Baldwin Aleta, Dodge Brian, Schick Vanessa R, Light Brenda, Scharrs Phillip W, Herbenick Debby, Fortenberry J Dennis
J Health Care Poor Underserved. 2018;29(4):1300-1318. doi: 10.1353/hpu.2018.0097.
Research demonstrates health disparities between gender-minority individuals and cisgender individuals. These disparities arise from multiple sources, including negative health care experiences. This study examines interactions between transgender and gender non-binary (TGGNB) individuals and their health care providers. We analyzed 119 participants' descriptions of positive and negative health care experiences, and what they wish providers knew about caring for TGGNB patients. Health care experiences went well when providers and staff used inclusive language, demonstrated their experience and education, and treated identity disclosure as routine. Negative interactions were characterized by misgendering, unfamiliarity with TGGNB people and health issues, and transphobic practices. Participants wished providers understood their health concerns, did not expect their patients to educate them, and created a welcoming clinical environment. Medical educators, administrators, and providers share responsibility for improving TGGNB patient experiences. Through a framework of cultural safety, we recommend several changes to ensure more equitable treatment in health care.
研究表明，性别少数群体个体与顺性别个体之间存在健康差异。这些差异源于多种因素，包括负面的医疗保健经历。本研究考察了跨性别和性别非二元（TGGNB）个体与其医疗保健提供者之间的互动。我们分析了119名参与者对正面和负面医疗保健经历的描述，以及他们希望提供者了解的关于照顾TGGNB患者的事项。当提供者和工作人员使用包容性语言、展示他们的经验和知识，并将身份披露视为常规操作时，医疗保健经历进展顺利。负面互动的特征是性别误称、对TGGNB人群和健康问题不熟悉以及恐跨行为。参与者希望提供者理解他们的健康问题，不期望患者对他们进行教育，并营造一个友好的临床环境。医学教育工作者、管理人员和提供者共同承担改善TGGNB患者就医体验的责任。通过文化安全框架，我们建议进行一些变革，以确保在医疗保健中实现更公平的待遇。
