Carlile Anna, Butteriss Ethan, Sansfaçon Annie Pullen
Department of Educational Studies, University of London, Goldsmiths, UK.
Mermaids, UK.
Int J Transgend Health. 2021 Jan 19;22(4):412-424. doi: 10.1080/26895269.2020.1870188. eCollection 2021.
Trans and non-binary children and young people in England, UK struggle to gain access to affirming clinical care, despite the international research evidence pointing toward this best practice approach. Concurrently, they are subject to constant discussion in the UK national media and politics, where many negative assumptions are made about their needs, experiences and clinical provision. Their journey to seek appropriate care has not yet been documented.
We trace the experiences of trans and non-binary children and youth and their families in their decision to seek, searches for and experiences with affirmative and non-affirmative clinical input for help with their gender.
27 dyadic, semi-structured interviews were undertaken with trans and non-binary children and young people and their parents from 13 families.
The process of seeking support via National Health Service clinical routes in England, UK is beset with lengthy waiting lists, issues with geographical inaccessibility, a lack of relevant clinical knowledge, and a failure to recognize the value of family expertise. Family doctors provide contraceptive hormones in lieu of proper access to puberty blocking or gender affirming hormones, and most families resort to private care they can ill afford.
Training in gender identity and gender dysphoria is recommended for both family doctors, and children's mental health services. Gender identity development services could be decentralized, with local hubs offering more accessible support.
在英国英格兰,跨性别和非二元性别的儿童及青少年难以获得肯定性的临床护理,尽管国际研究证据表明这种最佳实践方法是可行的。与此同时,他们在英国国家媒体和政治中不断被讨论,在这些讨论中,人们对他们的需求、经历和临床护理存在许多负面假设。他们寻求适当护理的过程尚未被记录下来。
我们追踪跨性别和非二元性别的儿童及青少年及其家庭在决定寻求、寻找以及接受肯定性和非肯定性临床干预以解决其性别问题方面的经历。
对来自13个家庭的跨性别和非二元性别的儿童及青少年及其父母进行了27次二元半结构式访谈。
在英国英格兰,通过国民医疗服务体系临床途径寻求支持的过程面临着漫长的等候名单、地理位置不便的问题、缺乏相关临床知识以及未能认识到家庭专业知识的价值。家庭医生提供避孕激素,而不是让他们获得适当的青春期阻滞剂或性别肯定激素,而且大多数家庭只能求助于他们负担不起的私人护理。
建议对家庭医生和儿童心理健康服务机构进行性别认同和性别焦虑症方面的培训。性别认同发展服务可以去中心化,由当地中心提供更容易获得的支持。