School for Policy Studies, University of Bristol, Bristol, UK.
Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University, Swansea, UK.
Health Expect. 2020 Oct;23(5):1231-1240. doi: 10.1111/hex.13104. Epub 2020 Jul 16.
Trans-identifying individuals experience unique barriers and challenges in negotiating health-care systems due to the cisnormative attitudes and practices which obstruct the receipt of trans-inclusive care. To date, there has been little exploration of older trans consumers' experiences of contemporary health-care services when seeking to transition medically in later life.
Qualitative findings are presented from a study of trans ageing and trans-related health and social care needs in Wales, UK (2016-18). The objectives are to (1) examine supportive and obstructive points of interaction with health-care professionals, and (2) identify key learning messages for improving trans-related health care from the perspectives of trans-identifying adults in later life.
Trans-identifying participants self-selected to take part in two interviews-a life-history interview and a semi-structured interview. Interview data were analysed thematically using the framework method approach.
This paper focuses on the accounts of 19 participants (50-74 years of age) who identified as trans and were seeking to transition medically in mid- to later life.
Findings indicate how older trans patients are positioned as reluctant educators for GPs in primary care settings and illustrate the transphobic practices and cisnormative assumptions encountered across health-care interactions and systems that impede their journey of transitioning in later life.
Messages from this study speak to the importance of improving professionals' knowledge of gender identity diversity across the life course and making changes at a systemic level in redressing cisnormative assumptions and systems that reinforce inequities on the basis of gender identity.
由于 cisnormative 态度和实践阻碍了获得跨性别包容性护理,跨性别者在协商医疗保健系统时会遇到独特的障碍和挑战。迄今为止,对于老年跨性别消费者在寻求晚年进行医学性别过渡时对当代医疗保健服务的体验,几乎没有探索。
本文呈现了英国威尔士(2016-18 年)一项关于跨性别者衰老和与跨性别相关的健康和社会护理需求的研究的定性发现。目的是(1)检查与医疗保健专业人员互动的支持点和障碍点,(2)从晚年跨性别认同成年人的角度确定改善与跨性别相关的医疗保健的关键学习信息。
跨性别认同参与者自行选择参加两次访谈——人生历程访谈和半结构化访谈。使用框架方法对访谈数据进行主题分析。
本文重点介绍了 19 名参与者(50-74 岁)的说法,他们认为自己是跨性别者,并正在寻求在中年至晚年进行医学过渡。
研究结果表明,老年跨性别患者如何被定位为初级保健环境中全科医生的不情愿的教育者,并说明了在医疗保健互动和系统中遇到的跨性别恐惧症做法和 cisnormative 假设,这些做法和假设阻碍了他们在晚年过渡的旅程。
本研究的信息表明,必须提高专业人员对整个生命周期中性别认同多样性的认识,并在系统层面进行变革,以纠正 cisnormative 假设和强化基于性别认同的不平等的系统。