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跨性别男性获取知识渊博的医疗服务提供者的途径及其在医疗保健环境中的体验:按人口统计学、心理健康和向提供者“出柜”程度的差异。

Trans Men's Access to Knowledgeable Providers and Their Experiences in Health Care Settings: Differences by Demographics, Mental Health, and Degree of Being "Out" to Providers.

机构信息

associate professor, School of Social Work, Georgia State University, PO Box 3992, Atlanta, GA 30302-3992.

assistant professor, School of Social Work and Department of Women's and Gender Studies, University of Michigan, Ann Arbor.

出版信息

Health Soc Work. 2021 Apr 3;45(4):229-239. doi: 10.1093/hsw/hlaa030.

Abstract

Transgender adults face a health care system rife with stigma, including a lack of culturally responsive providers and high likelihood of discrimination and mistreatment. However, there is a gap in knowledge about trans men-those assigned a female sex at birth who identify as men or as transmasculine-including subgroups, such as trans men of color. Using data from the U.S. Transgender Survey, the largest transgender survey conducted in the United States, this study analyzes whether trans men's access to knowledgeable providers and their experiences of mistreatment in health care were related to demographic and mental health characteristics and degree of being "out" to providers. Among 7,950 trans men, respondent race and ethnicity, education level, disability status, psychological distress, suicidality, and being less "out" were associated with assessing one's health care provider as not knowledgeable about trans-related care. Mistreatment in health care was more common among Alaska Native/American Indian trans men; those who lived in or near poverty; those who were queer, pansexual, bisexual, or an orientation not listed; those with a disability; those experiencing distress or suicidality; and those who were more "out." This article discusses how findings can inform culturally responsive health care interventions with trans men.

摘要

跨性别成年人面临着充斥着污名的医疗保健系统,包括缺乏对文化敏感的提供者,以及高度歧视和虐待的可能性。然而,人们对跨男性(出生时被指定为女性但认同为男性或跨男性气质的人)的了解存在差距,包括跨男性中的一些亚群,如跨男性有色人种。本研究使用美国 Transgender 调查的数据,这是美国进行的最大规模的跨性别调查,分析了跨男性获得知识渊博的提供者的机会以及他们在医疗保健中遭受虐待的经历是否与人口统计学和心理健康特征以及向提供者公开的程度有关。在 7950 名跨男性中,受访者的种族和民族、教育水平、残疾状况、心理困扰、自杀意念以及向提供者公开的程度与评估医疗保健提供者对跨性别相关护理的了解程度有关。在医疗保健中受到虐待的情况在阿拉斯加原住民/美洲印第安人跨男性中更为常见;那些生活在或接近贫困线的人;那些是酷儿、泛性恋、双性恋或未列出的性取向的人;那些有残疾的人;那些经历困扰或自杀意念的人;以及那些更公开的人。本文讨论了这些发现如何为跨男性提供文化响应的医疗保健干预措施提供信息。

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