Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, California.
Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, California.
Womens Health Issues. 2021 Jul-Aug;31(4):324-331. doi: 10.1016/j.whi.2021.02.008. Epub 2021 Apr 16.
Transgender and nonbinary (TNB) individuals assigned female sex at birth experience discrimination, misgendering, problems with insurance, and denial of services when accessing health care. This study aimed to understand the experiences of TNB young adults in accessing "women's" health care-a form of care that is structurally gendered that few studies have investigated.
In 2015, we conducted in-depth interviews with 20 TNB young (ages 18-29) adults assigned female sex at birth. We thematically analyzed the data.
Participants described feelings of comfort and trust-and lack thereof-at every step of the health care-seeking process, including scheduling, checking in, waiting, and interactions with clinicians and other staff. Gendered language served as a constant stressor; participants-especially nonbinary participants-noted few opportunities to provide their correct pronouns and names. Participants relayed negative experiences associated with waiting rooms in "women's" health care spaces, where TNB patients are forced to disclose their identity simply through their presence or owing to actions of staff that out them. These concerns deterred some from seeking care, with most expressing discomfort or anxiety that caused them to feel unsafe. Participants described "women's" health care providers making assumptions about their anatomy, reproductive desires, sexual orientation, and sexual practices, as well as inappropriately and harmfully emphasizing their bodies and TNB identities during health care interactions. Clinician competence and humility engendered participants' feelings of safety and undergirded their interest in engaging with "women's" health care.
A lack of patient-centered, TNB-competent care in structurally gendered health settings exacerbates health care and health inequities for TNB young adults.
出生时被指定为女性性别的跨性别和非二元性别（TNB）个体在获得医疗保健时会经历歧视、被误称、保险问题以及服务被拒绝。本研究旨在了解 TNB 年轻成年人在获得“女性”保健方面的经历——这种保健形式是结构性的性别化的，很少有研究对此进行过调查。
2015 年，我们对 20 名出生时被指定为女性性别的 TNB 年轻（18-29 岁）成年人进行了深入访谈。我们对数据进行了主题分析。
参与者描述了在寻求医疗保健的每一个步骤中都感到舒适和信任——以及缺乏这种感觉，包括预约、登记、等待以及与临床医生和其他工作人员的互动。性别语言是一个持续的压力源；参与者——特别是非二元性别参与者——表示很少有机会提供他们正确的代词和名字。参与者讲述了与“女性”保健空间中的等候室相关的负面经历，在这些空间中，TNB 患者仅仅因为他们的存在或者因为工作人员的行为而被迫暴露自己的身份。这些担忧阻止了一些人寻求医疗保健，大多数人表示感到不适或焦虑，使他们感到不安全。参与者描述了“女性”保健提供者对他们的解剖结构、生殖欲望、性取向和性行为做出假设，以及在医疗保健互动中不恰当地强调他们的身体和 TNB 身份。临床医生的能力和谦逊激发了参与者的安全感，并增强了他们对参与“女性”保健的兴趣。
在结构性性别化的医疗环境中缺乏以患者为中心、TNB 能力强的护理，加剧了 TNB 年轻成年人的医疗保健和健康不平等。
