Strauss Penelope, Winter Sam, Waters Zoe, Wright Toussaint Dani, Watson Vanessa, Lin Ashleigh
Telethon Kids Institute, University of Western Australia, Perth, Australia.
School of Population and Global Health, University of Western Australia, Perth, Australia.
Int J Transgend Health. 2021 Feb 17;23(3):295-307. doi: 10.1080/26895269.2021.1884925. eCollection 2022.
Increasing numbers of trans young people are seeking medical services worldwide, but there have been few qualitative investigations of the experiences of trans young people attempting to engage with these services to explore in-depth experiences of clinical interactions. We aimed to explore the experiences of trans young people accessing primary care and gender-affirming medical services in Australia for reasons related to their gender. Using data from a large mixed methods cross-sectional study, we explored the personal experiences of trans young people aged 14-25 (N = 859) receiving care within primary care services and gender-affirming medical services. Qualitative data on these service experiences were thematically analyzed. Trans young people in Australia reported experiencing difficulties when accessing medical services, especially in relation to gender-affirming medical intervention, referrals to specialist services, and obtaining clinical support in an affordable and timely manner. We found that trans young people were frequently confronted with negative experiences due to clinicians lacking expertise in providing gender-affirming care. Trans young people also reported many positive experiences, including feeling their gender identity was valued and respected by certain services. Although many practitioners attempted to assist their trans patients, they often did not provide satisfactory care and young people were often left to navigate the health care system unsupported. These interactions were often constrained by long waiting times and service cost. In general, clinicians require further training to be able to respectfully interact with trans patients and to adequately assist trans young people to obtain necessary medical care. The danger of providing such non-affirmative care to a trans young person is not only invalidating the young person's identity, but also an elevated risk of ill-health due to later avoidance of health care.
全球范围内，越来越多的跨性别青少年寻求医疗服务，但对于跨性别青少年尝试利用这些服务的经历，却鲜有定性调查，以深入探究临床互动体验。我们旨在探究澳大利亚跨性别青少年因性别相关原因获取初级保健和性别肯定医疗服务的经历。利用一项大型混合方法横断面研究的数据，我们探究了14至25岁（N = 859）在初级保健服务和性别肯定医疗服务中接受护理的跨性别青少年的个人经历。对这些服务体验的定性数据进行了主题分析。澳大利亚的跨性别青少年报告称，在获取医疗服务时遇到困难，尤其是在性别肯定医疗干预、转介至专科服务以及以可承受的价格及时获得临床支持方面。我们发现，由于临床医生缺乏提供性别肯定护理的专业知识，跨性别青少年经常面临负面经历。跨性别青少年也报告了许多积极经历，包括感到某些服务重视和尊重他们的性别认同。尽管许多从业者试图帮助他们的跨性别患者，但他们往往没有提供令人满意的护理，年轻人常常在没有支持的情况下自行应对医疗保健系统。这些互动往往受到长时间等待和服务成本的限制。总体而言，临床医生需要进一步培训，以便能够以尊重的方式与跨性别患者互动，并充分协助跨性别青少年获得必要的医疗护理。向跨性别青少年提供这种非肯定性护理的危险不仅会使年轻人的身份无效，还会因日后回避医疗保健而增加健康不良的风险。
