Hospital Vall d'Hebron, Barcelona, Spain.
Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Spain.
PLoS One. 2022 Aug 3;17(8):e0271484. doi: 10.1371/journal.pone.0271484. eCollection 2022.
Transgender identities are still considered a psychiatric pathology in many countries according to the prevailing biomedical model. However, in recent years, this pathologizing vision has begun to shift towards a perspective that focuses on the diversity of transgender peoples' experiences. However, some transgender people still face denial of services, discrimination, harassment, and even violence by healthcare professionals, causing them to avoid seeking ongoing or preventive healthcare. This article describes the health experiences of transgender people in Barcelona regarding their access and use of non-specialized health services. Semi-structured interviews were conducted using a descriptive phenomenological approach with sixteen transgender people between December 2018 and July 2019. The data were analyzed descriptively and thematically following the method proposed by Colaizzi with the help of the Atlas.ti8 software. Transgender people care experiences were divided into three categories: overcoming obstacles, training queries, and coping strategies. Participants identified negative experiences and difficulties with the health system due to healthcare providers' lack of competence. Discriminatory, authoritarian, and paternalist behaviors are still present and hinder the therapeutic relationship, care, and access to healthcare services. There is a fundamental need for the depathologization of transgender reality and training for healthcare professionals in the field of sexual diversity. Training in sexual and gender diversity must be included in the curricula of university courses in the health sciences.
根据流行的生物医学模式,在许多国家,跨性别身份仍被视为一种精神病理学。然而,近年来,这种病理化的观点开始转向关注跨性别者经历的多样性。然而,一些跨性别者仍然面临着医疗保健专业人员拒绝服务、歧视、骚扰,甚至暴力的问题,导致他们避免寻求持续或预防性的医疗保健。本文描述了巴塞罗那跨性别者在获得和使用非专业保健服务方面的健康体验。2018 年 12 月至 2019 年 7 月期间,采用描述性现象学方法,对 16 名跨性别者进行了半结构化访谈。在 Atlas.ti8 软件的帮助下,采用 Colaizzi 提出的方法对数据进行了描述性和主题分析。跨性别者的护理体验分为三个类别:克服障碍、培训查询和应对策略。参与者指出了由于医疗服务提供者缺乏能力而导致的健康系统中存在的负面体验和困难。歧视性、专制性和家长式作风仍然存在,阻碍了治疗关系、护理和获得医疗服务。有必要对跨性别者的现实进行去病理化,并对性多样性领域的医疗保健专业人员进行培训。性和性别多样性培训必须纳入健康科学大学课程的课程中。