De Vincenzo Ciro, Garolla Andrea, Delinna Sara, Pizzolato Laura, Testoni Ines
Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Via Venezia 14, Padova, Italy.
Department of Medicine, University of Padova, Padova, Italy.
BMC Psychol. 2025 Apr 6;13(1):342. doi: 10.1186/s40359-025-02675-3.
This study adopts a qualitative methodological framework to investigate the overall experiences of institutional gender affirmation pathway (GAP) with a focus on the narratives of mandatory psychological assessment in Trans and Nonbinary (TNB) people in Italy, who face daily discrimination, social prejudice, episodes of violence, and victimization. In the Italian context, psychological assessment is a prerequisite to receive a diagnosis of gender dysphoria, which is essential to access hormone therapy, surgical interventions, and legal change of name and gender marker.
The study employed a qualitative methodological design, since it allows a deep and flexible exploration of participants' experiences and perspectives. Specifically, the data collection technique consisted of semi-structured interviews with N = 21 participants. The corpus of data was analyzed consistently with thematic analysis and reflexive thematic analytic approach, for identifying, analysing and reporting patterns in data, allowing the corpus of data to be examined in terms of their principal themes, using both theory-driven (top-down) and bottom-up analytical strategies.
Through the reflexive thematic approach, we generated two themes, further divided into sub-themes. The first theme is "Being trans + in our society" and it is composed by the following sub-themes: "personal experiences of identity affirmation"; "minority stress and transphobia"; "supportive familiar and working contexts", "institutional gender affirmation process"; "resilience and self-determination". The second theme, "Experiences of mandatory psychological assessment" is divided in: "disrespectful experiences"; "affirming and supportive interactions"; "to take better care". The results highlight how TNB individuals often experience significant stress related to their minority status and face discrimination in healthcare settings. Furthermore, there is a lack of individualization in the approach by healthcare providers and a shortage of knowledge about gender sensible topics among them. This study therefore highlights an insufficient provision of effective psychological support and the need to adopt more inclusive approaches, dismantling the pathologizing dimension of the diagnostic process for TNB people.
It is therefore crucial to promote awareness programs on gender identity issues to foster a more welcoming and informed environment in healthcare settings.
The study has been approved by the Ethics Committee of the University of Padua with unique number D120DC6FDC5DF2694CF281D76B2CDB41 and protocol number 5003.
本研究采用质性研究方法框架，以调查机构性性别确认途径（GAP）的总体体验，重点关注意大利跨性别者和非二元性别者（TNB）的强制心理评估经历，他们每天都面临歧视、社会偏见、暴力事件和受害情况。在意大利，心理评估是获得性别焦虑症诊断的前提条件，而这对于获得激素治疗、手术干预以及合法更改姓名和性别标记至关重要。
本研究采用质性研究设计，因为它能够深入且灵活地探究参与者的经历和观点。具体而言，数据收集技术包括对N = 21名参与者进行半结构化访谈。对数据集进行分析时，采用了主题分析和反思性主题分析方法，以识别、分析和报告数据中的模式，从而能够运用理论驱动（自上而下）和自下而上的分析策略，从主要主题的角度审视数据集。
通过反思性主题分析方法，我们生成了两个主题，并进一步细分为子主题。第一个主题是“在我们的社会中身为跨性别者及其他”，它由以下子主题组成：“身份确认的个人经历”；“少数群体压力和跨性别恐惧症”；“支持性的家庭和工作环境”；“机构性性别确认过程”；“复原力和自我决定”。第二个主题“强制心理评估的经历”分为：“不尊重的经历”；“肯定和支持性的互动”；“给予更好的照料”。结果凸显了TNB个体如何经常因少数群体身份而经历重大压力，并在医疗环境中面临歧视。此外，医疗服务提供者的方法缺乏个性化，且他们对性别敏感话题的了解不足。因此，本研究凸显了有效心理支持的提供不足，以及采用更具包容性方法的必要性，消除对TNB人群诊断过程的病理化倾向。
因此，至关重要的是要推广关于性别认同问题的宣传项目，以在医疗环境中营造一个更包容和知识丰富的环境。
本研究已获得帕多瓦大学伦理委员会批准，编号为D120DC6FDC5DF2694CF281D76B2CDB41，方案编号为5003。
