LONDON (Thomson Reuters Foundation) - The second wave of the coronavirus pandemic is pushing transgender patients to the brink, according to a top U.S. surgeon, who says poverty, stress and breakdown are forcing many to cancel life-changing surgery.
“Many of our patients are living on the verge of poverty and have been pushed over,” Jess Ting, surgical director of one of the largest U.S. gender reassignment clinics, told the Thomson Reuters Foundation.
“We have had many cancellations or cases of people who say they can’t even afford train or bus fare or airline fare to come for their surgeries,” the 55-year-old surgeon said.
“Born to Be”, a documentary about Ting’s work and the surgical advances he has worked on since 2016, premiered at Film Forum’s virtual cinema in New York on Wednesday.
Ting said he was “very worried” that a second wave of the virus was disproportionately affecting his patients’ health, with new daily COVID-19 cases in the United States hitting 160,000 on Tuesday, according to Johns Hopkins University.
Despite building pressure, Ting vowed to keep Mount Sinai Hospital’s Center for Transgender Medicine and Surgery in New York open for as long as possible in the face of any lockdown, with hundreds at risk of delays to long-awaited surgery.
“A couple of weeks ago, I had a very sad situation where a patient called me and cancelled her surgery because she said she was afraid that if she came home in bandages, her landlord would realise that she was trans and evict her,” Ting said.
Under lockdown earlier this year, all elective surgeries at the Mount Sinai clinic were cancelled for about four months.
An estimated 1.4 million trans people live in the United States, according to a 2018 report from Johns Hopkins Medicine.
Its figures show that the number of surgical procedures grew four-fold between 2000 and 2014, with just over 4,100 electing for surgery in that period.
The percentage of those going forward with surgery is also growing, the Johns Hopkins report noted, with 72% of patients who sought gender reassignment procedures opting for genital surgery alone between 2000 and 2005.
Between 2006 and 2011, that figure rose to almost 84%.
Ting and his three partners carry out 15 to 20 surgeries a week at the centre, totalling about 1,000 ops a year.
Approximately 70% are male to female and 30% female to male, although that ratio is shifting, Ting added.
“We’re seeing more female-to-male patients,” he said. “But that trend is very slow.”
The introduction of an Affordable Care Act – commonly known as Obamacare – in 2010, let trans people claim reassignment surgery on their insurance, leading to a spike in demand.
Joe Biden’s victory in the U.S. presidential election - and the fact he cited trans people in his acceptance speech - will also help to alleviate prejudice, Ting said.
“Having a president who doesn’t mock trans people or just deny their legitimacy entirely and who isn’t, frankly, discriminatory is a huge step in the right direction,” he said.