Brandon-Friedman Richard A, Tabb Ali, Imburgia Teresa M, Swafford Tayon R, Fortenberry J Dennis, Canada Meredith, Donahue Kelly L
Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, Indiana, USA.
School of Social Work, Indiana University, Indianapolis, Indiana, USA.
LGBT Health. 2025 Feb-Mar;12(2):108-115. doi: 10.1089/lgbt.2024.0079. Epub 2024 Jul 23.
In the past 2 years, nearly all 50 states have debated bills seeking to ban minors' access to gender-affirming medical interventions, with many being passed into law. This study documents gender-diverse youths' (GDY) and their caregivers' experiences as they grapple with how such laws impact their families. Sixteen GDY and 16 caregivers participating in a longitudinal study of the impact of gender-affirming care on GDYs' well-being were interviewed about how the legal and social discourse was impacting them and their families. When interviewed, some participants had completed only the initial intake, others had completed the intake and an initial medical consultation, and a few had recently started gender-affirming hormones. Thematic analysis was used to identify common threads in the youths' and caregivers' experiences. Four main themes were identified: Direct effects of losing access to gender-affirming medical interventions, reflecting how losing access to care would impact well-being; growing hostility toward the gender-diverse community, noting increasing social negativity; personal and social upheaval, reflecting the many aspects of families' lives affected; and galvanization into social action, documenting drives to effect social change. Laws banning gender-affirming medical interventions impact GDY and their families beyond limiting access to medical care. They increase the social stressors, cause social network disruptions, increase hostility toward the gender-diverse community, and lead some GDY and caregivers to engage more politically to protect their community. Gender-affirming health care providers need to recognize how the social and political environment impact GDY and their families to provide high-quality, person-centered care.
在过去两年里,美国近50个州都对旨在禁止未成年人获得性别肯定性医疗干预措施的法案进行了辩论,其中许多法案已成为法律。本研究记录了性别多样化青少年(GDY)及其照顾者在应对此类法律如何影响其家庭时的经历。对参与一项关于性别肯定性护理对GDY幸福感影响的纵向研究的16名GDY和16名照顾者进行了访谈,询问法律和社会话语如何影响他们及其家庭。在接受采访时,一些参与者仅完成了初始问诊,另一些完成了问诊和初步医疗咨询,还有少数人最近开始使用性别肯定性激素。采用主题分析法来确定青少年和照顾者经历中的共同线索。确定了四个主要主题:失去获得性别肯定性医疗干预措施的直接影响,反映了失去医疗护理机会对幸福感的影响;对性别多样化群体的敌意增加,指出社会负面情绪在上升;个人和社会动荡,反映了家庭生活受到影响的诸多方面;以及激进化为社会行动,记录了推动社会变革的努力。禁止性别肯定性医疗干预措施的法律对GDY及其家庭的影响不仅限于限制医疗护理的获取。它们增加了社会压力源,导致社会网络中断,增加了对性别多样化群体的敌意,并导致一些GDY和照顾者更积极地参与政治活动以保护他们的群体。性别肯定性医疗保健提供者需要认识到社会和政治环境如何影响GDY及其家庭,以便提供高质量的、以患者为中心的护理。