For me to write this article with sincerity and integrity I will have to come out….as a fan of RuPaul’s Drag Race. It has been a guilty pleasure for a number of years. The premise of the show is the search for America’s next drag superstar hosted by the ever graceful Rupaul. It is full of colour, creativity, uniqueness, nerve and talent. Yet, underlying this are the individual stories of the contestants which bring the vulnerability of this subset of society to the surface.
Drag as an art form has always been around and there are even suggestions that the term ‘drag’ is an acronym for ‘Dressed As A Girl’. This was an instruction that playwrights would use in scripts to differentiate male from female characters in all-male casts. Fast forward to modern day and there is a thriving drag scene in almost all major cities around the world. The majority of performers are often men who identify as gay or transgender.
Disparities in Healthcare
Outside of gender identity clinics, the NHS has been identified to have failed gender variant communities. This was reported in 2016 by the Women and Equalities Select Committee. One reason for this is thought to be a lack of competent training for medical students and doctors. Whilst many medical institutions are addressing this, the methods and their delivery are still in their infancy.
RuPaul’s Drag Race
The show has just completed its 9th season. Over the years, many physical and mental health conditions that affect the LGBT community, (mostly the “G” and “T” elements) have been brought to the audience’s attention. In the latest season alone, there have been discussions about eating disorders, which are more prevalent in gender-variant individuals than in the general population, and discussions around depression and anxiety. In terms of physical ailments, one contestant described the treatment they had had for primary hepatic cancer. The risks for getting this type of cancer are higher for men who have unprotected sex with men due to an increased infection risk with hepatitis B and C . AIDS has also been on the agenda, especially when the winner of a challenge broke down in front of the judging panel as they explained that they had been living with HIV for 2 years. Whilst the progression of HIV to AIDS has been stemmed with antiretrovirals, men who have sex with men are still more likely to acquire HIV than the general population.
These are issues that the average cis-gendered individual living within the boundaries of heteronormativity will not encounter. It is only through watching a show like this that I have become aware of this community. Not only the creativity and exuberance that it provides society but also the underlying health care issues which many are unaware of.
An educational tool?
There are caveats to accepting a show like this as an educational tool, however. Firstly, I appreciate that not everyone would take a liking to the show. Secondly, some might feel that I am conflating homosexuality and gender variance into one category. This may well be the case, yet I would suggest that at this point in time there is very little available on LGBTQIA issues in the medical curriculum. Is this not the best place to start? There is also a notable lack of women of varying gender identities appearing on the show. What of their healthcare needs? These also vary compared to the general population.
Each individual is unique in the healthcare needs they have. This is highlighted when gender variant individuals have other protected characteristics such as disability or belonging to an ethnic minority. Not only must the healthcare professional manage the potential health issues arising from the individual’s gender identity, but also those that might be attributed to these other protected characteristics. Whilst tools are still in development I would argue that RuPaul’s Drag Race is the closest we can get to understanding LGBTQIA issues within the restrictions of our own identities.
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Any opinions above are the author’s alone and may not represent those of his/her affiliations. Any comment is based on the best available evidence at the time of writing. All data is based on externally validated studies unless expressed otherwise. Novel data is representative of the sample surveyed. An online recommendation is no substitute for seeing your own doctor and should not be taken as medical advice. Article edited for publication by Dr Hannah Arnstein
Image courtesy of pixabay
http://www.logotv.com/shows/rupauls-drag-race RuPaul’s Drag Race Official WebSite
https://www.merriam-webster.com/dictionary/drag%20queen Definition of Drag Queen
http://www.imdb.com/name/nm0750412/RuPaul’s profile on Internet Movie Database
http://www.nhs.uk/Livewell/Transhealth/Pages/Transhealthhome.aspxNHS WebPage on Transgender Health
http://www.gires.org.uk/assets/Medpro-Assets/GenderVarianceUK-report.pdfGender Identity Research and Education Society Document
https://publications.parliament.uk/pa/cm201516/cmselect/cmwomeq/390/39008.htm#_idTextAnchor259Women’s and Equality Select Committee Report on Transgender Health
https://lgbtqia.ucdavis.edu/educated/glossary.htmlDefinition of LGBTQIA
http://www.nhs.uk/Conditions/Eating-disorders/Pages/Introduction.aspxNHS WebPage on Eating Disorders
National Eating Disorders Association WebPage on Eating Disorders in the LGBT population (American)
http://www.nhs.uk/Livewell/LGBhealth/Pages/Mentalhealth.aspxNHS webpage on mental health disorders within the LGBT population
http://www.macmillan.org.uk/information-and-support/liver-cancer-primary/Webpage on primary hepatic cancer from Macmillan
http://www.webmd.com/hepatitis/default.htmWebpage on hepatitis from WebMD
http://www.nhs.uk/conditions/HIV/Pages/Introduction.aspxWebPage on HIV from the NHS
http://www.who.int/hiv/topics/treatment/en/ Webpage on antiretroviral treatment from the WHO
https://www.cdc.gov/hiv/group/msm/index.html Webpage on rates of HIV infection in men who have sex with men from the Centre for Disease Control (American)
http://time.com/3636430/cisgender-definition/Time magazine article on the definition of cis-genderism
https://www.merriam-webster.com/dictionary/heteronormativeDictionary definition of heteronormative
https://www.equalityhumanrights.com/en/equality-act/protected-characteristicsDefinition of protected characteristics