From the Departments of Behavioral Sciences and Health Education and Health Policy and Management, Rollins School of Public Health, Emory University, and the Departments of Psychiatry and Behavioral Sciences, Medicine (Division of General Internal Medicine and Geriatrics), and Medicine (Division of Endocrinology, Metabolism, and Lipids), School of Medicine, Emory University, Atlanta, Georgia.
South Med J. 2021 Jun;114(6):334-338. doi: 10.14423/SMJ.0000000000001261.
Transgender (trans) individuals experience high discrimination levels when accessing medical and mental health care, resulting in poorer health outcomes compared with the general population and other minority populations. A community-based research design was used to elicit direct input from the trans community about critical trans-knowledgeable care components to address these disparities. The data collection included several focus groups with individuals recruited from the trans community. The information from this research guided the opening of the Gender Center, a centralized, multidisciplinary center of care for trans individuals within an urban safety-net hospital in Atlanta, Georgia.
The research team conducted five focus groups with 27 self-identified trans individuals between December 2016 and April 2017. Focus groups solicited the negative and positive experiences of trans individuals in the healthcare system and sought input about how best to serve this population.
Analysis was done January through April 2020. Focus group participants identified financial difficulties, lack of insurance coverage, being underinsured, discrimination within the healthcare system and from providers, and a shortage of trans-competent providers as the most significant barriers to care. Participants emphasized the need to pay attention to creating a welcoming clinic environment, including trans-positive signage, and integrating trans staff members into the care team.
This study demonstrates the importance of community-based research in addressing health disparities for trans people. It also offers insight into the unmet healthcare needs of the trans community, describes typical healthcare-related experiences of trans individuals, and identifies critical elements for providing high-quality trans-appropriate health care.
跨性别（trans）个体在获得医疗和精神保健方面经历着高度歧视，导致他们的健康状况比普通人群和其他少数群体更差。本研究采用社区为基础的研究设计，从跨性别群体中直接收集关于解决这些差异的关键跨知识护理组成部分的意见。数据收集包括从跨性别群体中招募的个体的几个焦点小组。该研究的信息指导了性别中心的开设，该中心是佐治亚州亚特兰大市一家城市医疗保障医院内的一个集中、多学科的跨性别个体护理中心。
研究团队于 2016 年 12 月至 2017 年 4 月期间进行了五次焦点小组，参与者为 27 名自我认同的跨性别个体。焦点小组征集了跨性别个体在医疗系统中的负面和正面经历，并征求了如何最好地为这一群体服务的意见。
分析于 2020 年 1 月至 4 月进行。焦点小组参与者确定了财务困难、缺乏保险覆盖、保险不足、医疗系统和提供者的歧视以及缺乏跨专业能力的提供者是护理的最大障碍。参与者强调需要注意营造一个欢迎的诊所环境，包括使用跨性别积极的标识，并将跨性别工作人员纳入护理团队。
本研究表明，社区为基础的研究对于解决跨性别者的健康差异非常重要。它还提供了对跨性别群体未满足的医疗需求的洞察，描述了跨性别个体的典型医疗相关经历，并确定了提供高质量跨性别适宜保健的关键要素。
