跨性别者断臂综合征:一项关于性别相关医学误诊及侵入性询问的混合方法研究
Trans broken arm syndrome: A mixed-methods exploration of gender-related medical misattribution and invasive questioning.
作者信息
Wall Catherine S J, Patev Alison J, Benotsch Eric G
机构信息
Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
出版信息
Soc Sci Med. 2023 Mar;320:115748. doi: 10.1016/j.socscimed.2023.115748. Epub 2023 Jan 30.
RATIONALE
Gender-related medical misattribution and invasive questioning (GRMMIQ), colloquially known as "trans broken arm syndrome," is a form of medical discrimination faced by transgender and gender diverse (TGD) patients wherein a provider incorrectly assumes that a medical condition results from a patient's gender identity or medical transition. This phenomenon may take one of two forms: (1) the incorrect and explicit misattribution of gender identity or medical transition as being the cause of an acute complaint, or (2) invasive and unnecessary questions regarding a patient's gender identity or gender transition status.
OBJECTIVE
Using mixed-methods procedures, this study aims to explore the incidence, some common correlates, and manifestations of GRMMIQ.
METHODS
American TGD participants (N = 147), recruited through an online recruitment platform, completed questions assessing their experiences in the healthcare system including lifetime incidence of GRMMIQ, outness to healthcare providers, and additional experiences of gender-related discrimination in a medical setting. Participants who indicated experiences of GRMMIQ were asked open-ended questions about one such experience.
RESULTS
Nearly one-third of participants reported experiencing GRMMIQ. Experiences were associated with outness to acute care providers and other types of gender-related discrimination in healthcare settings. Analysis of qualitative data revealed four primary themes: (1) assumptions of disordered thinking and being, (2) hyperfocus on aspects of medical transition, (3) cultural ignorance and incompetence, and (4) dismissiveness of the patient.
CONCLUSION
Together, these results enhance the understanding of an underexplored aspect of medical discrimination faced by TGD individuals while highlighting commonalities across different experiences.
理论依据
与性别相关的医学误诊和侵入性询问(GRMMIQ),通俗地称为“跨性别者断臂综合征”,是跨性别和性别多样化(TGD)患者所面临的一种医学歧视形式,即医疗服务提供者错误地认为某种医疗状况是由患者的性别认同或医学转变导致的。这种现象可能有两种形式:(1)将性别认同或医学转变错误且明确地归因于急性病症的原因;(2)对患者的性别认同或性别转变状况进行侵入性且不必要的询问。
目的
本研究采用混合方法程序,旨在探讨GRMMIQ的发生率、一些常见相关因素及表现形式。
方法
通过在线招募平台招募了美国的TGD参与者(N = 147),他们完成了评估其在医疗系统经历的问题,包括GRMMIQ的终生发生率、向医疗服务提供者公开身份的情况,以及在医疗环境中与性别相关的其他歧视经历。表明有GRMMIQ经历的参与者被问及关于一次此类经历的开放式问题。
结果
近三分之一的参与者报告有过GRMMIQ经历。这些经历与向急诊医疗服务提供者公开身份以及医疗环境中其他类型的性别相关歧视有关。对定性数据的分析揭示了四个主要主题:(1)对思维和存在紊乱的假设;(2)过度关注医学转变的方面;(3)文化无知和能力不足;(4)对患者的轻视。
结论
这些结果共同增进了对TGD个体所面临的医学歧视中一个未被充分探索方面的理解,同时突出了不同经历之间的共性。