Lyman Briggs College, Michigan State University, 919 E. Shaw Ln., East Lansing, MI, 48825, USA.
Soc Sci Med. 2024 Jun;350:116913. doi: 10.1016/j.socscimed.2024.116913. Epub 2024 Apr 26.
Organizations and their practices contribute to the marginalization of transgender and gender diverse (TGD) populations by rewarding gender normativity and punishing gender transgression. The present study draws on data gleaned from four focus groups completed in 2023 with a total of 19 participants to explore TGD U.S. medical students' perceptions of TGD content inclusion in their medical school curricula. Using abductive analysis, I argue that curricular oversights which omit socio-political contexts regarding TGD health and healthcare, as well as continued pathologization of TGD communities and people, contribute to a hostile learning environment for TGD medical students and residents. I conceptualize medical schools as cisgendered organizations where inequities devaluing TGD people and experiences are embedded in the organizational structure, including curriculum development and implementation. I provide recommendations for medical schools and stakeholders to align their formal, informal, and hidden curricula through practical means (e.g., incorporating TGD standardized patients throughout) and structural means (e.g. hiring and supporting TGD faculty across disciplines to assist with curriculum development and training), and argue for governing bodies to push back against legislative restriction and criminalization of TGD medical care.
组织及其实践通过奖励性别规范性和惩罚性别越轨来促成跨性别和性别多样化(TGD)人群的边缘化。本研究利用 2023 年完成的四个焦点小组的数据,共有 19 名参与者,探讨了美国 TGD 医学生对其医学院课程中包含 TGD 内容的看法。通过归纳分析,我认为课程忽视了关于 TGD 健康和医疗保健的社会政治背景,以及继续将 TGD 社区和人群病理化,这导致了 TGD 医学生和住院医师面临敌对的学习环境。我将医学院视为顺性别组织,其中不平等现象贬低了 TGD 人群及其经历,这些不平等现象嵌入在组织结构中,包括课程开发和实施。我为医学院和利益相关者提供了建议,通过实际手段(例如,在整个课程中纳入 TGD 标准化患者)和结构手段(例如,聘请和支持跨学科的 TGD 教师来协助课程开发和培训)来调整正式、非正式和隐性课程,并主张管理机构反对立法限制和对 TGD 医疗的刑事定罪。