The Impact of Societal Stigma on Oral Health-Seeking Behaviour among the Transgender Community and Strategies to Address

Download Article

DOI: 10.21522/TIJPH.2013.13.02.Art089

Authors : Bharathi Selvaraj, Deepavalli Arumuganainar

Abstract:

Oral health is a vital aspect of overall well-being, yet transgender individuals often face significant challenges in accessing dental care. This review examines the impact of social stigma on the dental care-seeking behaviours of transgender populations, highlighting common oral health challenges and proposing inclusive dental practices. Many transgender individuals experience discrimination in healthcare settings, leading them to postpone or avoid dental appointments. This contributes to a higher prevalence of cavities, periodontal disease, and mucosal lesions. These oral health issues are further linked to systemic conditions, including heart disease, type 2 diabetes, and respiratory illnesses. Moreover, economic instability, lack of oral health literacy, and negative experiences with healthcare providers exacerbate mental health challenges such as anxiety, depression, and substance abuse, ultimately impairing self-care routines. This review advocates for a multifaceted approach, including cultural competency training for dental professionals, integration of LGBTQ+ health topics into dental education, and the development of gender-affirming clinical settings. Policy reforms are also necessary to expand dental insurance coverage and enforce anti-discrimination measures in healthcare. Additionally, community-based programs and tele-dentistry are highlighted as key strategies for early diagnosis and intervention. By implementing these strategies, healthcare systems can help mitigate stigma, improve access to quality dental care, and enhance the overall well-being of transgender individuals.

References:

[1].   Baiju, R. M., Peter, E., Varghese, N. O., & et al., 2017, Oral Health and Quality of Life: Current Concepts. J Clin Diagn Res. 11: ZE21–ZE26.

[2].   Shetty, B., Fazal, I., Khan, S. F., & et al., 2023, Association between cardiovascular diseases and periodontal diseases: More than what meets the eye. Drug Target Insights. 17: 31–38.

[3].   Sowmya, S., Haripriya, A., 2024, The Influence of Epilepsy on Oral Health Outcomes: A Retrospective Study in South Indian Adults. Cureus. 16: e66101.

[4].   Sowmya, S., Sangavi, R., 2024, Effectiveness of Oral Health Education and Interventions in Improving Oral Health Outcomes in Type II Diabetes Mellitus Patients: A Prospective Study. Cureus. 16: e58227.

[5].   Araújo, V. M. A., Melo, I. M., & Lima, V., 2015, Relationship between Periodontitis and Rheumatoid Arthritis: Review of the Literature. Mediators Inflamm. 2015: 259074.

[6].   Daalderop, L. A., Wieland, B. V., Tomsin, K., & et al., 2018, Periodontal Disease and Pregnancy Outcomes: Overview of Systematic Reviews. JDR Clin Trans Res. 3: 10–27.

[7].   Indiran, M. A., Pandiyan, I., Doraikanan, S., & et al., 2024, Oral Health Status and Oral Health-related Quality of Life among Construction Workers in Chennai City: A Cross-sectional Study. World Journal of Dentistry. 15: 248–252.

[8].   Saravanan, N., Thiruneervannan, R., & Christopher, P., 2014, A Study to Assess the Periodontal Status of Transgender in Chennai City. Biosci Biotechnol Res Asia. 11: 1673–1678.

[9].   Mehta, V., Negi, S., Mathur, A., & et al., 2024, Oral health status among the transgender population of India: A systematic review and meta-analysis. Spec Care Dentist. 44: 1535–1546.

[10].  Gilbert, P. A., Pass, L. E., Keuroghlian, A. S., & et al., 2018, Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies. Drug Alcohol Depend. 186: 138–146.

[11].  Falck, F., & Bränström, R., 2023, The significance of structural stigma towards transgender people in health care encounters across Europe: Health care access, gender identity disclosure, and discrimination in health care as a function of national legislation and public attitudes. BMC Public Health. 23: 1031.

