University of Pittsburgh School of Social Work, 2117 Cathedral of Learning, 4200 Fifth Avenue, Pittsburgh, PA, 15260, USA.
University of Denver Graduate School of Social Work, 2148 South High Street, Denver, CO, 80208, USA.
Soc Sci Med. 2024 May;348:116836. doi: 10.1016/j.socscimed.2024.116836. Epub 2024 Mar 30.
Transgender and gender diverse adults, referred to collectively as trans, experience eating disorders (EDs) at high rates and struggle to find primary care providers (PCPs) knowledgeable in both gender-affirming care and EDs. Most research regarding healthcare experiences of trans people with EDs focuses on specialized treatment. This qualitative study explored the experiences of trans patients with ED symptoms in trans-affirming primary care, which offers clinical support for gender affirmation in the context of interpersonally gender-affirming primary care services. Twenty-two participants were recruited via social media to participate in focus groups (n = 5). Researchers utilized thematic analysis. Participants reported gender-affirming and non-affirming experiences, experienced unwelcome comments from providers regarding bodies and gender, encountered barriers to disclosing their ED symptoms, felt transition-related medical care supported recovery but did not always resolve their ED symptoms, felt they had to self-advocate, and wanted their providers to recognize them as whole people (beyond their ED and transness) who experience joy. Importantly, despite being trans-affirming, participants critiqued trans-affirming primary care as perpetuating weight stigma and binary gender norms. Participants recommended providers receive ED training, implement universal ED screening, and explore how sociocultural norms regarding weight and gender negatively impact trans health outcomes.
跨性别和性别多样化的成年人，通常被称为跨性别者，他们患有饮食失调（ED）的比例很高，并且很难找到既精通性别肯定护理又精通 ED 的初级保健提供者（PCP）。大多数关于跨性别者 ED 治疗体验的研究都集中在专门的治疗上。这项定性研究探讨了跨性别 ED 患者在跨性别肯定初级保健中的体验，这种保健在人际性别肯定初级保健服务的背景下为性别肯定提供了临床支持。通过社交媒体招募了 22 名参与者参加焦点小组（n=5）。研究人员采用主题分析。参与者报告了性别肯定和非肯定的体验，他们曾受到提供者关于身体和性别的不欢迎的评论，在披露 ED 症状时遇到障碍，感到与过渡相关的医疗保健支持康复，但并不总是解决 ED 症状，他们觉得必须为自己辩护，并希望他们的提供者将他们视为完整的人（超越 ED 和跨性别），他们也会体验到快乐。重要的是，尽管是跨性别肯定的，参与者还是批评了跨性别肯定的初级保健，认为它延续了体重污名和二元性别规范。参与者建议提供者接受 ED 培训，实施普遍的 ED 筛查，并探讨有关体重和性别的社会文化规范如何对跨性别者的健康结果产生负面影响。
