Department of Communication & Media, Texas A&M University-Corpus Christi.
Department of Communication, Rutgers University.
Health Commun. 2022 Jul;37(8):1031-1040. doi: 10.1080/10410236.2021.1885774. Epub 2021 Feb 10.
As identified in HealthyPeople 2020, the transgender population faces various barriers in accessing quality health care. One barrier includes the fear of negative response or refusal of treatment after disclosing one's transgender identity. In an effort to address this concern, it is essential to understand the criteria that transgender patients consider when determining if they will disclose their gender identity. The disclosure decision-making model (DD-MM) describes how individuals make decisions to share non-visible, health-relevant information with others. Applying the information assessment component of the DD-MM, the present study investigated the salient information assessment themes that contribute to transgender patients' decisions to disclose or withhold their gender identity from medical providers. The sample ( = 26) included transgender individuals who participated in in-depth interviews and described instances and criteria of disclosure decisions. Results revealed that when gauging stigma, participants consider cultural attitudes, how providers may attribute health concerns to their transgender identity, and if providers will perceive them as "trans enough" to provide access to transition-related care. When transition-related care is not necessary, participants' disclosure decision criteria include thoughts on how providers will perceive their gender expression and whether their transgender identity is salient to the medical interaction. Findings also highlighted opportunities for extending prior theoretical conceptualizations and practical implications for transgender care.
正如《健康人 2020》所指出的，跨性别群体在获得高质量医疗保健方面面临各种障碍。其中一个障碍是，跨性别者在透露自己的跨性别身份后，担心会遭到负面回应或拒绝治疗。为了解决这一问题，了解跨性别患者在决定是否透露其性别认同时所考虑的标准至关重要。披露决策模型（DD-MM）描述了个体如何决定与他人分享非可见的、与健康相关的信息。本研究应用 DD-MM 的信息评估部分，调查了促成跨性别患者向医疗服务提供者披露或隐瞒其性别认同的重要信息评估主题。样本（n=26）包括参与深入访谈并描述披露决策实例和标准的跨性别者。结果表明，在衡量污名时，参与者会考虑文化态度、提供者如何将健康问题归因于他们的跨性别身份，以及提供者是否会认为他们“足够跨性别”以获得与过渡相关的护理。当不需要过渡相关护理时，参与者的披露决策标准包括对提供者如何看待他们的性别表达的思考，以及他们的跨性别身份是否与医疗互动有关。研究结果还强调了扩展先前理论概念化和跨性别护理实践意义的机会。
