Ross Maeghan B, van de Grift Tim C, Elaut Els, Nieder Timo O, Becker-Hebly Inga, Heylens Gunter, Kreukels Baudewijntje P C
Department of Plastic Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Int J Transgend Health. 2021 Sep 9;24(1):26-37. doi: 10.1080/26895269.2021.1964409. eCollection 2023.
To evaluate the experienced barriers of care for treatment-seeking trans individuals (TSTG) in three large European clinics. An online follow-up questionnaire was filled out by 307 TSTG individuals as part of the research protocol of the European Network for the Investigation of Gender Incongruence (ENIGI). Data was collected during follow-up in 2017/2018, around 5 years after participants had their initial clinical appointments in Ghent (Belgium), Amsterdam (the Netherlands), or Hamburg (Germany). Background characteristics, country, treatment characteristics and mental health were analyzed in relation to experienced barriers of care (EBOC, measured though agreement with statements). The majority of participants reported various EBOC, oftentimes more than one. The most-frequently reported EBOCs pertained to the lack of family and friends' support (28.7%, n = 88) and travel time and costs (27.7%, n = 85), whereas around one-fifth felt hindered by treatment protocols. Also, a significant share expressed the feeling that they had to convince their provider they needed care and/or express their wish in such way to increase their likelihood of receiving care. A higher number of EBOCs reported was associated with more mental health problems, lower income and female gender. A substantial number of TSTG individuals within three European health care systems experiences EBOCs. EBOCs relate to both personal and systemic characteristics. These findings can help health care providers and centers to improve care. More research must be done to better understand the diversity among TSTG individuals and the corresponding barriers experienced. Supplemental data for this article is available online at https://doi.org/10.1080/26895269.2021.1964409.
评估欧洲三家大型诊所中寻求治疗的跨性别者（TSTG）在就医过程中遇到的障碍。作为欧洲性别认同不一致调查网络（ENIGI）研究方案的一部分，307名TSTG个体填写了一份在线随访问卷。数据收集于2017/2018年随访期间，此时距离参与者在比利时根特、荷兰阿姆斯特丹或德国汉堡首次就诊约5年。分析了背景特征、国家、治疗特征和心理健康与就医障碍（通过对陈述的认同程度来衡量的EBOC）之间的关系。大多数参与者报告了各种就医障碍，通常不止一种。最常报告的就医障碍与缺乏家人和朋友的支持（28.7%，n = 88）以及出行时间和费用（27.7%，n = 85）有关，而约五分之一的人感到受到治疗方案的阻碍。此外，相当一部分人表示觉得他们必须说服医疗服务提供者他们需要治疗，和/或以某种方式表达自己的愿望以增加获得治疗的可能性。报告的就医障碍数量较多与更多的心理健康问题、较低的收入和女性性别相关。欧洲三个医疗系统中的大量TSTG个体经历了就医障碍。就医障碍与个人和系统特征都有关。这些发现可以帮助医疗服务提供者和医疗中心改善治疗。必须开展更多研究以更好地了解TSTG个体之间的差异以及他们所经历的相应障碍。本文的补充数据可在https://doi.org/10.1080/26895269.2021.1964409在线获取。
