Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil.
Int J Environ Res Public Health. 2024 Aug 21;21(8):1106. doi: 10.3390/ijerph21081106.
This review aims to analyze the evidence related to violence perpetrated against transgender individuals in health services based on their narratives. This is a systematic literature review of qualitative studies. A search was carried out in the Scopus, Web of Science, Latin American and Caribbean Literature in Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, and MEDLINE databases using the descriptors "transgender people", "violence", and "health services". The eligibility criteria included original qualitative articles addressing the research question, with fully available text, reporting violence specifically by health workers, involving trans individuals aged 18 and above, and published in Portuguese, English, or Spanish. In addition, studies were included that reported experiences of violence suffered by the trans population, through their narratives, in health services. A total of 3477 studies were found, of which 25 were included for analysis. The results highlighted situations such as refusal of service; resistance to the use of social names and pronouns; barriers to accessing health services; discrimination and stigma; insensitivity of health workers; lack of specialized care and professional preparedness; and a system focused on binarism. The analysis of the studies listed in this review highlights the multiple facets of institutional violence faced by the transgender population in health services. It is evident that the forms of violence often interlink and reinforce each other, creating a hostile environment for the transgender population in health services. Thus, there is an urgent need to create strategies that ensure access to dignified and respectful care for all individuals, regardless of their gender identity.
本综述旨在基于跨性别者的叙述分析针对健康服务中的跨性别者实施暴力的相关证据。这是一项关于定性研究的系统文献综述。使用“跨性别者”、“暴力”和“健康服务”等术语在 Scopus、Web of Science、拉丁美洲和加勒比健康科学文献（LILACS）、护理和联合健康文献累积索引（CINAHL）、EMBASE 和 MEDLINE 数据库中进行了检索。入选标准包括针对研究问题的原始定性文章，全文可获取，专门报告卫生工作者实施的暴力行为，涉及年龄在 18 岁及以上的跨性别者，以葡萄牙语、英语或西班牙语发表。此外，还纳入了报告跨性别者在健康服务中通过叙述经历的暴力事件的研究。共发现 3477 项研究，其中有 25 项被纳入分析。研究结果突出了一些情况，如拒绝服务；抵制使用社会姓名和代词；获得卫生服务的障碍；歧视和污名化；卫生工作者的麻木不仁；缺乏专业护理和职业准备；以及一个以二元论为中心的系统。对本综述中列出的研究进行分析，突出了跨性别者在健康服务中面临的多种机构暴力形式。显然，暴力形式往往相互交织并相互加强，在健康服务中为跨性别者创造了一个充满敌意的环境。因此，迫切需要制定策略，确保所有个体都能获得有尊严和尊重的护理，无论其性别认同如何。
