Porsch-Ortega Lauren, Henderson Sara Birnel
Research and Evaluation Department, Planned Parenthood Federation of America, New York, New York, United States of America.
PLoS One. 2025 Jul 23;20(7):e0329075. doi: 10.1371/journal.pone.0329075. eCollection 2025.
Among the recent surge of legislative restrictions on the provision of gender affirming care to youth in the United States, some legislation, such as bills passed in 2023 in Florida and Missouri, have impacted the provision of care to adults. We sought to understand the impacts of these restrictions on both adult patients and health care providers seeking and providing gender affirming hormone therapy. We conducted semi-structured qualitative interviews with 21 patients and seven health care providers and staff from Planned Parenthood health centers in these two states and identified key themes related to their experiences of accessing and providing gender affirming hormone therapy before and after the implementation of the restrictions on care. Main themes emerging from interviews with both patients and providers/staff included disruptions to accessing or providing care after the restrictions were implemented, their range of reactions to learning about the restrictions, the negative impacts of the restrictions on transgender and gender diverse (TGD) people's access to health care and providers' provision of care, and what they want policymakers to know about the impact of the restrictions. Providers and staff also discussed the internal rewards of providing gender affirming hormone therapy, and patients shared the negative consequences of the restrictions on their lives and well-being. Our findings suggest that legislative restrictions on gender affirming care cause psychological, physical, and financial harm to TGD individuals by creating conditions that impose lapses in care and contribute to a hostile environment for TGD people.
在美国近期对为青少年提供性别确认治疗的立法限制激增的情况下，一些立法，如2023年在佛罗里达州和密苏里州通过的法案，已经影响到了对成年人的治疗。我们试图了解这些限制对寻求和提供性别确认激素治疗的成年患者和医疗服务提供者的影响。我们对来自这两个州的计划生育健康中心的21名患者以及7名医疗服务提供者和工作人员进行了半结构化定性访谈，并确定了与他们在护理限制实施前后获取和提供性别确认激素治疗的经历相关的关键主题。从对患者和提供者/工作人员的访谈中出现的主要主题包括限制实施后获取或提供护理的中断、他们对了解到这些限制的一系列反应、这些限制对跨性别和性别多样化（TGD）人群获得医疗保健以及提供者提供护理的负面影响，以及他们希望政策制定者了解这些限制的影响。提供者和工作人员还讨论了提供性别确认激素治疗的内在回报，患者分享了这些限制对他们生活和幸福的负面影响。我们的研究结果表明，对性别确认护理的立法限制通过制造导致护理中断的条件并助长对TGD人群的敌对环境，对TGD个体造成心理、身体和经济伤害。
