Greaves Natalie, Emmanuel Maisha K, Harvey Arianne, Harewood Heather, Gromer Jill, Majumder Md Anwarul Azim, Campbell Michael H
Faculty of Medical Sciences, The University of the West Indies-Cave Hill, Bridgetown, Barbados.
College of Social Work, Florida State University, Tallahassee, Florida, USA.
Transgend Health. 2023 Dec 13;8(6):550-557. doi: 10.1089/trgh.2022.0027. eCollection 2023 Dec.
This study explored medical educators' understanding of the term transgender and their attitudes and perspectives regarding (1) health system responsiveness to transgender needs and (2) transgender curriculum in medical education.
The study employed purposive sampling of medical educators responsible for design and delivery of curriculum. Fifteen of 18 eligible educators participated in Zoom focus groups (FG1 =7, FG2 =8). FGs averaged 93 min and were recorded, transcribed verbatim, and analyzed using a qualitative interpretivist methodology with deductive and inductive coding assisted by NVivo 12 Pro software.
Educators were knowledgeable about the term transgender and the physical and psychosocial needs of transgender people. Participants viewed transgender care as a significant emerging health area. However, infrequent personal or clinical contact, coupled with constraints in human and other resources, resulted in the perception that transgender content as a stand-alone component of curriculum is difficult to justify. Participants articulated a need for broad-based diversity content, including disabilities, primarily at the undergraduate level. Educators saw transgender health as relevant for undergraduate-level psychiatry and postgraduate medical specializations. Analysis and discussion framed participant perspectives in the context of stigma, discrimination, and medicolegal and health systems that impede access to health care for transgender people.
Participants demonstrated knowledge of transgender and transgender health care needs. Areas for improvements in health care responsiveness were identified, particularly related to structural stigma and discrimination. Although participants expressed interest in including transgender health in the curriculum, this would require pragmatic optimization of teaching resources.
本研究探讨了医学教育工作者对“跨性别者”一词的理解，以及他们对以下两方面的态度和观点：（1）卫生系统对跨性别者需求的响应能力；（2）医学教育中的跨性别者课程。
本研究采用目的抽样法，选取负责课程设计与授课的医学教育工作者。18名符合条件的教育工作者中有15名参加了Zoom焦点小组讨论（焦点小组1 = 7人，焦点小组2 = 8人）。焦点小组讨论平均时长为93分钟，讨论过程进行了录音、逐字转录，并使用定性解释主义方法进行分析，借助NVivo 12 Pro软件进行演绎和归纳编码。
教育工作者对“跨性别者”一词以及跨性别者的身体和心理社会需求有一定了解。参与者认为跨性别者护理是一个重要的新兴健康领域。然而，由于个人或临床接触较少，以及人力和其他资源的限制，导致人们认为将跨性别者相关内容作为课程的一个独立组成部分难以说得通。参与者明确表示需要广泛的多样性内容，包括残疾相关内容，主要是在本科阶段。教育工作者认为跨性别者健康与本科阶段的精神病学以及研究生医学专业相关。分析和讨论将参与者的观点置于污名、歧视以及阻碍跨性别者获得医疗保健的法医学和卫生系统背景下。
参与者展示了对跨性别者及其医疗保健需求的了解。确定了卫生保健响应能力方面需要改进的领域，特别是与结构性污名和歧视相关的领域。尽管参与者表示有兴趣将跨性别者健康纳入课程，但这需要对教学资源进行务实的优化。
