Oak Ridge Institute for Science and Education (ORISE), TN, United States of America.
Oak Ridge Institute for Science and Education (ORISE), TN, United States of America.
J Pediatr Nurs. 2021 Jan-Feb;56:54-59. doi: 10.1016/j.pedn.2020.09.021. Epub 2020 Nov 10.
Transgender populations experience health inequities that underscore the importance of ensuring access to high quality care. We thematically summarize the health care experiences of transgender youth living in the southeast United States to identify potential barriers and facilitators to health care.
Transgender youth recruited from community settings in an urban area of the southeast United States participated in individual interviews (n = 33) and focus groups (n = 9) about protective factors. We conducted a thematic analysis of data from 42 participants who described their experiences seeking and receiving health care.
Participants reported a wide range of gender identities. The individual interview sample was majority Black (54.5%) and the mean age was 21.7 years and focus group participants were all white and the mean age was 16.8 years. Participants described numerous barriers to health care, including limited availability of gender affirming care, logistical challenges, such as gatekeeping and cost, concerns about confidentiality in relation to sexual behavior and gender identity, and inadequate cultural competency among providers regarding gender-affirming care. Facilitators included intake procedures collecting chosen pronouns and names and consistent use of them by providers, and open communication, including active listening.
Findings underscore the need for a multi-component approach to ensure both transgender- and youth-friendly care.
Providers and office staff may benefit from transgender cultural competency trainings. In addition, clinic protocols relating to confidentiality and chosen name and pronoun use may help facilitate access to and receipt of quality care.
跨性别群体经历着健康不平等，这突显了确保他们获得高质量医疗保健的重要性。我们对生活在美国东南部的跨性别青年的医疗保健经历进行了主题总结，以确定他们在医疗保健方面可能面临的障碍和促进因素。
从美国东南部一个城市社区环境中招募的跨性别青年参加了关于保护因素的个人访谈（n=33）和焦点小组（n=9）。我们对来自 42 名参与者的数据进行了主题分析，这些参与者描述了他们寻求和接受医疗保健的经历。
参与者报告了广泛的性别认同。个人访谈样本中，黑人占多数（54.5%），平均年龄为 21.7 岁，焦点小组参与者均为白人，平均年龄为 16.8 岁。参与者描述了医疗保健方面的许多障碍，包括获得性别肯定护理的机会有限、后勤方面的挑战，如把关和费用、对性行为和性别认同方面保密性的担忧、以及提供者在性别肯定护理方面的文化能力不足。促进因素包括收集选择的代词和名字的入职程序以及提供者始终使用这些代词和名字，以及开放的沟通，包括积极倾听。
研究结果强调需要采取多方面的方法来确保医疗保健既适合跨性别群体，又适合青年群体。
提供者和办公室工作人员可能受益于跨性别文化能力培训。此外，与保密性和选择的名字和代词使用相关的诊所协议可能有助于促进获得和接受高质量的医疗保健。
