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跨性别和性别多样化青少年的医疗保健经历:定性研究的系统综述

Transgender and gender diverse youths' experiences of healthcare: A systematic review of qualitative studies.

作者信息

Goulding Ryan, Goodwin John, O'Donovan Aine, Saab Mohamad M

机构信息

Catherine McAuley School of Nursing & Midwifery, University College Cork, Cork, Ireland.

出版信息

J Child Health Care. 2025 Jun;29(2):523-545. doi: 10.1177/13674935231222054. Epub 2023 Dec 22.

Abstract

Transgender and gender-diverse (TGD) populations are identified as high-risk for negative healthcare outcomes. Limited data exists on experiences of TGD youths in healthcare. The review aim is to systematically review literature on healthcare experiences of TGD youths. Seven electronic databases were systematically searched for relevant studies. Pre-determined eligibility criteria were used for inclusion with a double-screening approach. Sixteen studies were included. Studies included were quality appraised, data were extracted, and findings were synthesized narratively. Four narratives were identified including experiences of: accessing care, healthcare settings and services, healthcare providers, and healthcare interventions. Long waiting times, lack of competent providers, and fear were reported as challenges to accessing gender-affirming care. Negative experiences occurred in mental health services and primary care, while school counseling and gender clinics were affirming. Puberty blockers and hormone-replacement therapy were identified as protective factors. TGD youths are at risk of negative health outcomes due to an under resourced healthcare system. Further research is needed to assess interventions implemented to improve TGD youth's experiences.

摘要

跨性别和性别多样化(TGD)人群被认定为健康护理负面结果的高风险群体。关于TGD青少年在医疗保健方面经历的数据有限。本综述的目的是系统地回顾关于TGD青少年医疗保健经历的文献。我们系统地检索了七个电子数据库以查找相关研究。采用预先确定的纳入标准,并通过双重筛选方法进行筛选。共纳入了16项研究。对纳入的研究进行了质量评估,提取了数据,并对研究结果进行了叙述性综合分析。确定了四个方面的叙述内容,包括:获得护理的经历、医疗保健机构和服务、医疗保健提供者以及医疗保健干预措施。报告称,等待时间长、缺乏合格的提供者以及恐惧是获得性别肯定护理的挑战。心理健康服务和初级保健中出现了负面经历,而学校咨询和性别诊所则给予肯定。青春期阻滞剂和激素替代疗法被确定为保护因素。由于医疗保健系统资源不足,TGD青少年面临健康负面结果的风险。需要进一步研究以评估为改善TGD青少年经历而实施的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d839/12145476/f29cde9d0a23/10.1177_13674935231222054-fig1.jpg

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