Kengis Lyon, Kruse Michael, Urquhart Robin, Goldstein Judah
Emergency Health Services Nova Scotia, Dartmouth, NS, Canada.
Division of Emergency Medical Services, Dalhousie Department of Emergency Medicine, Halifax Infirmary, Administrative Offices, Dalhousie University, Halifax, NS, Canada.
CJEM. 2025 Jun 3. doi: 10.1007/s43678-025-00947-w.
Transgender and gender diverse people report high rates of healthcare avoidance, yet they also access emergency departments at higher rates than the general population. Our research explores the paramedic perspective of providing care to transgender and gender diverse populations. The objectives were to assess paramedic comfort, confidence, and knowledge in providing healthcare to transgender and gender diverse communities.
A descriptive, cross-sectional electronic survey was administered to paramedics licensed with the College of Paramedics of Nova Scotia (n = 1281) between April 9 and May 7, 2018. A 4-point Likert scale and open-ended questions about paramedic comfort, confidence, and knowledge were included. Descriptive statistics were used to describe respondent characteristics. Open-ended questions pertaining to paramedic knowledge needs were evaluated using constant comparative analyses employing open coding to identify themes.
The response rate for the survey was 30%, with 387 licensed paramedics participating. Most respondents (66.2%) reported providing care to a patient who identified as transgender and gender diverse. A few respondents (4.9%) felt very confident in their knowledge regarding transgender and gender diverse identities and only 26.6% felt very comfortable in providing optimal care. Of those surveyed, 74.7% had no formal education on transgender and gender diverse health. Close to half (41.9%) reported observing transphobia in the workplace. Most respondents (70%) were interested in obtaining formal education and believed that it should be included in formative education curricula. Paramedics identified four distinct barriers to delivering equitable healthcare to transgender and gender diverse populations: (1) systemic, (2) personal, (3) socio-cultural, and (4) educational barriers.
Paramedics provide emergency healthcare to transgender and gender diverse patients. Comfort and confidence in providing this care were relatively low and identifiable barriers inhibit paramedic capacity to provide equitable healthcare. There was strong interest for education on transgender and gender diverse health and emergency presentations.
跨性别者和性别多样化人群报告称，他们避免就医的比例很高，但他们前往急诊科的比例也高于普通人群。我们的研究探讨了护理人员对为跨性别和性别多样化人群提供护理的看法。目标是评估护理人员在为跨性别和性别多样化社区提供医疗保健方面的舒适度、信心和知识水平。
2018年4月9日至5月7日，对在新斯科舍省护理人员学院获得执照的护理人员（n = 1281）进行了一项描述性横断面电子调查。调查包括一个4点李克特量表以及关于护理人员舒适度、信心和知识的开放式问题。描述性统计用于描述受访者特征。使用恒定比较分析对与护理人员知识需求相关的开放式问题进行评估，采用开放编码来确定主题。
调查的回复率为30%，有387名获得执照的护理人员参与。大多数受访者（66.2%）报告曾为自认为是跨性别和性别多样化的患者提供护理。少数受访者（4.9%）对自己关于跨性别和性别多样化身份的知识非常有信心，只有26.6%的人对提供最佳护理感到非常自在。在接受调查的人中，74.7%没有接受过关于跨性别和性别多样化健康的正规教育。近一半（41.9%）的人报告在工作场所观察到恐跨现象。大多数受访者（70%）有兴趣接受正规教育，并认为应将其纳入在职教育课程。护理人员确定了为跨性别和性别多样化人群提供公平医疗保健的四个明显障碍：（1）系统性障碍，（2）个人障碍，（3）社会文化障碍，以及（4）教育障碍。
护理人员为跨性别和性别多样化患者提供紧急医疗保健。提供此类护理的舒适度和信心相对较低，且可识别的障碍阻碍了护理人员提供公平医疗保健的能力。人们对跨性别和性别多样化健康及紧急情况处理方面的教育有浓厚兴趣。
