Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
College of Population Health, Thomas Jefferson University, Philadelphia, PA.
Urology. 2021 Feb;148:47-52. doi: 10.1016/j.urology.2020.10.026. Epub 2020 Oct 28.
To describe perspectives and experiences related to urology care-seeking of transgender and non-binary (TGNB) individuals assigned male at birth.
This HIPAA-compliant study was IRB approved and followed Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines. Through semistructured interviews, perspectives, and experiences of individuals related to urology care-seeking were explored. Open-ended questions were designed to elicit a range of responses rather than quantifiable data. Thematic codes were developed and explicitly defined. Codes pertaining to patient experiences were assessed and described.
Twenty-five TGNB individuals assigned male at birth were interviewed. Participants reported an array of factors that informed and inhibited care-seeking, factors that framed individual urologic care experiences, and their overall impression of the healthcare system's ability to effectively and respectfully serve the TGNB population. Specifically, participants reported that prior negative healthcare experiences dissuaded them from seeking care such as feeling discriminated against and having a lack of trust in providers. Additionally, participants reported feeling a need and responsibility to "educate" providers on both their medical needs and psychosocial experiences. Participants were also unclear how best to identify "trans-friendly" urologists who are culturally competent and have appropriate medical knowledge.
TGNB individuals face significant barriers to care for unique healthcare needs. TGNB participants described care avoidance and reported experiences of healthcare discrimination. These data highlight the importance for urologists to understand the perspectives and historical experiences of these individuals who may seek urological care.
描述出生时被分配为男性的跨性别和非二进制（TGNB）个体寻求泌尿科护理的观点和经验。
这项符合 HIPAA 标准的研究获得了机构审查委员会的批准，并遵循了定性研究报告的统一标准（COREQ）指南。通过半结构化访谈，探讨了与寻求泌尿科护理相关的个体的观点和经验。设计了开放式问题以引出各种反应，而不是可量化的数据。制定并明确定义了主题代码。评估和描述了与患者体验相关的代码。
对 25 名出生时被分配为男性的 TGNB 个体进行了采访。参与者报告了一系列影响他们寻求护理的因素，这些因素框定了他们个体的泌尿科护理体验，并总体描述了医疗保健系统为 TGNB 人群提供有效和尊重服务的能力。具体来说，参与者报告说，先前的负面医疗保健经历使他们不愿意寻求护理，例如感到受到歧视和对提供者缺乏信任。此外，参与者还报告说，他们感到有责任和需要向提供者传授他们的医疗需求和心理社会经验。参与者也不清楚如何最好地识别具有文化能力和适当医学知识的“跨性别友好”泌尿科医生。
TGNB 个体在寻求独特的医疗保健需求方面面临重大障碍。TGNB 参与者描述了避免护理的情况，并报告了医疗保健歧视的经历。这些数据强调了泌尿科医生了解这些可能寻求泌尿科护理的个体的观点和历史经验的重要性。
