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“他们就是知道,而这至关重要”:理解加拿大跨性别者的积极医疗体验。

"They just knew, and that makes all the difference": Understanding positive healthcare experiences among trans people in Canada.

作者信息

Goldfarb Rachel, Katz M A, Travers R, Poliwoda J, Sadri-Gerrior M, Valiant C, Murugan A Ananthavel, Tang J, Henry G, Coleman T

机构信息

Department of Health Sciences, Wilfrid Laurier University, Waterloo, Canada.

Department of Psychology, Wilfrid Laurier University, Waterloo, Canada.

出版信息

Int J Transgend Health. 2024 Jan 31;26(3):698-708. doi: 10.1080/26895269.2024.2305196. eCollection 2025.


DOI:10.1080/26895269.2024.2305196
PMID:40756712
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12312127/
Abstract

BACKGROUND: Trans people face persistent systemic challenges and barriers in healthcare systems. Despite these obstacles, many trans people have had positive healthcare experiences, however little is known regarding their commonalities. AIMS: This study aims to better understand factors that influence positive healthcare experiences among trans people. METHODS: 33 longform interviews were conducted with trans individuals, with 29 being used for the final sample. Interviews were recorded, transcribed verbatim, and analyzed using NVIVO 12 software. Thematic analysis was conducted for the coding process with a combination of inductive and deductive approaches used to develop the coding frame. RESULTS: Four healthcare provider (HCP) characteristics and two patient attributes were identified as promoters of positive healthcare experiences. Positive HCP characteristics included having a provider who was 1) a member of the LGBTQ community, 2) knowledgeable, experienced, and willing to learn about trans health, 3) transparent and empowered patients regarding their medical decisions; and 4) sensitive, accepting, and validating of patients' gender identities. The two patient attributes included: 1) engaging in self-advocacy regarding their care, and 2) being connected to a variety of supportive trans communities, both online and in-person. DISCUSSION: Better understanding these positive healthcare experiences can help in the development of curricula and policy to facilitate improved quality healthcare for trans people in Canada.

摘要

背景:跨性别者在医疗保健系统中面临持续的系统性挑战和障碍。尽管存在这些障碍,但许多跨性别者仍有积极的就医体验,然而对于他们的共性却知之甚少。 目的:本研究旨在更好地了解影响跨性别者积极就医体验的因素。 方法:对跨性别个体进行了33次长篇访谈,最终样本采用了其中29次访谈。访谈进行了录音,逐字转录,并使用NVIVO 12软件进行分析。编码过程采用主题分析,结合归纳法和演绎法来制定编码框架。 结果:确定了四个医疗服务提供者(HCP)特征和两个患者属性为积极就医体验的促进因素。积极的HCP特征包括有一个提供者:1)是 LGBTQ 社区的成员;2)知识渊博、经验丰富且愿意了解跨性别健康;3)在医疗决策方面对患者透明且赋权;4)对患者的性别认同敏感、接纳并认可。两个患者属性包括:1)在护理方面进行自我倡导;2)与各种线上和线下的支持性跨性别社区建立联系。 讨论:更好地理解这些积极的就医体验有助于制定课程和政策,以促进加拿大跨性别者获得更高质量的医疗保健。

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本文引用的文献

[1]
Trans broken arm syndrome: A mixed-methods exploration of gender-related medical misattribution and invasive questioning.

Soc Sci Med. 2023-3

[2]
The Cisnormative Blindspot Explained: Healthcare Experiences of Trans Men and Non-Binary Persons and the accessibility to inclusive sexual & reproductive Healthcare, an integrative review.

Sex Reprod Healthc. 2022-6

[3]
Implementation of transgender and gender diverse curriculum in medical imaging programs: A review of the literature.

J Med Imaging Radiat Sci. 2021-12

[4]
Experiences and Perspectives of Transgender Youths in Accessing Health Care: A Systematic Review.

JAMA Pediatr. 2021-11-1

[5]
Transgender-Competent Health Care: Lessons from the Community.

South Med J. 2021-6

[6]
"It's Being Compassionate, Not Making Assumptions": Transmasculine and Nonbinary Young Adults' Experiences of "Women's" Health Care Settings.

Womens Health Issues. 2021

[7]
Decision-Making Criteria When Contemplating Disclosure of Transgender Identity to Medical Providers.

Health Commun. 2022-7

[8]
Transgender patients' experiences of health care.

Br J Nurs. 2020-12-10

[9]
Creating inclusive health care environments: Health care stories from the trans population.

J Am Assoc Nurse Pract. 2020-6-9

[10]
Healthcare avoidance due to anticipated discrimination among transgender people: A call to create trans-affirmative environments.

SSM Popul Health. 2020-5-28

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