Trans individuals' experiences in primary care.

OBJECTIVE

To explore past experiences and describe the expectations of members of the trans community regarding the delivery of primary care by their family physicians.

DESIGN

Qualitative phenomenologic approach.

SETTING

Kingston, Ont, which has a population of approximately 123 000.

PARTICIPANTS

A convenience sample of 11 individuals older than 18 years of age who self-identified as trans was recruited through community agencies and family medicine clinics.

METHODS

Semistructured interviews were recorded and transcribed verbatim, and thematic analysis of transcripts was carried out by 2 independent researchers using NVivo.

MAIN FINDINGS

Eleven interviews took place between September and November 2016; 4 individuals identified as trans men, 6 as trans women, and 1 as gender nonconforming. Themes identified included perceived physician knowledge of trans identities, patient self-advocacy, discrimination, positive spaces, and expectations of ideal care. The expected role of the family physician for trans patients includes hormone assessment and prescription and referrals for gender-affirming surgeries.

CONCLUSION

The trans community has several physical and mental health needs that are not being met by the current health care system. Family physicians need to be empowered to provide services such as hormone initiation and gender-affirming surgery referrals. Although other specialists might have a role for some patients, most trans people expect care to be delivered by family physicians whenever possible.