[12].  White Hughto, J. M., Reisner, S. L., & Pachankis, J. E., 2015, Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions. Soc Sci Med. 147: 222–231.

[13].  Seelman, K. L., Colón-Diaz, M. J. P., LeCroix, R. H., & et al., 2017, Transgender Noninclusive Healthcare and Delaying Care Because of Fear: Connections to General Health and Mental Health Among Transgender Adults. Transgend Health. 2: 17–28.

[14].  Knaak, S., Mantler, E., & Szeto, A., 2017, Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthc Manage Forum. 30: 111–116.

[15].  Sathyanarayanan, U., & John, B., 2022, Oral health-related attitude and practices of transgender population in Puducherry UT, India—A cross-sectional questionnaire survey. J Family Med Prim Care. 11: 1815.

[16].  Safer, J. D., Coleman, E., Feldman, J., & et al., 2016, Barriers to healthcare for transgender individuals. Curr Opin Endocrinol Diabetes Obes. 23: 168–171.

[17].  Tamrat, J., 2022, ‘Trans-forming’ dental practice norms: Exploring transgender identity and oral health implications. Can J Dent Hyg. 56: 131–139.

[18].  Malik, Z., Holden, A. C. L., Sohn, W., & et al., 2021, A disability-based exploration of psychosocial barriers and enablers to accessing dental services for people with clinically severe obesity: A qualitative study. Clin Obes. 11: e12429.

[19].  Bjørkvik, J., Henriquez Quintero, D. P., Vika, M. E., & et al., 2022, Barriers and facilitators for dental care among patients with severe or long-term mental illness. Scand J Caring Sci. 36: 27–35.

[20].  Puckett, J., Giffel, R., Brown, F., & et al., 2024, Suggestions for improving healthcare for transgender and gender-diverse people in the United States. Int J Transgend Health. 25: 233–250.

[21].  Haley, C. M., Macri, D., Perez, H. L., & et al., 2022, LGBTQ+ and dental education: Analyzing the present and recommendations for the future. J Dent Educ. 86: 1191–1197.

[22].  Stroumsa, D., 2014, The state of transgender health care: Policy, law, and medical frameworks. Am J Public Health. 104: e31-8.

[23].  Hilgeman, M. M., Lange, T. M., Bishop, T., & et al., 2023, Spreading pride in all who served: A health education program to improve access and mental health outcomes for sexual and gender minority veterans. Psychol Serv. 20: 596–608.

[24].  Islam, M. R. R., Islam, R., Ferdous, S., & et al., 2022, Teledentistry as an effective tool for the communication improvement between dentists and patients: An overview. Healthcare (Basel). 10. DOI: 10.3390/healthcare10081586.

[25].  Fakhrjahani, I., Tiwari, T., Jessani, A., & et al., 2024, A Scoping Review of Oral Health Outcomes and Oral Health Service Utilization of 2SLGBTQ+ People. JDR Clin Trans Res. 9: 199–211.

[26].  Kumar, G., Brahma, P., Jena, S., & et al., 2023, Barriers in Dental Care Utilization—An Explorative Study among Transgender Community of Bhubaneswar, Odisha. J Pharm Bioallied Sci. 15: S888–S891.

[27].  Manpreet, K., Ajmal, M. B., Raheel, S. A., & et al., 2021, Oral health status among transgender young adults: A cross-sectional study. BMC Oral Health. 21: 575.

[28].  Marlecha, R., Mary, V., Ramakrishnan, K., & et al., 2020, Oral health status, dental awareness, and dental services utilization barriers among transgender population in Chennai. Drug Invention Today. 14: 1143–1148.

[29].  Raisin, J. A., Keels, M. A., Roberts, M. W., & et al., 2023, Barriers to oral health care for transgender and gender nonbinary populations. J Am Dent Assoc. 154: 384-392.e4.