Department of Plastic Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands.
Amsterdam Public Health Institute, 1081 BT Amsterdam, The Netherlands.
Int J Environ Res Public Health. 2023 Jul 15;20(14):6367. doi: 10.3390/ijerph20146367.
When seeking gender-affirming care, trans* and gender-diverse individuals often describe experiencing barriers. However, a deeper understanding of what constitutes such barriers is generally lacking. The present research sought to better understand the barriers trans* and gender-diverse individuals experienced, and their effects, when seeking gender-affirming care in the Netherlands. Qualitative interviews were conducted with trans* and gender-diverse individuals who sought care at a Dutch multidisciplinary medical center. Twenty-one participants were included, of which 12 identified as (trans) male, six identified as (trans) female, one as trans*, and one as gender-nonconforming (GNC)/non-binary. The interviews were mostly conducted at the homes of the participants and lasted between 55 min and 156 min (mean = 85 min). Following data collection and transcription, the interviews were analyzed using axial coding and thematic analysis. A total of 1361 codes were extracted, which could be classified into four themes describing barriers: lack of continuity: organizational and institutional factors (n = 546), patient-staff dynamics (n = 480), inadequate information and support (n = 210), and lack of autonomy in decision making (n = 125). Within our study, trans* and gender-diverse individuals described encountering multiple and diverse barriers when seeking gender-affirming care in the Netherlands. Future studies are needed to evaluate whether individualized care, the decentralization of care, and the use of decision aids can improve the experienced barriers of trans* and gender-diverse individuals seeking gender-affirming care within the Dutch healthcare system.
当寻求性别肯定护理时，跨性别和性别多样化的个体经常描述遇到障碍。然而，对于构成这些障碍的因素缺乏更深入的理解。本研究旨在更好地了解跨性别和性别多样化的个体在荷兰寻求性别肯定护理时所经历的障碍及其影响。对在荷兰多学科医疗中心寻求护理的跨性别和性别多样化个体进行了定性访谈。共纳入 21 名参与者，其中 12 名自认为是（跨）男性，6 名自认为是（跨）女性，1 名自认为是跨性别，1 名自认为是性别非规范（GNC）/非二元性别。访谈大多在参与者的家中进行，持续时间为 55 分钟至 156 分钟（平均 85 分钟）。在数据收集和转录后，使用轴向编码和主题分析对访谈进行了分析。共提取了 1361 个代码，可分为四个主题来描述障碍：连续性缺失：组织和机构因素（n = 546）、医患动态（n = 480）、信息和支持不足（n = 210）以及决策自主权缺乏（n = 125）。在我们的研究中，跨性别和性别多样化的个体在荷兰寻求性别肯定护理时描述了遇到多种和不同的障碍。需要进一步研究评估个体化护理、护理去中心化和使用决策辅助工具是否可以改善荷兰医疗保健系统中寻求性别肯定护理的跨性别和性别多样化个体所经历的障碍。
