ‘It’s difficult as a black person trying to access any form of healthcare or support that is from like another person of colour’. They added, ‘having them understand trans issues or being trans is additionally difficult in a racial sense.’ N made the point that, ‘most information in the [trans] community is written usually by white, non-disabled, trans people… that’s if it’s lucky enough to be written by any of us, or it’s written for them.’
Max says that the basic information’ they found was very white’ and he couldn’t relate to that at all.
Erion talks about his experience of sickle cell anaemia and the assumptions of healthcare professionals.
Jaz talks about finding information about gender confirmation surgery saturated with whiteness’ and seeing no representation of poc bodies.
Some young people talked about discrimination they experienced from within the LGBTQ+ community. Begam talked about feeling excluded by other trans people ‘making impressions and observations on what my cultural upbringing is …my race and other ethnicity factors’. She said some trans people don’t realise that it’s ‘much harder…being from a BME community with all of this going on.’
Rahul talks about his experiences of racism in the gay male community, people are unwilling to acknowledge that a [dating] preference can be racist.
Representation in healthcare and information
A common theme throughout many of the interviews was the impact and importance of representation of trans people of colour, in healthcare and elsewhere. Young people noticed that there was little representation of diversity when finding information. Max talked about their experience of finding trans healthcare information, ‘if I’m honest with you, most of it was very white…and I couldn’t relate to that at all.’
The young people we spoke to talked about the importance of hearing about transition experiences of trans people of colour. Max added ‘it took a lot for me to find a YouTube video about another trans guy [who] was also black or just non-white.’ He said ‘it was just nice to hear of people who are also black [transitioning]’.
M talks about the importance of black trans representation in their lives.
Anderson talks about the pressure they feel when it comes to representing black trans masculinity.
It was also difficult for young people to see themselves represented by the healthcare professionals they came into contact with. Tyra said, ‘seeing representation of people that look like me [in healthcare] is ‘a lot less likely.’ When it comes to healthcare professionals ‘unfortunately it seems black people don’t necessarily have access to the same resources when it comes to going and doing degrees to then be psychologists’.
Anderson said, ‘my doctor is a brown man, which I appreciate.’ They said when approaching private healthcare providers ‘I was very specifically like, “I want a person of colour psychologist, I’m going to speak to them.”. They explained, ‘it’s a lot of energy speaking to white people and it’s a lot of energy being able to share this kind of stuff’.
When seeking counselling M wanted to see ‘ideally a therapist of colour’, but said that they are ‘few and far between [especially those who are] either trans themselves or …like trained in like trans issues’. Tyra spoke about accessing healthcare services with white healthcare practitioners and feeling limited in the things she could talk about. She said, ‘my blackness was not really something that I got to address with them… when you’re white… you’re in a community that’s… a lot bigger than the black community, so you’ve got more room to grow’.
Max talks about the benefit of having a counsellor who was LGBT and a person of colour.
Finding community and activism
People we spoke to talked about how important it was for them and others to find and connect with supportive communities and have safe spaces to do so. They sometimes had disappointing experiences with LGBTQ+ youth groups. Begam said there aren’t many ‘LGBT communities or groups…for BAME people [with] different ethnicities and backgrounds’. She added that ‘there is still a lot… of racism in the [LGBT] scene. I don’t feel comfortable there… because I’ve experienced it myself.’ This left her ‘very lonely and isolated’.
Max said that sometimes it’s ‘frustrating’ to be the only black person in a ‘very white group’. Young people talked about the benefits of finding youth groups specifically for LGBTQ+ people of colour. Shash said she joined a ‘BAME LGBT group’ in her local area ‘which is a group that meets up monthly [with] other LGBT PoC people’. The activities included ‘doing speeches and things like that and talking to other activists’.
Max talks about his experience of being the only black person in youth groups it was just awkward.
Tyra talks about their experiences of race, class and religion and the impact on accessing healthcare.
A felt it’s important for other Asian trans people to know ‘that you’re not alone. There are other people like you’. They said ‘we are very under-represented in everything really… in the media you never hear about Asian trans people at all, but we do exist’. Anderson said, ‘I think that if you’re a queer person of colour, who’s spent time thinking about your gender, and your place in the world… it’s a weight but it’s also a blessing’. They said ‘it means that I can… find such connection, and such conversation and [I am] able to reach much higher notes than if I hadn’t yeah chosen to engage with my…identity like that.’
Some young people also talked about the positive impact activism had on their wellbeing and the importance of making their voices heard. Anderson said, ‘as a black trans person you should be definitely out there saying that your life matters and that you exist, and that you’re here struggling on your own with no access to services and care’. Tyra said, ‘until black trans lives matter, all lives can’t matter…we’d all just like to be equal’.
H shares his message for other trans people struggling to get support from their families for religious and cultural reasons.
June says I think that BAME trans people need to be prioritised in all aspects of lifeplatform us, share our story.
Recognising and understanding privilege
Many white trans young people thought about their own access to healthcare and the need to advocate for equity in healthcare. Some young people talked about the differences experienced in discrimination and their own privileges. Kat said, ‘Other than being trans, I’m white, I’m kind of fairly upper middle class I’d say… we don’t really get [or] feel much discrimination’. Noelle said, ‘I’m a white person in Britain, which means that I pretty much dodge all racial discrimination. I’m British, so I don’t have any like cultural heritage to speak of, besides genocide and imperialism… I’m quite privileged in that respect.’
Cassie talked about the lack of representation for trans women of colour in her city, ‘do I think that there are no trans women of colour? Absolutely fucking not. I think [white trans people are] just the ones who find it easier to exist, in public.’ Jessica said, ‘Even if I don’t wanna recognise that privilege, it’s been, it has been an advantage in terms of being able to get private healthcare and stuff’. Bay said, ‘I am just acutely aware that I have been fortunate enough to be able to access things in alternative ways that for other people isn’t an option.’
Henry says race is never something that makes me feel disempowered whereas for somebody who isn’t where, that could be totally disempowering.
Alistair talks about their privilege position being from a white middle class family and its impact when accessing healthcare services.
People we interviewed also discussed how their privilege meant that healthcare practitioners might respond to their needs differently. Read more about advocacy and empowerment in healthcare settings. Patrick said, ‘I went to school where everyone was entitled and like the more entitled you are the more you’re gonna get people to acquiesce your demands’. He added, ’it means [that] people that are working class or from migrant backgrounds who don’t have that kind of education or who don’t speak in the same kind of accent get patronised’.
One young person talked about the impact transitioning had on their privilege and status. Henry said, ‘It feels strange passing as a white man’ it is ‘something that I’m having to come to terms with… it’s a privilege in itself and is also uncomfortable sometimes.’
Cassie talks about her privileged position as a white, privately educated, medical student I know how to navigate a [medical] consultation.
CJ says we cannot have a white middle class narrative being the thing that drives what it is to be trans.