Experiences of Transgender and Gender Expansive Physicians.
Experiences of Transgender and Gender Expansive Physicians.
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DOI：
10.1001/jamanetworkopen.2022.19791
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发表时间：
2022-06-01
影响因子：
13.8
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中科院分区：
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美国跨性别和/或性别扩张（TGE）医生的专业经验是什么？在这项定性研究的24名医生谁确定为TGE，主要主题出现集中在整个医疗培训和实践的频谱与显性和微妙的跨性别恐惧症相关的情绪困扰。确定了需要进行结构和人际关系方面的变革，以提高医生对性别多样性个人的理解，并促进工作场所的包容性，并列举了缓解战略的具体实例。这些发现表明，机构和个人需要采取战略，以针对医疗保健环境中的跨性别恐惧症和性别偏见。LGBTQIA+（女同性恋，男同性恋，双性恋，变性人，酷儿和其他性和性别少数）医生在工作场所的经验偏见，有一个关于医生的经验，谁特别确定为变性人和/或性别扩张的数据很少（TGE;性别扩张是一个总括术语，涵盖了可能存在于二元框架之外的个人和性别身份[例如，可能包括非二元，性别酷儿，和代理人）。探索TGE医生的专业经验，识别包容性的障碍，并强调促进包容性工作场所的股东衍生战略。这项由半结构化访谈提供信息的定性研究于2021年4月1日至12月31日在美国的24名TGE医生中进行。TGE医生的样本是使用方便和雪球抽样招募的。访谈被记录和转录。使用主题分析，研究团队的至少2名成员在迭代过程中对每个转录本进行盲编码。数据收集和主题分析检查医生的经验的主题。在接受采访的24名医生（平均[SD]年龄，39 [1.4]岁）中，8名（33%）自我认定为跨性别女性，7名（29%）为跨性别男性，4名（17%）为非二元，3名（13%）为跨性别和非二元，2名（8%）为性别酷儿。访谈的突出主题包括跨性别恐惧症导致的情绪困扰，僵化的二元性别范式的主导地位，以及与心理和身体安全以及作为TGE医生的孤立感相关的结构和制度因素。明确的肯定步骤，可以减轻情绪压力，包括安全的迹象，积极的盟友关系，并指导其他TGE医生。在这项定性研究中，TGE医生报告说，他们面临着与身份和性别表现相关的明显和微妙的偏见。与会者还指出，一些人际和结构性因素减轻了这些偏见的影响。这项定性研究探讨了跨性别和/或性别扩张医生的专业经验，确定了包容性的障碍，并强调了促进包容性工作场所的股东衍生战略。
What are the professional experiences of US physicians who are transgender and/or gender expansive (TGE)? In this qualitative study of 24 physicians who identify as TGE, major themes emerged centering on emotional distress associated with overt and subtle transphobia throughout the spectrum of medical training and practice. A need for structural and interpersonal changes to improve physicians’ understanding of gender diverse individuals and promote workplace inclusivity was identified, with specific examples of mitigation strategies. These findings signal a need for institutions and individuals to engage with strategies to target transphobia and gender biases in the health care setting. Although LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority) physicians experience bias in the workplace, there is a paucity of data on the experiences of physicians who identify specifically as transgender and/or gender expansive (TGE; gender expansive is an umbrella term encompassing individuals and gender identities that may exist beyond the binary framework [eg, may include nonbinary, genderqueer, and agender individuals]). To explore the professional experiences of TGE physicians, identify barriers to inclusion, and highlight stakeholder-derived strategies that promote an inclusive workplace. This qualitative study informed by semistructured interviews was conducted among 24 TGE physicians in the US from April 1 to December 31, 2021. The sample of TGE physicians was recruited using convenience and snowball sampling. Interviews were recorded and transcribed. Using thematic analysis, at least 2 members of the research team performed blinded coding of each transcript, in an iterative process. Data collection and thematic analysis examining themes of physicians’ experiences. Among 24 physicians (mean [SD] age, 39 [1.4] years) interviewed, 8 (33%) self-identified as transgender women, 7 (29%) as transgender men, 4 (17%) as nonbinary, 3 (13%) as transgender and nonbinary, and 2 (8%) as genderqueer. Prominent themes of the interviews included emotional distress as a result of transphobia, dominance of a rigid binary gender paradigm, and structural and institutional factors that are associated with psychological and physical safety and feelings of isolation as a TGE physician. Clear steps of affirmation were identified that could mitigate the emotional stressors, including signs of safety, active allyship, and mentorship by other TGE physicians. In this qualitative study, TGE physicians reported facing both overt and subtle biases associated with their identity and gender presentation. Participants also noted several interpersonal and structural factors that mitigate the effect of these biases. This qualitative study explores the professional experiences of transgender and/or gender expansive physicians, identifies barriers to inclusion, and highlights stakeholder-derived strategies that promote an inclusive workplace.