Reported Emergency Department Avoidance, Use, and Experiences of Transgender Persons in Ontario, Canada: Results From a Respondent-Driven Sampling Survey
Reported Emergency Department Avoidance, Use, and Experiences of Transgender Persons in Ontario, Canada: Results From a Respondent-Driven Sampling Survey
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DOI：
10.1016/j.annemergmed.2013.09.027
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发表时间：
2014-06-01
影响因子：
6.2
通讯作者：
Massarella, Carys
中科院分区：
文献类型：
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作者：
Bauer, Greta R.;Scheim, Ayden I.;Massarella, Carys
研究目标：跨性别者、变性者或跨性别者报告称，由于负面经历或对此类经历的恐惧而逃避医疗护理。跨性别者特定的负面急诊科 (ED) 经历以及回避 ED 的程度尚未有记录。 方法：Trans PULSE 项目于 2009 年至 2010 年对加拿大安大略省的跨性别者 (n=433) 进行了一项调查，采用受访者驱动抽样（一种基于跟踪网络的方法来研究隐藏人群）。对安大略省的跨性别人群和报告其感觉性别的 ED 使用情况的亚组 (n=167) 进行了加权频率和自举 95% 置信区间 (Cis) 的估计。结果：408 名参与者完成了 ED 体验项目。跨性别者很年轻（34% 年龄在 16 至 24 岁之间，只有 10% > 55 岁）；大约一半是女性对男性，一半是男性对女性。 37%（95% Cl 30% 至 46%）使用了医学监督下的激素，27%（95% Cl 20% 至 35%）至少接受过 1 次与变性相关的手术。 33%（95% Cl 26% 至 40%）的跨安大略省人报告了去年的 ED 需求，但只有 71%（95% Cl 40% 至 91%）自我报告需求的人表示他们能够获得护理。据估计，有 21%（95% Cl 14% 至 25%）的人报告曾经避免接受急诊治疗，因为他们认为自己的跨性别身份会对此类遭遇产生负面影响。 52%（95% Cl 34% 至 72%）的用户报告了跨性别者特定的负面 ED 经历，他们以自己的感觉性别呈现。 结论：这是对跨性别者 ED 回避、利用和经历的首次探索性分析，记录了跨性别安大略人的 ED 回避和可能未得到满足的紧急护理需求。需要进行更多研究，包括措施验证。
Study objective: Transgender, transsexual, or transitioned (trans) people have reported avoiding medical care because of negative experiences or fear of such experiences. The extent of trans-specific negative emergency department (ED)experiences, and of ED avoidance, has not been documented.Methods: The Trans PULSE Project conducted a survey of trans people in Ontario, Canada (n=433) in 2009 to 2010, using respondent-driven sampling, a tracked network-based method for studying hidden populations. Weighted frequencies and bootstrapped 95% confidence intervals (Cis) were estimated for the trans population in Ontario and for the subgroup (n=167) reporting ED use in their felt gender.Results: Four hundred eight participants completed the ED experience items. Trans people were young (34% aged 16 to 24 years and only 10% >55 years); approximately half were female-to-male and half male-to-female. Medically supervised hormones were used by 37% (95% Cl 30% to 46%), and 27% (95% Cl 20% to 35%) had at least 1 transitionrelated surgery. Past-year ED need was reported by 33% (95% Cl 26% to 40%) of trans Ontarians, though only 71% (95% Cl 40% to 91%) of those with self-reported need indicated that they were able to obtain care. An estimated 21% (95% Cl 14% to 25%) reported ever avoiding ED care because of a perception that their trans status would negatively affect such an encounter. Trans-specific negative ED experiences were reported by 52% (95% Cl 34% to 72%) of users presenting in their felt gender.Conclusion: This first exploratory analysis of ED avoidance, utilization, and experiences by trans persons documented ED avoidance and possible unmet need for emergency care among trans Ontarians. Additional research, including validation of measures, is needed.