von Vogelsang Ann-Christin, Milton Camilla, Ericsson Ingrid, Strömberg Lars
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Neurosurgery, R2:02, Karolinska University Hospital, Stockholm, Sweden.
J Clin Nurs. 2016 Dec;25(23-24):3577-3588. doi: 10.1111/jocn.13271. Epub 2016 Jun 6.
To describe transsexual persons' experiences of encounters with healthcare professionals during the sex reassignment process.
Transsexual persons are individuals who use varying means to alter their natal sex via hormones and/or surgery. Transsexual persons may experience stigma, which increases the risk of psychological distress. Mistreatments by healthcare professionals are common. Qualitative studies addressing transsexual persons' experiences of healthcare are scarce.
Qualitative descriptive design.
A Swedish non-clinical convenience sample was used, consisting of six persons who had been diagnosed as transsexual, gone through sex reassignment surgery or were at the time of the interview awaiting surgery. Semi-structured interviews were undertaken, and data were analysed using manifest qualitative content analysis.
Three categories and 15 subcategories were identified. The encounters were perceived as good when healthcare professionals showed respect and preserved the transsexual person's integrity, acted in a professional manner and were responsive and built trust and confidence. However, the participants experienced that healthcare professionals varied in their level of knowledge, exploited their position of power, withheld information, expressed gender stereotypical attitudes and often used the wrong name. They felt vulnerable by having a condescending view of themselves, and they could not choose not to be transsexual. They felt dependent on healthcare professionals, and that the external demands were high.
Transsexual persons are in a vulnerable position during the sex reassignment surgery process. The encounters in healthcare could be negatively affected if healthcare professionals show inadequate knowledge, exploit their position of power or express gender stereotypical attitudes. A good encounter is characterised by preserved integrity, respect, responsiveness and trust.
Improved education on transgender issues in nursing and medical education is warranted. Healthcare professionals should be aware of how their attitudes and their level of knowledge affect the care given during the sex reassignment surgery process.
描述变性者在性别重置过程中与医护人员接触的经历。
变性者是指通过激素和/或手术等多种方式改变其出生时性别的个体。变性者可能会遭受污名化，这会增加心理困扰的风险。医护人员的不当对待很常见。针对变性者医疗经历的定性研究很少。
定性描述性设计。
采用瑞典非临床便利样本，由六名被诊断为变性者、已接受性别重置手术或在访谈时正在等待手术的人组成。进行了半结构化访谈，并使用显性定性内容分析法对数据进行了分析。
确定了三个类别和15个子类别。当医护人员表现出尊重、维护变性者的尊严、以专业的方式行事、做出回应并建立信任时，这些接触被认为是良好的。然而，参与者体验到医护人员的知识水平各不相同，利用其权力地位、隐瞒信息、表现出性别刻板态度，并且经常叫错名字。他们因被医护人员以居高临下的眼光看待而感到脆弱，而且他们无法选择不变性。他们感到依赖医护人员，并且外部要求很高。
变性者在性别重置手术过程中处于弱势地位。如果医护人员知识不足、利用其权力地位或表现出性别刻板态度，医疗接触可能会受到负面影响。良好的接触以维护尊严尊重、做出回应和建立信任为特征。
有必要在护理和医学教育中加强对跨性别问题的教育。医护人员应该意识到他们的态度和知识水平如何影响性别重置手术过程中的护理。
