University of Southern California, Dornsife College of Letters, Arts, and Sciences, Spatial Sciences Institute, 3616 Trousdale Parkway, AHF B55, Los Angeles, CA, 90089, USA; Center for Applied Transgender Studies, Chicago, IL, USA.
University of Southern California, Keck School of Medicine, Institute on Inequalities in Global Health, 2001 N Soto St, Los Angeles, CA, 90032, USA.
Soc Sci Med. 2022 Jun;303:115014. doi: 10.1016/j.socscimed.2022.115014. Epub 2022 May 11.
What little data on transgender healthcare is available often focuses on transgender people's negative experiences in accessing healthcare. However, no research has been conducted that illustrates where gender-affirming hormone therapy, one part of transgender-specific medical care, is available. Without these data, large scale research to discern patterns of availability of and access to gender-affirming medical care is nearly impossible. Community-based organizations, and even trans individuals themselves have constructed repositories and databases of healthcare providers to inform other care seekers where they can access transition-related care providers, but their data are often incomplete, and usually formatted to be user-facing rather than streamlined for research purposes. To fill this gap, this article outlines the methodology for the construction of a spatial database of providers of gender-affirming hormone therapy for transgender people in the US, which is available on GitHub, created from existing community-based resources and the accompanying verification process. The completeness of the database is tested via comparison to data from the US Transgender Survey in which respondents reported travel distance to access transgender-specific care providers. The database accounted for all but 7.5% of respondents who may have accessed unknown facilities based on self-reported travel distance. Results indicate that existing methodologies for database construction regarding healthcare providers are difficult to apply when working with transgender-specific medical care and that tests for replicability and validation often take for granted the wide availability of relevant data and information. While the database unto itself can only demonstrate where care is available, it will enable future research into why these geographic patterns in care availability exist. Finally, the methodology can be replicated to produce databases for other kinds of specialized or politicized medical care such as abortion, gender-affirming surgery, or HIV treatment.
关于 transgender 医疗保健的可用数据很少关注 transgender 人在获得医疗保健方面的负面经历。但是，没有研究表明性别肯定激素治疗（ transgender 特定医疗保健的一部分）的可用性。没有这些数据，就几乎不可能进行大规模研究以确定性别肯定医疗保健的可用性和可及性模式。社区组织，甚至 trans 个人本身都构建了医疗保健提供者的存储库和数据库，以告知其他寻求护理的人可以在哪里获得与过渡相关的护理提供者，但是他们的数据通常不完整，并且通常格式化为面向用户，而不是为研究目的而简化。为了填补这一空白，本文概述了构建美国 transgender 人接受性别肯定激素治疗的提供者的空间数据库的方法，该数据库可在 GitHub 上使用，是根据现有的社区资源和伴随的验证过程构建的。通过与美国 transgender 调查中的数据进行比较，测试了数据库的完整性，该调查中的受访者报告了为获取 transgender 特定护理提供者而旅行的距离。该数据库除了可能根据自我报告的旅行距离访问未知设施的受访者外，涵盖了所有受访者。结果表明，当涉及 transgender 特定医疗保健时，现有的医疗保健提供者数据库构建方法很难应用，并且可重复性和验证性测试通常认为相关数据和信息的广泛可用性是理所当然的。尽管该数据库本身只能说明护理的可用性，但它将使未来能够研究护理可用性的地理模式为何存在。最后，该方法可以复制以生成其他种类的专门或政治化医疗保健（例如堕胎、性别肯定手术或 HIV 治疗）的数据库。
