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一种关系方法在青年保健:检查年轻人的、父母的和临床医生的经验在变化中的性别特征的背景下。

A relational approach to youth healthcare: Examining young people's, parents' and clinicians' experiences in the context of variations in sex characteristics.

机构信息

School of Psychological and Social Sciences, University of Waikato, Aotearoa New Zealand.

Department of Psychology, Lund University, Sweden.

出版信息

Soc Sci Med. 2024 Aug;355:117099. doi: 10.1016/j.socscimed.2024.117099. Epub 2024 Jul 6.

Abstract

According to popular understandings, children grow from a state of dependence to eventually become independent adults. Interdependence helps to disrupt the in/dependence binary and is a useful concept for making sense of the experiences young people with variations in sex characteristics in relation to healthcare. This study used semi-structured interviews with 32 health professionals, 33 caregivers and 12 young people recruited in the UK and Sweden. The analysis is guided by the questions: (1) how do young people, carers and health professionals position themselves in the adult/young person relationship in the context of healthcare? (2) how is the (in/ter)dependence of young people imagined when young people, carers and health professionals talk about healthcare? Our analysis shows how carers and health professionals might support dominant understandings about young people growing towards independence while providing little opportunity for young people's agency and voice. Interviews with young people gave clear examples of their negotiating relational ways of being, seeking agency in the context of healthcare and not simply becoming independent of adults. This analysis also draws attention to the ways young people might be silenced within healthcare contexts. The present paper is based on secondary analysis of data from the SENS. It works with concepts of relationality and interdependence to draw out the possibilities of voice and agency for young people with variations in sex characteristics in healthcare contexts.

摘要

根据普遍的理解,儿童从依赖状态成长为最终独立的成年人。相互依存有助于打破独立/依赖的二元对立,是理解与医疗保健相关的性别特征存在差异的年轻人的经验的有用概念。本研究使用半结构化访谈,在英国和瑞典招募了 32 名卫生专业人员、33 名照顾者和 12 名年轻人。分析的指导问题是:(1) 在医疗保健背景下,年轻人、照顾者和卫生专业人员如何在成人/年轻人的关系中定位自己?(2) 当年轻人、照顾者和卫生专业人员谈论医疗保健时,他们如何想象年轻人的(相互)依存?我们的分析表明,照顾者和卫生专业人员可能会支持关于年轻人朝着独立成长的主导观念,而几乎没有为年轻人的代理和声音提供机会。对年轻人的采访清楚地举例说明了他们在寻求医疗保健背景下的代理关系方面的协商方式,而不是简单地独立于成年人。这种分析还提请注意年轻人在医疗保健背景下可能被沉默的方式。本文基于 SENS 数据的二次分析,运用关系性和相互依存性的概念,为在医疗保健环境中有性别特征差异的年轻人提供发声和代理的可能性。

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