Kbo-Isar-Amper-Klinikum Region München, 85540 Haar, Germany.
Institute of the History, Philosophy and Ethics of Medicine, Ulm University, 89073 Ulm, Germany.
Int J Environ Res Public Health. 2022 Feb 24;19(5):2650. doi: 10.3390/ijerph19052650.
Individuals of sexual and gender minority (SGM) form a vulnerable group with specific healthcare needs that might be prone to experience discrimination and restrictions regarding their access to healthcare. As the judgments of the European Court of Human Rights (ECtHR) offer a normative perspective on these issues, we analyzed them systematically (1) to identify whether and in what manner ECtHR's judgments concern restriction of access to healthcare for SGM individuals and (2) to identify and categorize the ways of discrimination to which SGM individuals are exposed. We conducted a systematic search of the database of the ECtHR's judgments with the use of specified search terms. Descriptive statistics were performed on the identified judgments. Subsequently, we analyzed the judgments with the use of a qualitative method of thematic analysis. We identified n = 73 cases relevant for our study. In n = 7 (9.59%) of judgments, we found limitations of access to healthcare for SGM individuals, e.g., in cases of restrictions for transsexual individuals to receive hormone or surgical therapy. We regard this as a specific form of discrimination. Furthermore, we identified five other categories of discrimination: restriction of parental rights, failure to respect one's gender identity/sexual orientation, discrimination by jurisdiction, prohibition of promotion, and verbal/physical attacks. The ECtHR proves to have a balanced view on the sensitive topic of sexual self-determination condemning any form of discrimination or restriction of access to healthcare. However, there is a need for further research on discriminatory acts by other individuals, e.g., healthcare providers, rather than by public authorities.
性少数群体和跨性别者（SGM）个体是一个弱势群体，他们有特殊的医疗保健需求，可能容易受到歧视，并在获得医疗保健方面受到限制。由于欧洲人权法院（ECtHR）的判决为这些问题提供了规范性的视角，我们系统地分析了这些判决（1）以确定 ECtHR 的判决是否以及以何种方式涉及对 SGM 个体获得医疗保健的限制，以及（2）确定和分类 SGM 个体所面临的歧视方式。我们使用指定的搜索词对 ECtHR 判决数据库进行了系统搜索。对确定的判决进行了描述性统计。随后，我们使用定性的主题分析方法对判决进行了分析。我们确定了 n = 73 项与我们的研究相关的案件。在 n = 7（9.59%）项判决中，我们发现 SGM 个体获得医疗保健的机会受到限制，例如，限制跨性别者接受激素或手术治疗。我们认为这是一种特殊形式的歧视。此外，我们还确定了其他五种歧视类别：限制父母权利、不尊重一个人的性别认同/性取向、管辖权歧视、禁止推广以及言语/身体攻击。ECtHR 在敏感的性自我决定问题上证明了持平衡的观点，谴责任何形式的歧视或限制获得医疗保健的机会。然而，有必要进一步研究其他个人（例如医疗保健提供者）的歧视行为，而不是公共当局的歧视行为。
