Oorthuys Anna O J, Ross Maeghan, Kreukels Baudewijntje P C, Mullender Margriet G, van de Grift Tim C
Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands.
Amsterdam Public Health Institute, 1081 BT Amsterdam, The Netherlands.
Healthcare (Basel). 2022 Dec 28;11(1):89. doi: 10.3390/healthcare11010089.
Gender-affirming treatments are reported to improve mental health significantly. However, a substantial number of transgender individuals report a relapse in, or persistence of, mental health problems following gender-affirming treatments. This is due to multiple stressors occurring during this period, and in general as a consequence of widespread stigma and minority stress.
The aim of this pilot study was to identify different coping strategies that transgender individuals use in response to stressors prior to and following gender-affirming treatments, as mediator of mental health.
Qualitative interviews were conducted to better understand the treatment outcomes and healthcare experiences of Dutch transgender individuals who had received gender-affirming treatments. Nineteen participants were included, of which 12 identified as (transgender) male, six as (transgender) female and one as transgender.
Inductive coding and theory-informed thematic analysis were used to assess stressors (n = 335) and coping strategies (n = 869).
Four stressor domains were identified, including lack of support system, stressors related to transition, and physical and psychosocial stressors post-transition. We identified six adaptive coping strategies of which acceptance, help seeking and adaptive cognitions concerning gender and transition were reported most frequently. Of the seven maladaptive strategies that we identified, social isolation and maladaptive cognitions concerning gender and transition were the most-reported maladaptive coping strategies Clinical implications: The results indicated that transgender individuals may experience significant stress, both transgender-specific and non-specific, prior to and following gender-affirming treatments and, as a result, use many coping strategies to adapt. Increased awareness of stressors and (mal)adaptive coping strategies may help to improve mental healthcare and overall support for transgender individuals. Strengths and Limitations: This is the first (pilot) study to provide insight into the range of stressors that transgender individuals experience during and after gender-affirming treatments, as well as the variety of coping strategies that are used to adapt. However, since this was a pilot study assumptions and generalizations of the evidence should be made cautiously.
Results of this pilot study showed that transgender individuals may undergo significant stress during and after gender-affirming medical treatment related to the treatments and the social experiences that occur during this period, and as a result, use a range of coping strategies to adapt to the stress.
据报道，性别肯定治疗能显著改善心理健康。然而，相当数量的跨性别者报告称，在接受性别肯定治疗后，心理健康问题出现复发或持续存在。这是由于在此期间出现的多种压力源，总体而言是普遍的污名化和少数群体压力的结果。
这项试点研究的目的是确定跨性别者在接受性别肯定治疗之前和之后应对压力源时所采用的不同应对策略，作为心理健康的调节因素。
进行了定性访谈，以更好地了解接受性别肯定治疗的荷兰跨性别者的治疗结果和医疗保健经历。纳入了19名参与者，其中12人认定为（跨性别）男性，6人认定为（跨性别）女性，1人认定为跨性别者。
确定了四个压力源领域，包括缺乏支持系统、与过渡相关的压力源以及过渡后的身体和心理社会压力源。我们确定了六种适应性应对策略，其中接受、寻求帮助以及关于性别和过渡的适应性认知最为常见。在我们确定的七种适应不良策略中，社会隔离以及关于性别和过渡的适应不良认知是报告最多的适应不良应对策略。临床意义：结果表明，跨性别者在接受性别肯定治疗之前和之后可能会经历重大压力，包括特定于跨性别者的和非特定的压力，因此会使用多种应对策略来适应。提高对压力源和（适应不良的）适应性应对策略的认识可能有助于改善对跨性别者的心理医疗保健和整体支持。优点和局限性：这是第一项（试点）研究，旨在深入了解跨性别者在接受性别肯定治疗期间和之后所经历的压力源范围，以及用于适应的各种应对策略。然而，由于这是一项试点研究，对证据的假设和概括应谨慎进行。
这项试点研究的结果表明，跨性别者在接受性别肯定医疗治疗期间和之后可能会因治疗以及在此期间发生的社会经历而承受重大压力，因此会使用一系列应对策略来适应压力。
