University of Hawai'i John A. Burns School of Medicine, Department of Obstetrics, Gynecology, and Women's Health, Honolulu, HI (GM, SL, RS, SR).
Kua'ana Project, Hawai'i Health and Harm Reduction Center, Honolulu, HI (CK, MS).
Hawaii J Health Soc Welf. 2024 Mar;83(3):68-74.
The purpose of this study was to assess the reproductive health experiences of transgender and gender diverse people in Hawai'i, identify reproductive health needs that were unmet, and explore opportunities for addressing those needs. This was a qualitative, semi-structured individual interview study. Adults who identified as transgender or gender diverse were interviewed about their experiences accessing reproductive health services, their needs, and their ideas about clinical settings in which to receive reproductive health care services. Interviews were conducted until thematic saturation was reached. Six trans men, 6 trans women, and 4 people who identified as non-binary or genderqueer were interviewed. Negative experiences in health care settings, particularly when seeking reproductive health care services, were common. Participants often had multiple providers and gender-affirming care was often accessed separately from other health care services. Desires for fertility and pregnancy varied widely between participants but were often not addressed at the initiation of gender-affirming care. Finding trans-friendly providers was notably difficult and participants often relied on friends and other members of the transgender community for guidance. Obstetrics and gynecology clinics present a potential opportunity for access to reproductive health services although their gendered environment was concerning for some participants. Transgender and gender diverse people in Hawai'i have access to some reproductive health services but experience stigma in certain settings. There is a need for ongoing improvement in reproductive health care services in Hawai'i to improve access for transgender and gender nonconforming people in Hawai'i.
本研究旨在评估夏威夷跨性别和性别多样化人群的生殖健康体验，确定未满足的生殖健康需求，并探讨满足这些需求的机会。这是一项定性、半结构式的个体访谈研究。我们对自认为跨性别或性别多样化的成年人进行了访谈，了解他们获得生殖健康服务的经验、需求，以及他们对接受生殖健康护理服务的临床环境的看法。访谈一直进行到主题达到饱和为止。共采访了 6 名跨男性、6 名跨女性和 4 名非二元性别或性别酷儿。在医疗保健环境中经常会有负面体验，特别是在寻求生殖健康服务时。参与者通常有多个提供者，而性别肯定护理通常是独立于其他医疗保健服务获得的。参与者对生育和怀孕的愿望差异很大，但在开始性别肯定护理时往往没有得到解决。找到对跨性别友好的提供者特别困难，参与者通常依靠朋友和其他跨性别社区成员的指导。妇产科诊所为获得生殖健康服务提供了一个潜在的机会，尽管一些参与者对其性别化的环境感到担忧。夏威夷的跨性别和性别多样化人群可以获得一些生殖健康服务，但在某些环境中会受到歧视。夏威夷需要不断改进生殖健康护理服务，以改善夏威夷跨性别和性别不符合规范人群的获得机会。
