A Qualitative Evaluation of Transgender and Gender-Nonconforming Patients' Experiences in Southern California's Inland Empire
A Qualitative Evaluation of Transgender and Gender-Nonconforming Patients' Experiences in Southern California's Inland Empire
复制标题
DOI：
10.1089/trgh.2020.0187
复制
发表时间：
2021-07-19
影响因子：
2
通讯作者：
Polonijo, Andrea N.
中科院分区：
文献类型：
--
作者：
Olivares, Angela;Flores, Justino;Polonijo, Andrea N.
用途：评估加州内陆帝国种族-民族多元化的跨性别和性别歧视（TGNC）社区内的消极和积极的医疗保健经验。方法：在加州的内陆帝国进行了三个焦点小组的种族，民族不同的样本20 TGNC确定的个人。严格和加速数据简化（RADaR）技术被用来系统地分析定性数据，并确定突出的主题。结果如下：关键主题包括以下内容：缺乏TGNC的文化能力之间的供应商，人际障碍的医疗保健，感知系统性障碍的医疗保健，以及不当的护理对TGNC患者的健康的影响。缺乏文化能力包括提供者将性别和性行为混为一谈，以及不了解非二元性别身份。人际交往障碍包括患者被误认为是性别，拒绝治疗，并提到他们的死亡名字。被认为存在的系统性障碍包括保险范围、交通问题和缺乏应急护理。与会者强调了不当护理的影响，他们在无法获得及时和适当的护理时寻求替代的、有时是不安全的护理形式。结论：与会者建议在提供者培训中增加TGNC观点的代表性，让提供者参与TGNC社区的外联活动，并要求提供者的推荐信和认证被认为是TGNC文化能力的手段，以改善TGNC患者护理。
Purpose: To evaluate negative and positive health care experiences within the racial-ethnically diverse transgender and gender-nonconforming (TGNC) community in the Inland Empire, California. Methods: Three focus groups were conducted with a racial-ethnically diverse sample of 20 TGNC-identified individuals in California's Inland Empire. The rigorous and accelerated data reduction (RADaR) technique was used to systematically analyze the qualitative data and identify salient themes. Results: Key themes included the following: a lack of TGNC cultural competency among providers, interpersonal barriers to health care, perceived systemic barriers to health care, and the effects of improper care on TGNC patients' health. Lack of cultural competency included providers' conflations of gender and sexuality and unawareness of nonbinary gender identities. Interpersonal barriers included patient experiences of being misgendered, refused treatment, and referred to by their deadnames. Perceived systemic barriers included insurance coverage, transportation issues, and a lack of expedient care. The effects of improper care were highlighted by participants seeking alternative and sometimes unsafe forms of care when timely and appropriate care was inaccessible. Conclusion: Participants recommended increasing representation of TGNC perspectives into provider trainings, involving providers in outreach with the TGNC community, and requiring letters of recommendation and certifications for providers to be deemed TGNC culturally competent as means of improving TGNC patient care.