Carlile Anna
Department of Educational Studies, Goldsmiths University of London, London, UK.
Int J Transgend Health. 2019 Nov 23;21(1):16-32. doi: 10.1080/15532739.2019.1693472. eCollection 2020.
Transgender and non-binary children and young people and their parents in England, UK are poorly served across a range of healthcare settings. Whilst UK equalities legislation and international guidance on transgender healthcare pathways protects this group from discrimination and mandates an affirmative approach, services in England are not keeping pace. This study aims to draw on the experiences of transgender and non-binary children, young people and their parents in a support group in England in order to investigate their experiences of healthcare provision, and to develop some ideas for improvement. Data was collected with participants in a family support group which offers a parent helpline service, social groups for children and parents, and training for schools and other organizations. 65 parents and children from 27 families from the family support group attended participatory workshops where they were given a range of briefs: "health," "family," "friends," and "education." Their participation involved being asked to define their own interview questions and collect data by interviewing each other. Their interview notes constituted the raw data. Data was coded inductively by the author with respondent checking as a second stage. Results constitute the views of a small group of people, so cannot be generalized. However, they do illustrate some of the issues which may arise. Participants' experiences elicited five key themes: professionals' perceived lack of clinical and therapeutic knowledge; mental distress caused by excessive waiting lists; professionals' stereotyped gender assumptions; direct discrimination within healthcare settings; and a lack of attention to parent and child voice, especially in terms of school-based experiences and where a patient had a diagnosis of autism.
在英国英格兰地区,跨性别及非二元性别的儿童、青少年及其父母在一系列医疗保健环境中都未得到良好的服务。尽管英国的平等立法以及关于跨性别医疗保健途径的国际指南保护了这一群体免受歧视,并要求采取肯定性的方法,但英格兰的服务却未能跟上步伐。本研究旨在借鉴英格兰一个支持小组中跨性别及非二元性别的儿童、青少年及其父母的经历,以调查他们在医疗保健服务方面的体验,并提出一些改进的想法。数据是通过一个家庭支持小组的参与者收集的,该小组提供家长帮助热线服务、儿童和家长社交小组以及针对学校和其他组织的培训。来自该家庭支持小组的27个家庭中的65名家长和孩子参加了参与式工作坊,在那里他们收到了一系列的任务说明:“健康”“家庭”“朋友”和“教育”。他们的参与包括被要求自行定义访谈问题,并通过互相访谈来收集数据。他们的访谈记录构成了原始数据。作者对数据进行了归纳编码,并在第二阶段进行了受访者核对。研究结果仅代表一小部分人的观点,因此不能一概而论。然而,它们确实说明了可能出现的一些问题。参与者的经历引出了五个关键主题:专业人员在临床和治疗知识方面被认为的欠缺;过长的等候名单导致的精神困扰;专业人员刻板的性别假设;医疗保健环境中的直接歧视;以及对家长和孩子的声音缺乏关注,尤其是在学校经历方面以及患者被诊断患有自闭症的情况下。