Martinez-Velez Jose J, Melin Kyle, Rodriguez-Diaz Carlos E
University of Puerto Rico-Medical Sciences Campus, School of Public Health, Center for Sociomedical Research and Evaluation, San Juan, Puerto Rico.
University of Puerto Rico-Medical Sciences Campus, School of Pharmacy, Department of Pharmacy Practice, San Juan, Puerto Rico.
Transgend Health. 2019 Jan 30;4(1):9-17. doi: 10.1089/trgh.2018.0045. eCollection 2019.
Transgender and gender nonconforming (GNC) people continue to experience suboptimal health care, social exclusion, and lower quality of life. Globally, lack of access to services, institutional violence, and public harassment have been reported. However, there is limited data on transgender health in Puerto Rico and the Caribbean. The purpose of this study is to assess the social determinants of health and wellbeing of transgender and GNC people living in Puerto Rico. Utilizing a community-based participatory research approach, 52 self-identified transgender and GNC individuals living in Puerto Rico completed a survey, which included questions on access to health care services, social support, and violence, among others. Data were collected from March to Ma y of 2015 and descriptive statistical analysis was conducted. Most of the participants reported experiences of discrimination across multiple social settings, most commonly at school (70.6%) and work (67.4%). Regarding experiences of violence, more than half (65.4%) had been verbally attacked in a public space. Many reported that access to gender-affirming health care services is difficult in Puerto Rico (88.5%) due to lack of knowledgeable providers (59.6%) and discomfort during the encounter (55.8%). The main perceived priority for their wellbeing was a transgender health care center. Although the LGBT equality movement has reached great milestones, access to gender-affirming health services and safe educational and work spaces are still needed. Findings from the study provide guidance for actions to reduce health disparities by addressing the needs for health and wellbeing among transgender and GNC individuals.
跨性别者和性别不一致（GNC）者持续面临医疗保健欠佳、社会排斥以及生活质量较低的问题。在全球范围内，都有关于难以获得服务、机构暴力和公众骚扰的报道。然而，关于波多黎各和加勒比地区跨性别者健康的数据有限。本研究的目的是评估居住在波多黎各的跨性别者和GNC者健康和幸福的社会决定因素。采用基于社区的参与性研究方法，52名自我认定为跨性别者和GNC的居住在波多黎各的个体完成了一项调查，其中包括关于获得医疗保健服务、社会支持和暴力等方面的问题。数据于2015年3月至5月收集，并进行了描述性统计分析。大多数参与者报告了在多个社会环境中遭受歧视的经历，最常见的是在学校（70.6%）和工作场所（67.4%）。关于暴力经历，超过一半（65.4%）的人在公共场所遭到言语攻击。许多人报告说，由于缺乏知识渊博的提供者（59.6%）以及就诊时的不适感（55.8%），在波多黎各很难获得性别确认医疗保健服务（88.5%）。他们认为幸福的主要优先事项是一个跨性别者医疗保健中心。尽管 LGBT 平等运动已经取得了巨大的里程碑式进展，但仍然需要获得性别确认健康服务以及安全的教育和工作场所。该研究的结果为通过满足跨性别者和GNC个体的健康和幸福需求来减少健康差距的行动提供了指导。
