School of Psychological Sciences, College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia.
School of Social Sciences, College of Arts, Law, & Education, University of Tasmania, Hobart, Tasmania, Australia.
Aust N Z J Obstet Gynaecol. 2024 Feb;64(1):55-62. doi: 10.1111/ajo.13741. Epub 2023 Jul 26.
Lesbian, gay, bisexual, transgender, queer, asexual/aromantic (LGBTQA+) people, assigned female at birth (AFAB), experience disproportionately poorer gynaecological healthcare outcomes compared to their cisgender, heterosexual peers. The barriers to gynaecological care remain poorly understood. In a step toward bridging this gap, the current study explored the lived gynaecological healthcare experiences of Australian LGBTQA+ AFAB people and the barriers they experience in accessing care.
Semi-structured interviews were conducted with 22 LGBTQA+ AFAB people. An inductive thematic qualitative design was used to explore the lived experiences and identify themes associated with the reported experiences.
Thematic analysis identified seven themes related to experiences in accessing gynaecological healthcare, including discrimination, fear, perceived provider or cultural incompetency, accessibility, and gender identity. Several sub-themes were also identified such as refusal of care, microaggression, misgendering, and patient as educator.
Participants suggested that barriers to care could be alleviated by the integration of LGBTQA+ specific healthcare training into the university-level medical curriculum and professional development programs that address cultural competency and inclusive healthcare. These preliminary findings inform the necessity for the development of evidence-based practice guidelines that specifically address the unique and diverse needs of the LGBTQA+ AFAB population.
与顺性别、异性恋者相比，出生时被指定为女性（AFAB）的女同性恋、男同性恋、双性恋、跨性别、酷儿、无性恋/无浪漫倾向（LGBTQA+）人群在妇科保健方面的结果明显较差。他们在获得妇科保健方面的障碍仍未得到充分理解。为了缩小这一差距，本研究探讨了澳大利亚 LGBTQA+AFAB 人群的真实妇科保健体验以及他们在获得护理方面所经历的障碍。
对 22 名 LGBTQA+AFAB 人群进行了半结构化访谈。采用归纳主题的定性设计来探索他们的真实体验，并确定与所报告的体验相关的主题。
主题分析确定了与获取妇科保健相关的七个主题，包括歧视、恐惧、认为提供者或文化能力不足、可及性以及性别认同。还确定了几个子主题，如拒绝护理、微侵犯、错误性别称呼和患者作为教育者。
参与者认为，可以通过将 LGBTQA+特定的医疗保健培训纳入大学水平的医学课程以及解决文化能力和包容性医疗保健的专业发展计划，来缓解护理障碍。这些初步发现表明需要制定基于证据的实践指南，以专门满足 LGBTQA+AFAB 人群的独特和多样化需求。
