Transgender and Gender Nonconforming in Emergency Departments: A Qualitative Report of Patient Experiences.

Autor:	Chisolm-Straker M; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York., Jardine L; Department of Emergency Medicine, SUNY Downstate College of Medicine, Brooklyn, New York., Bennouna C; Department of Population and Family Health, Columbia University School of Public Health, New York City, New York., Morency-Brassard N; Emergency Response Team, International Rescue Committee, New York City, New York., Coy L; Obstetrics, Gynecology and Reproductive Services, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California., Egemba MO; New York City Teens Connection, Center for Health Equity, New York City Department of Health and Mental Hygiene, Queens, New York., Shearer PL; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York.
Jazyk:	angličtina
Zdroj:	Transgender health [Transgend Health] 2017 Feb 01; Vol. 2 (1), pp. 8-16. Date of Electronic Publication: 2017 Feb 01 (Print Publication: 2017).
DOI:	10.1089/trgh.2016.0026
Abstrakt:	Background: Individuals who have a transgender or gender nonconforming (TGGNC) experience belong to a marginalized segment of the U.S. population, and healthcare can be difficult for them to navigate. Although emergency departments (EDs) traditionally serve as healthcare "safety nets" for vulnerable populations, quantitative studies outside the United States have found that TGGNC-experienced persons tend to avoid EDs and/or have negative experiences. This qualitative study primarily describes the ED experiences of people with a TGGNC history; furthermore, the study explores reasons why this population avoids U.S. EDs and their recommendations for improvements to ED care. Methods: This qualitative study used data about TGGNC-historied persons' experiences in U.S. EDs from retrospective, anonymous, written surveys (paper or web based). National data collection took place from June 2012 through December 2014. Participant responses ( n =240) were examined using thematic analysis. Results: Using a framework that recognized positive and negative responses, the themes of Self-Efficacy and Power Inequity surfaced. These themes exposed the tension between patients with TGGNC experiences and clinicians who were perceived to lack training in this area, resulting in negative patient experiences. When practitioners had specific training about this population, participants reported positive care experiences. Conclusions: This study indicates that many TGGNC-historied persons who use U.S. EDs have negative experiences, largely due to lack of provider sensitivity toward and training about this patient population. Data from this investigation suggest that training of U.S. ED providers and institutional support would help improve care for this marginalized group. Competing Interests: No competing financial interests exist.
Databáze:	MEDLINE
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