Department for Healthcare Delivery and Population Science, University of Massachusetts Chan Medical School-Baystate, Springfield.
Department of Emergency Medicine, University of Massachusetts Chan Medical School-Baystate, Springfield.
JAMA Netw Open. 2022 Jun 1;5(6):e2219791. doi: 10.1001/jamanetworkopen.2022.19791.
Although LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority) physicians experience bias in the workplace, there is a paucity of data on the experiences of physicians who identify specifically as transgender and/or gender expansive (TGE; gender expansive is an umbrella term encompassing individuals and gender identities that may exist beyond the binary framework [eg, may include nonbinary, genderqueer, and agender individuals]).
To explore the professional experiences of TGE physicians, identify barriers to inclusion, and highlight stakeholder-derived strategies that promote an inclusive workplace.
DESIGN, SETTING, AND PARTICIPANTS: This qualitative study informed by semistructured interviews was conducted among 24 TGE physicians in the US from April 1 to December 31, 2021. The sample of TGE physicians was recruited using convenience and snowball sampling. Interviews were recorded and transcribed. Using thematic analysis, at least 2 members of the research team performed blinded coding of each transcript, in an iterative process.
Data collection and thematic analysis examining themes of physicians' experiences.
Among 24 physicians (mean [SD] age, 39 [1.4] years) interviewed, 8 (33%) self-identified as transgender women, 7 (29%) as transgender men, 4 (17%) as nonbinary, 3 (13%) as transgender and nonbinary, and 2 (8%) as genderqueer. Prominent themes of the interviews included emotional distress as a result of transphobia, dominance of a rigid binary gender paradigm, and structural and institutional factors that are associated with psychological and physical safety and feelings of isolation as a TGE physician. Clear steps of affirmation were identified that could mitigate the emotional stressors, including signs of safety, active allyship, and mentorship by other TGE physicians.
In this qualitative study, TGE physicians reported facing both overt and subtle biases associated with their identity and gender presentation. Participants also noted several interpersonal and structural factors that mitigate the effect of these biases.
尽管 LGBTQIA+（女同性恋、男同性恋、双性恋、跨性别、酷儿和其他性少数和性别少数群体）医生在工作场所会经历偏见，但关于明确认同跨性别和/或性别扩张（TGE；性别扩张是一个涵盖可能超出二元框架的个人和性别认同的总称[例如，可能包括非二元性别、性别酷儿和无性别个体]）的医生的经历的数据却很少。
探讨 TGE 医生的职业经历，确定包容的障碍，并强调促进包容工作场所的利益相关者衍生策略。
设计、设置和参与者：这项由半结构化访谈提供信息的定性研究在美国进行，共有 24 名 TGE 医生参与，时间为 2021 年 4 月 1 日至 12 月 31 日。TGE 医生的样本是通过便利和滚雪球抽样招募的。访谈被记录并转录。使用主题分析，研究团队的至少 2 名成员对每个转录本进行盲目的编码，这是一个迭代过程。
数据收集和主题分析，检查医生经历的主题。
在接受采访的 24 名医生（平均[标准差]年龄，39[1.4]岁）中，8 名（33%）自我认同为跨性别女性，7 名（29%）为跨性别男性，4 名（17%）为非二元性别，3 名（13%）为跨性别和非二元性别，2 名（8%）为性别酷儿。访谈的突出主题包括由于跨性别恐惧症而导致的情绪困扰、僵化的二元性别范式的主导地位，以及与 TGE 医生的心理和身体安全以及孤立感相关的结构和制度因素。还确定了明确的肯定步骤，可以减轻情绪压力源，包括安全迹象、积极的盟友关系和其他 TGE 医生的指导。
在这项定性研究中，TGE 医生报告说，他们既面临与自己的身份和性别表现相关的明显偏见，也面临微妙的偏见。参与者还指出了几个减轻这些偏见影响的人际和结构因素。
