Astraea Lesbian Foundation for Justice, New York, USA.
School of Business and Graduate Studies, Trinity Washington University, Washington, DC, USA.
Int J Equity Health. 2023 Feb 13;22(1):31. doi: 10.1186/s12939-023-01843-4.
Although discriminatory experiences of transgender people seeking healthcare services have been well-documented in several studies, differentiating those experiences based on gender identity/expression and related factors has been limited. The aim of this study was to compare the characteristics, experiences, attitude, and expectation toward accessing healthcare service and healthcare providers of transgender women and transgender men in Thailand.
A cross-sectional study was conducted from October 2017 to March 2018. The data were collected from transgender women and transgender men aged ≥ 18 years old who lived in Thailand using online platform via different websites and Facebook pages of local transgender group. Binary logistic regression was used to identify the factors related to the study outcomes.
Of 186 transgender people who responded to the questionnaire and were eligible for the study, 73.7% (95% confidence interval [CI] = 66.7-79.8) were transgender women and 26.3% (95% CI = 20.2-33.3) were transgender men. Transgender women were more likely to seek general healthcare from non-traditional healthcare services (crude odds ratio [cOR] = 4.28; 95% CI = 1.55-11.81; P = 0.005), buy hormone treatment from non-traditional healthcare services (cOR = 3.89; 95% CI = 1.18-12.83; P = 0.026), and receive healthcare counseling from non-traditional healthcare providers (cOR = 5.16; 95% CI = 1.42-18.75; P = 0.013) than transgender men. According to the results of applying a multivariable model, transgender respondents who did not know that gender-affirming healthcare services existed in Thailand were more unwilling to receive counseling from gender-affirming healthcare providers than those who did (adjusted odds ratio = 3.70; 95% CI = 1.11-12.36; P = 0.033).
The findings from this cross-sectional study indicate that transgender women are more likely than transgender men to receive general healthcare and hormone treatment from non-traditional healthcare services and buy hormone treatment without a physician's supervision. We also found approximately 15% of transgender individuals who did not receive gender-affirming counseling services. Continuing to improve access to care for the transgender community, increasing public relations channels may encourage transgender people to access more healthcare services.
尽管已有多项研究详细记录了跨性别者在寻求医疗服务时所经历的歧视，但基于性别认同/表达和相关因素对这些经历进行区分的研究还很有限。本研究旨在比较泰国跨性别女性和跨性别男性在寻求医疗服务和医疗服务提供者方面的特征、经历、态度和期望。
这是一项横断面研究，于 2017 年 10 月至 2018 年 3 月进行。通过不同网站和当地跨性别群体的 Facebook 页面，使用在线平台收集了年龄≥18 岁的跨性别女性和跨性别男性的相关数据。采用二元逻辑回归分析识别与研究结果相关的因素。
在 186 名回应问卷且符合研究条件的跨性别者中，73.7%（95%置信区间 [CI] = 66.7-79.8）为跨性别女性，26.3%（95% CI = 20.2-33.3）为跨性别男性。跨性别女性更倾向于从非传统医疗保健服务中寻求一般医疗保健（粗优势比 [cOR] = 4.28；95% CI = 1.55-11.81；P = 0.005），从非传统医疗保健服务中购买激素治疗（cOR = 3.89；95% CI = 1.18-12.83；P = 0.026），并从非传统医疗保健提供者处获得医疗保健咨询（cOR = 5.16；95% CI = 1.42-18.75；P = 0.013），而非跨性别男性。根据多变量模型的应用结果，不知道泰国存在性别肯定医疗服务的跨性别受访者比知道的受访者更不愿意接受性别肯定医疗服务提供者的咨询（调整后的优势比 [aOR] = 3.70；95% CI = 1.11-12.36；P = 0.033）。
本横断面研究结果表明，跨性别女性比跨性别男性更有可能从非传统医疗保健服务中获得一般医疗保健和激素治疗，并且更有可能在没有医生监督的情况下购买激素治疗。我们还发现，大约有 15%的跨性别者没有接受性别肯定咨询服务。继续改善跨性别群体获得护理的机会，增加公共关系渠道可能会鼓励跨性别者更多地获得医疗服务。
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