Olivares Angela, Flores Justino, Ly Kodiak, Christensen Chris, Brown Brandon, Polonijo Andrea N
Department of Biochemistry, University of California, Riverside, Riverside, California, USA.
Body Image, Sexuality, and Health Lab, California State University, San Diego, San Diego, California, USA.
Transgend Health. 2022 Oct 7;7(5):440-448. doi: 10.1089/trgh.2020.0187. eCollection 2022 Oct.
To evaluate negative and positive health care experiences within the racial-ethnically diverse transgender and gender-nonconforming (TGNC) community in the Inland Empire, California.
Three focus groups were conducted with a racial-ethnically diverse sample of 20 TGNC-identified individuals in California's Inland Empire. The rigorous and accelerated data reduction (RADaR) technique was used to systematically analyze the qualitative data and identify salient themes.
Key themes included the following: a lack of TGNC cultural competency among providers, interpersonal barriers to health care, perceived systemic barriers to health care, and the effects of improper care on TGNC patients' health. Lack of cultural competency included providers' conflations of gender and sexuality and unawareness of nonbinary gender identities. Interpersonal barriers included patient experiences of being misgendered, refused treatment, and referred to by their deadnames. Perceived systemic barriers included insurance coverage, transportation issues, and a lack of expedient care. The effects of improper care were highlighted by participants seeking alternative and sometimes unsafe forms of care when timely and appropriate care was inaccessible.
Participants recommended increasing representation of TGNC perspectives into provider trainings, involving providers in outreach with the TGNC community, and requiring letters of recommendation and certifications for providers to be deemed TGNC culturally competent as means of improving TGNC patient care.
评估加利福尼亚州内陆帝国不同种族和族裔的跨性别者及性别认同不符者（TGNC）群体的负面和正面医疗保健经历。
对加利福尼亚州内陆帝国20名自我认同为TGNC的不同种族和族裔样本进行了三个焦点小组访谈。采用严格且加速的数据缩减（RADaR）技术系统分析定性数据并确定突出主题。
关键主题如下：医疗服务提供者缺乏TGNC文化能力、医疗保健的人际障碍、感知到的医疗保健系统障碍以及不当护理对TGNC患者健康的影响。文化能力不足包括医疗服务提供者将性别和性取向混为一谈以及对非二元性别认同缺乏认识。人际障碍包括患者被错误称呼性别、被拒绝治疗以及被称呼其曾用名的经历。感知到的系统障碍包括保险覆盖范围、交通问题以及缺乏便捷护理。当无法获得及时且适当的护理时，参与者寻求替代且有时不安全的护理形式凸显了不当护理的影响。
参与者建议在医疗服务提供者培训中增加TGNC视角的代表性，让医疗服务提供者参与针对TGNC群体的外展活动，并要求医疗服务提供者获得推荐信和认证以被视为具备TGNC文化能力，以此作为改善TGNC患者护理的手段。
