School of Social Work, Michigan State University, East Lansing, Michigan.
Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Kitchener, Canada.
J Womens Health (Larchmt). 2019 Nov;28(11):1487-1492. doi: 10.1089/jwh.2018.7384. Epub 2019 Aug 14.
Transmasculine individuals who have a cervix may be at risk of cervical cancer, but they face a number of barriers to accessing care, including difficulty finding knowledgable and culturally sensitive providers who are willing to care for transgender patients. We examined gynecologic health care providers' willingness to provide routine care and Papanicolaou tests (Pap tests) to transmasculine individuals, including the role of personal, clinical, and professional factors. We surveyed attending physicians, advanced practitioners, and residents in the Women's Health department of a large, integrated Midwest health system ( = 60, 74.1% response rate). A majority of participants were female (68.3%) and white (73.3%). Most had met a transgender person before (79.7%), and 40.7% had cared for a transgender patient in the past 5 years. Most reported willingness to provide routine care (74.6%) and Pap tests (85.0%) to transmasculine people. Bivariate analysis suggests that having met a transgender person ( = 0.028), higher empathy scores ( = 0.015), political views ( = 0.0130), and lower transphobia ( = 0.012) were associated with willingness to provide routine care to transmasculine individuals. Lower transphobia ( = 0.034) and political views ( < 0.001) were also associated with willingness to provide Pap tests to transmasculine people. Providers' willingness was not associated with barriers related to training or knowledge-only with personal biases and experiences. Transgender-inclusive health care training that addresses personal attitudes should be a routine part of training for all health professionals.
跨性别男性如果有子宫颈，可能面临宫颈癌风险，但他们在获得护理方面面临许多障碍，包括难以找到愿意照顾跨性别患者的有知识且文化敏感的医护人员。我们研究了妇科保健提供者为跨性别男性提供常规护理和巴氏试验（Pap 试验）的意愿，包括个人、临床和专业因素的作用。我们调查了一家大型综合性中西部医疗系统妇女健康科的主治医生、高级执业医师和住院医师（ = 60，74.1%的回应率）。大多数参与者为女性（68.3%）和白人（73.3%）。大多数人以前见过跨性别者（79.7%），40.7%的人在过去 5 年中照顾过跨性别患者。大多数人表示愿意为跨性别男性提供常规护理（74.6%）和巴氏试验（85.0%）。单变量分析表明，见过跨性别者（ = 0.028）、同理心评分较高（ = 0.015）、政治观点（ = 0.0130）和反跨性别偏见较低（ = 0.012）与为跨性别男性提供常规护理的意愿相关。较低的反跨性别偏见（ = 0.034）和政治观点（ < 0.001）也与为跨性别男性提供巴氏试验的意愿相关。提供者的意愿与培训相关的障碍无关，而仅与个人偏见和经验有关。解决个人态度问题的跨性别包容的医疗保健培训应该成为所有卫生专业人员培训的常规内容。
