Koehler Andreas, Motmans Joz, Mulió Alvarez Leo, Azul David, Badalyan Karen, Basar Koray, Dhejne Cecilia, Duišin Dragana, Grabski Bartosz, Dufrasne Aurore, Jokic-Begic Natasa, Prunas Antonio, Richards Christina, Sabir Kirill, Veale Jaimie, Nieder Timo Ole
Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Transgender Infopunt, Ghent University Hospital, Ghent, Belgium.
Int J Transgend Health. 2021 Oct 18;24(3):346-359. doi: 10.1080/26895269.2021.1986191. eCollection 2023.
Due to the COVID-19 pandemic, access to medical care is restricted for nearly all non-acute conditions. Due to their status as a vulnerable social group and the inherent need for transition-related treatments, transgender people are assumed to be affected particularly severely by the restrictions caused by the COVID-19 pandemic.
As an ad hoc collaboration between researchers, clinicians and 23 community organizations, we developed a web-based survey in German that was translated into 26 languages. Participants were recruited via community sources, social media channels, and snowball sampling since May 2020. The present sample is based on the data collected until August 9, 2020. We assessed demographical data, health problems, risk factors, COVID-19 data (e.g., contact history), and the influence of the COVID-19 pandemic on access to transgender health care services. To identify factors associated with the experience of restrictions, we conducted multiple logistic regression analysis.
5267 transgender people from 63 upper-middle-income and high-income countries participated in the study. Over 50% of the participants had risk factors for a severe course of a COVID-19 infection and were at a high risk of avoiding COVID-19 treatment due to the fear of mistreatment or discrimination. Access to transgender health care services was restricted for 50% of the participants. Male sex assigned at birth and a lower monthly income were significant predictors for the experience of restrictions to health care. 35.0% reported at least one mental health condition and 3.2% have attempted suicide since the beginning of the COVID-19 pandemic.
Transgender people suffer under the severity of the pandemic due to the intersections between their status as a vulnerable social group, their high number of medical risk factors, and their need for ongoing medical treatment. The COVID-19 pandemic can potentiate these vulnerabilities, add new challenges for transgender people, and, therefore, can lead to devastating consequences, like severe physical or mental health issues, self-harming behavior, and suicidality.
由于新冠疫情，几乎所有非急性病症的医疗服务获取都受到限制。由于跨性别者作为弱势群体的身份以及与过渡相关治疗的内在需求，他们被认为尤其受到新冠疫情造成的限制的严重影响。
作为研究人员、临床医生和23个社区组织之间的临时合作，我们开发了一项基于网络的德语调查，并将其翻译成26种语言。自2020年5月起，通过社区资源、社交媒体渠道和滚雪球抽样招募参与者。本样本基于截至2020年8月9日收集的数据。我们评估了人口统计学数据、健康问题、风险因素、新冠数据（如接触史）以及新冠疫情对跨性别医疗服务获取的影响。为了确定与限制体验相关的因素，我们进行了多重逻辑回归分析。
来自63个中高收入和高收入国家的5267名跨性别者参与了该研究。超过50%的参与者有感染新冠后病情严重的风险因素，并且由于害怕受到虐待或歧视而有很高的避免新冠治疗的风险。50%的参与者获取跨性别医疗服务受到限制。出生时被指定为男性以及月收入较低是医疗服务受限体验的显著预测因素。自新冠疫情开始以来，35.0%的人报告至少有一种心理健康状况，3.2%的人曾尝试自杀。
跨性别者因作为弱势群体的身份、大量的医疗风险因素以及持续医疗需求之间的相互交织而在疫情的严峻形势下受苦。新冠疫情可能会加剧这些脆弱性，给跨性别者带来新的挑战，因此可能导致毁灭性后果，如严重的身心健康问题、自我伤害行为和自杀倾向。
