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跨性别者对跨学科跨性别医疗保健的需求与关注:一项非临床在线调查。

Needs and concerns of transgender individuals regarding interdisciplinary transgender healthcare: A non-clinical online survey.

作者信息

Eyssel Jana, Koehler Andreas, Dekker Arne, Sehner Susanne, Nieder Timo O

机构信息

Department for Sex Research and Forensic Psychiatry, Interdisciplinary Transgender Healthcare Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.

Centre for Experimental Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.

出版信息

PLoS One. 2017 Aug 28;12(8):e0183014. doi: 10.1371/journal.pone.0183014. eCollection 2017.

Abstract

This study investigates the needs and concerns transgender (short: trans) individuals have concerning trans healthcare (THC) in interdisciplinary THC centres. Trans individuals' gender does not (fully/constantly) match their sex assigned at birth. To be able to live in their gender role and to prevent or minimise gender dysphoria, they might require a multidisciplinary set of transition related healthcare services. The current shift from the traditionally highly regulated, hierarchical and pathologising approach to THC towards a more patient-centred approach has highlighted the importance of trans patients' satisfaction with treatment processes and results. As the still influential regulations have a negative effect on patient satisfaction, and might also keep trans individuals from seeking transition related treatment, it is crucial to investigate what trans individuals, whether patients or not, need and fear regarding transition related healthcare. Against the backdrop of mixed reactions received from the local trans community regarding the foundation of the Interdisciplinary Transgender Healthcare Centre Hamburg (ITHCCH), Germany, this study seeks to determine what trans individuals need with respect to THC in order to guarantee for high quality service provision at the ITHCCH. To this end, an online questionnaire was developed. The researchers employed a participatory approach to questionnaire development by involving a working group consisting of local trans support group representatives and (THC) specialists (N = 4). The sample consisted of N = 415 trans-identified individuals aged between 16 and 76. Most of them were based in Germany. 85.2% (n = 382) reported experience with transition related healthcare and 72.5% (n = 301) had (additional) treatments planned. Analysis revealed a need for communication and feedback opportunities. Furthermore, during the treatment process, addressing individual needs was considered crucial by participants. They agreed moderately with concerns towards THC centres. 96.5% of participants would like high decision-making power concerning treatment-associated decisions. The results demonstrate the importance of patient-centred THC that takes patients' individual needs and realities into consideration and involves patients in decision-making processes.

摘要

本研究调查了跨性别者在跨学科跨性别医疗中心对跨性别医疗保健(THC)的需求和担忧。跨性别者的性别与其出生时被指定的性别不完全(或始终)相符。为了能够以自己的性别角色生活,并预防或尽量减少性别焦虑,他们可能需要一系列多学科的与过渡相关的医疗服务。目前,THC正从传统上高度规范、等级森严且带有病态化的方式转向以患者为中心的方式,这凸显了跨性别患者对治疗过程和结果满意度的重要性。由于仍然具有影响力的规定对患者满意度有负面影响,并且可能还会阻碍跨性别者寻求与过渡相关的治疗,因此,调查跨性别者(无论是否为患者)在与过渡相关的医疗保健方面的需求和担忧至关重要。在德国汉堡跨学科跨性别医疗中心(ITHCCH)成立后,当地跨性别群体对此反应不一,在此背景下,本研究旨在确定跨性别者在THC方面的需求,以便为ITHCCH提供高质量服务提供保障。为此,研究人员设计了一份在线问卷。研究人员采用参与式方法来设计问卷,邀请了一个由当地跨性别支持小组代表和(THC)专家组成的工作组(N = 4)参与。样本包括415名年龄在16至76岁之间、自我认同为跨性别的个体。他们中的大多数人居住在德国。85.2%(n = 382)报告有过与过渡相关的医疗保健经历,72.5%(n = 301)计划进行(额外)治疗。分析表明,需要沟通和反馈机会。此外,在治疗过程中,参与者认为满足个体需求至关重要。他们对THC中心的担忧程度适中。96.5%的参与者希望在与治疗相关的决策中拥有高度决策权。研究结果表明,以患者为中心的THC非常重要,它需要考虑患者的个体需求和实际情况,并让患者参与决策过程。

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