Department of Psychology, University of Otago, Dunedin, Aotearoa, New Zealand.
Department of Primary Health Care and General Practice, University of Otago, Wellington, Aotearoa, New Zealand.
Fam Pract. 2022 Sep 24;39(5):834-842. doi: 10.1093/fampra/cmac005.
Past research has established that transgender people experience significant disparities in mental health outcomes and healthcare dissatisfaction compared with cisgender people, but more research is needed on how supportive healthcare interactions relate to the mental health of transgender people.
The 2 main aims of our analyses were: (i) to establish the most common negative experiences in healthcare and the most common supportive experiences specifically with primary care doctors for transgender people; and (ii) to examine the association of supportive experiences with mental health variables after controlling for demographic factors.
Data from the 2018 Counting Ourselves nationwide survey of transgender people were analysed using regression modelling. The 948 participants with a primary care doctor or general practitioner were included in analyses. Participants were aged 14-83 years old (mean 30.20).
The most common supportive experiences involved primary care doctors treating transgender people equitably, with competence, and with respect. Participants with more negative healthcare experiences had higher psychological distress as well as higher likelihood of reporting nonsuicidal self-injury and suicidality. Conversely, participants with more experiences of supportive primary care doctors had lower psychological distress and were less likely to have attempted suicide in the past 12 months.
When transgender people receive supportive care from their primary care providers they experience better mental health, despite ongoing negative healthcare experiences. Future research is needed to confirm ways of supporting positive trajectories of mental health for transgender people but these findings demonstrate the importance of positive aspects of care.
过去的研究已经证实，与顺性别者相比，跨性别者在心理健康结果和医疗保健满意度方面存在显著差异，但需要更多的研究来了解支持性的医疗保健互动如何与跨性别者的心理健康相关。
我们分析的主要目的有两个：（i）确定跨性别者在医疗保健中最常见的负面经历，以及与初级保健医生特别相关的最常见的支持性经历；（ii）在控制人口统计学因素后，研究支持性经历与心理健康变量的关联。
使用回归建模分析了来自 2018 年全国性的 Counting Ourselves 调查的跨性别者数据。共有 948 名有初级保健医生或全科医生的参与者纳入分析。参与者年龄在 14-83 岁之间（平均 30.20 岁）。
最常见的支持性经历涉及初级保健医生平等、有能力和尊重地对待跨性别者。有更多负面医疗保健经历的参与者心理困扰程度更高，报告非自杀性自我伤害和自杀意念的可能性也更高。相反，有更多经历过支持性初级保健医生的参与者心理困扰程度较低，在过去 12 个月内自杀未遂的可能性也较低。
尽管跨性别者仍面临负面的医疗保健经历，但当他们从初级保健提供者那里获得支持性护理时，他们的心理健康状况会更好。未来需要进一步的研究来确认支持跨性别者心理健康积极轨迹的方法，但这些发现表明了关注护理积极方面的重要性。
