School of Social Welfare, University of Kansas, 1545 Lilac Lane, Lawrence, KS 66045, USA.
Luskin School of Public Affairs, University of California Los Angeles, 3250 Public Affairs Building, Los Angeles, CA 90095, USA.
Int J Environ Res Public Health. 2021 Sep 1;18(17):9219. doi: 10.3390/ijerph18179219.
Transgender and gender diverse (TGD) youth experience health disparities due to stigma and victimization. Gender-affirming healthcare mitigates these challenges; yet, we have limited understanding of TGD youth's healthcare experiences in the U.S. Midwest and South. Using a multiple case study design, we aimed to develop an in-depth and cross-contextual understanding of TGD youth healthcare experiences in one Midwestern state. Families with a TGD child under 18 were recruited with the goal of cross-case diversity by child age, gender, race, and/or region of the state; we obtained diversity in child age and region only. Four white families with TGD boys or non-binary youth (4-16) in rural, suburban, and small towns participated in interviews and observations for one year; public data were collected from each family's community. Thematic analysis was used within and across cases to develop both family-level understanding and identify themes across families. Findings include a summary of each family as it relates to their child's TGD healthcare experiences as well as the themes identified across cases: accessibility and affirming care. Although limited by a small sample with lack of gender and race diversity, this study contributes to our understanding of TGD youth healthcare in understudied regions.
跨性别和性别多样化（TGD）的年轻人由于受到污名化和受害而经历健康差距。性别肯定的医疗保健可以减轻这些挑战；然而，我们对美国中西部和南部 TGD 年轻人的医疗保健经验了解有限。我们采用多案例研究设计，旨在深入了解和跨文化理解一个中西部州 TGD 年轻人的医疗保健经验。我们招募了有 TGD 孩子（18 岁以下）的家庭，目标是通过孩子的年龄、性别、种族和/或州的地区实现跨案例多样性；我们仅在孩子的年龄和地区方面实现了多样性。有四个白人家庭，家中有 TGD 男孩或非二元性别青年（4-16 岁），居住在农村、郊区和小镇，参与了为期一年的访谈和观察；从每个家庭所在社区收集了公开数据。在案例内和跨案例内使用主题分析来发展家庭层面的理解并确定跨家庭的主题。研究结果包括每个家庭与其 TGD 医疗保健经验相关的总结，以及跨案例确定的主题：可及性和肯定性护理。尽管由于缺乏性别和种族多样性以及样本量小而受到限制，但本研究有助于我们理解在研究较少的地区 TGD 年轻人的医疗保健。
