Department of Primary Health Care and General Practice, University of Otago, Te Whare Wananga o Otago ki Te Whanganui-a-Tara, PO Box 7343, Wellington South, Wellington 6242, New Zealand.
Department of Public Health, University of Otago, Te Whare Wananga o Otago ki Te Whanganui-a-Tara, Wellington 6242, New Zealand.
J Prim Health Care. 2024 Sep;16(3):301-307. doi: 10.1071/HC23170.
Introduction Gender affirming hormone therapy (GAHT) is an important aspect of health care for many transgender and non-binary (TNB) people, but little is known about the long-term outcomes for TNB people in Aotearoa New Zealand (NZ). Pathways to access GAHT are shifting from secondary care towards primary care, so this is an opportune time to commence local research on long-term health and wellbeing outcomes for people initiating GAHT. Aim This paper aims to report on the key findings from four meetings held to inform the design of a prospective cohort study to follow the journey of people initiating GAHT in primary and secondary care settings in NZ. Methods We worked with a community advisory group of six TNB young people and sought input from 14 health care providers involved in the care of TNB people initiating GAHT (GPs, secondary care doctors, and mental health providers). Semi-structured interview schedules were used to guide discussions. Template analysis was used to initially code data based on themes identified from the interview schedule and new themes from discussions were added. Results Participants shared ideas about recruitment and data collection priorities for baseline and follow-up surveys. These included understanding the journey to starting hormone therapy (information-seeking, decision-making), access to services for GAHT initiation, appropriateness of information provision, receipt of the first prescription, goals for and experience of GAHT, and the unique needs of non-binary people. Discussion Input from a TNB advisory group and health care professionals has informed the development of a survey that will be used to understand the experience of, and outcomes for, people starting GAHT in NZ. Findings from this planned prospective cohort study have the potential to improve access to GAHT for TNB people who wish to pursue this option.
引言
性别肯定激素治疗（GAHT）是许多跨性别和非二元性别（TNB）人群医疗保健的重要方面，但对于新西兰（NZ）的 TNB 人群，人们对其长期结果知之甚少。获得 GAHT 的途径正在从二级护理转向初级护理，因此，现在是开始对开始 GAHT 的人群的长期健康和幸福感结果进行本地研究的好时机。
目的
本文旨在报告为设计一项前瞻性队列研究而举行的四次会议的主要结果，该研究旨在跟踪在新西兰初级和二级保健环境中开始 GAHT 的人群的历程。
方法
我们与一个由六名跨性别青年组成的社区咨询小组合作，并征求了 14 名参与 TNB 人群开始 GAHT 护理的医疗保健提供者（全科医生、二级保健医生和精神保健提供者）的意见。使用半结构化访谈表来指导讨论。模板分析最初根据访谈表中确定的主题和讨论中提出的新主题对数据进行编码。
结果
参与者就基线和随访调查的招募和数据收集重点分享了想法。这些想法包括了解开始激素治疗的历程（信息寻求、决策）、获得 GAHT 起始服务的途径、信息提供的适当性、第一份处方的接收、GAHT 的目标和经验，以及非二元人群的独特需求。
讨论
TNB 咨询小组和医疗保健专业人员的意见为调查的制定提供了信息，该调查将用于了解新西兰开始 GAHT 的人群的体验和结果。这项计划中的前瞻性队列研究的结果有可能改善希望选择这种治疗方案的 TNB 人群获得 GAHT 的途径。
