PITTSBURGH, March 27 At the beginning of the Oscar-nominated movie TransAmerica, Bree Osbourne, a transgender woman, eagerly awaits the sex change surgery that will make her a complete woman and allow her to live a more fulfilled life. However, a few days before the scheduled surgery, Bree is contacted by a son she never knew she had. Her therapist, concerned that this unresolved issue may disrupt Bree's ability to successfully integrate into a new life, refuses to sign off on the sex-change operation until Bree travels to meet her son.

Although the therapist portrayed in TransAmerica is highly competent in dealing with Bree's transgender conundrum, in real life the majority of health care professionals are completely unprepared to address these types of issues, according to Michael D. Shankle, M.P.H., a research specialist at the University of Pittsburgh Graduate School of Public Health (GSPH), department of infectious diseases and microbiology and editor of the newly published The Handbook of Lesbian, Gay, Bisexual, and Transgender Public Health: A Practitioner's Guide to Service.

"When most health care practitioners think about lesbian, gay, bisexual or transgender health, they immediately conjure up images of HIV and AIDS. However, the public health landscape for sexual minorities is much larger and significantly more complicated than just sexually transmitted diseases. That is why there is a great need for this handbook," he explained.

Mr. Shankle said that the lack of in-depth knowledge about lesbian, gay, bisexual and transgender, or LGBT, issues by practitioners often leads to less-than-optimal delivery of health care and other public services. For example, many lesbian and bisexual women may not undergo routine reproductive examinations. Therefore, they tend to be diagnosed with reproductive cancers at a significantly later stage then their heterosexual counterparts.

"Unfortunately, many health care providers don't emphasize
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27-Mar-2006

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