De Montfort University, UK.
York St John University, UK.
Health (London). 2024 Mar;28(2):235-252. doi: 10.1177/13634593221138616. Epub 2022 Nov 26.
This article addresses the complex issues surrounding trans youths' shared care perceived by parents in primary care settings in the UK. The analyses in this article draws on qualitative data derived from an online survey of 153 parents with trans children. Through the conceptual framework of healthcare assemblages, findings suggest that quality shared care for trans youth is based upon transient service relationships inherent in their healthcare-primary care, gender identity services, endocrinologists, and Adolescent Mental Health Services (CAHMS)-and, as such, this complexity must be understood better by GPs in order for quality shared care to be administered. We explored various blockages to quality shared care within primary care surgeries that produced limit situations, such as lack of knowledge, training, or experience with trans healthcare. One other key factor was that there were strong external forces that were limiting trans youths' quality shared care in the form of abject depictions from beyond the consultation, which all produced negative effects. Despite these blockages, we also demonstrate how and where quality shared care is received. For instance, we show that continuity of care or treatment after an initial diagnosis or assessment contributes to quality shared care as too does personalized care to those youths receiving it. Overall, this research provides insights into the complex perceptions of parents about what quality shared care is and ought to be for trans youth.
本文探讨了英国初级保健环境中父母对跨性别青年共同照护的复杂看法。本文的分析基于对 153 名有跨性别子女的父母进行的在线调查的定性数据。通过医疗保健组合体的概念框架,研究结果表明,为跨性别青年提供优质的共同照护,基于他们的医疗保健(初级保健、性别认同服务、内分泌科和青少年心理健康服务)中固有的短暂服务关系,因此,全科医生必须更好地理解这种复杂性,才能进行优质的共同照护。我们探讨了初级保健诊所中存在的各种阻碍优质共同照护的因素,这些因素导致了限制情况,如缺乏跨性别保健方面的知识、培训或经验。另一个关键因素是,存在强烈的外部力量限制了跨性别青年的共同照护质量,表现为咨询之外的负面描述,这些都产生了负面影响。尽管存在这些障碍,但我们也展示了在哪里以及如何获得优质的共同照护。例如,我们表明,初始诊断或评估后的连续护理或治疗有助于共同照护质量,而对接受治疗的青年进行个性化护理也是如此。总的来说,这项研究深入了解了父母对跨性别青年共同照护的复杂看法,以及什么是优质的共同照护,以及它应该是什么样子。