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初级保健中的共同护理和性别认同支持:年轻跨性别者的父母/照顾者的观点和经验。

Shared care and gender identity support in Primary Care: The perspectives and experiences of parents/carers of young trans people.

机构信息

De Montfort University, UK.

York St John University, UK.

出版信息

Health (London). 2024 Mar;28(2):235-252. doi: 10.1177/13634593221138616. Epub 2022 Nov 26.

DOI:10.1177/13634593221138616
PMID:36433767
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10900856/
Abstract

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.

摘要

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。

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本文引用的文献

1
Perspectives of trans and gender diverse young people accessing primary care and gender-affirming medical services: Findings from Trans Pathways.跨性别和性别多元青少年获得初级保健和性别肯定医疗服务的情况:来自“跨性别途径”的研究结果
Int J Transgend Health. 2021 Feb 17;23(3):295-307. doi: 10.1080/26895269.2021.1884925. eCollection 2022.
2
Transgender health care in primary care.初级保健中的跨性别者医疗保健。
Br J Gen Pract. 2021 Jul 29;71(709):377-378. doi: 10.3399/bjgp21X716753. Print 2021 Aug.
3
Electronic Consultations as an Educational Tool to Improve the Care of Transgender Patients in Primary Care.电子咨询作为一种教育工具,可改善初级保健中跨性别患者的护理。
J Health Care Poor Underserved. 2021;32(2):680-687. doi: 10.1353/hpu.2021.0097.
4
Supporting the Health of Transgender and Gender-Diverse Youth in Primary Care Settings.在初级保健环境中支持跨性别和性别多元青少年的健康。
Prim Care. 2021 Jun;48(2):259-270. doi: 10.1016/j.pop.2021.02.003. Epub 2021 Apr 22.
5
A Qualitative Scoping Review of Transgender and Gender Non-conforming People's Physical Healthcare Experiences and Needs.跨性别和性别非典型人群的身体保健体验和需求的定性范围综述。
Front Public Health. 2021 Feb 5;9:598455. doi: 10.3389/fpubh.2021.598455. eCollection 2021.
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Common barriers to healthcare for transgender people in the U.S. Southeast.美国东南部跨性别者获得医疗保健的常见障碍。
Int J Transgend Health. 2019 Dec 11;21(1):70-78. doi: 10.1080/15532739.2019.1700203. eCollection 2020.
7
A Model for Improving Health Care Quality for Transgender and Gender Nonconforming Patients.改善跨性别和性别不一致患者医疗保健质量的模型。
Jt Comm J Qual Patient Saf. 2020 Jan;46(1):37-43. doi: 10.1016/j.jcjq.2019.09.005. Epub 2019 Nov 8.
8
Transgender and Nontrans Patients Do Not Receive Statistically Different Quality Primary Care at Whitman-Walker Health, 2008-2016.2008年至2016年期间,在惠特曼-沃克健康中心,跨性别患者和非跨性别患者接受的初级医疗保健质量在统计学上没有差异。
Transgend Health. 2019 Sep 23;4(1):200-208. doi: 10.1089/trgh.2019.0022. eCollection 2019.
9
Stigma, Gender Affirmation, and Primary Healthcare Use Among Black Transgender Youth.黑人跨性别青年的污名、性别认同和初级保健利用。
J Adolesc Health. 2019 Oct;65(4):483-490. doi: 10.1016/j.jadohealth.2019.04.029. Epub 2019 Jul 11.
10
Transgender Adolescents' Experiences in Primary Care: A Qualitative Study.跨性别青少年在初级保健中的体验:一项定性研究。
J Adolesc Health. 2019 Sep;65(3):344-349. doi: 10.1016/j.jadohealth.2019.03.009. Epub 2019 Jun 18.