Grant Ruby, Russell Ash, Dane Sharon, Dunn Isabel
Australian Research Centre in Sex, Health, and Society, La Trobe University, Melbourne, Victoria, Australia.
School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.
Int J Transgend Health. 2023 Nov 7;25(4):804-815. doi: 10.1080/26895269.2023.2276179. eCollection 2024.
Gender affirmation through hormone replacement therapies and surgery can significantly improve the health and wellbeing of some transgender, nonbinary, and gender diverse people. Despite the well-documented benefits of gender affirming care, barriers persist for many trans and gender diverse people, particularly those in rural areas. This exploratory study aimed to identify the barriers trans and gender diverse people faced when seeking to medically affirm their gender in the rural state of Tasmania, Australia. This article draws on qualitative data from a mixed-methods online survey of 84 trans and gender diverse Tasmanians aged 18-70. Participants identified financial and geographical barriers, discrimination, and medical gatekeeping as the three key factors that prevented or delayed their gender affirmation. Costly services that require multiple referrals to access limit trans and gender diverse patients' options, impacting their mental health and wellbeing. Gender affirmation on the basis of informed consent would reduce unnecessary medical gatekeeping and improve trans and gender diverse health and wellbeing.
通过激素替代疗法和手术进行性别肯定可以显著改善一些跨性别者、非二元性别者以及性别多样化者的健康和福祉。尽管性别肯定治疗的益处有充分记录，但许多跨性别者和性别多样化者仍然面临障碍，尤其是农村地区的人群。这项探索性研究旨在确定在澳大利亚塔斯马尼亚州农村地区，跨性别者和性别多样化者在寻求医学上的性别肯定时所面临的障碍。本文借鉴了对84名年龄在18至70岁之间的塔斯马尼亚跨性别者和性别多样化者进行的混合方法在线调查的定性数据。参与者将经济和地理障碍、歧视以及医疗把关确定为阻碍或延迟他们性别肯定的三个关键因素。需要多次转诊才能获得的昂贵服务限制了跨性别者和性别多样化患者的选择，影响了他们的心理健康和福祉。基于知情同意的性别肯定将减少不必要的医疗把关，并改善跨性别者和性别多样化者的健康和福祉。
