Experiences of transgender and non-binary youth accessing gender-affirming care: A systematic review and meta-ethnography

Abstract

Objective Transgender and non-binary individuals frequently engage with healthcare services to obtain gender-affirming care. Little data exist on the experiences of young people accessing gender care. This systematic review and meta-ethnography aimed to identify and synthesise data on youths’ experiences accessing gender-affirming healthcare. Method A systematic review and meta-ethnography focusing on qualitative research on the experiences of transgender and non-binary youth accessing gender care was completed between April-December 2020. The following databases were used: PsychINFO, MEDLINE, EMBASE, and CINAHL. The protocol was registered on PROSPERO, international prospective register of Systematic Reviews (CRD42020139908). Results Ten studies were included in the final review. The sample included participants with diverse gender identities and included the perspective of parents/caregivers. Five dimensions (third-order constructs) were identified and contextualized into the following themes: 1.) Disclosure of gender identity. 2.) The pursuit of care. 3.) The cost of care. 4.) Complex family/caregiver dynamics. 5.) Patient-provider relationships. Each dimension details a complicated set of factors that can impact healthcare navigation and are explained through a new conceptual model titled “The Rainbow Brick Road”. Conclusion This synthesis expands understanding into the experience of transgender and non-binary youth accessing gender-affirming healthcare. Ryvicker’s behavioural-ecological model of healthcare navigation is discussed in relation to the findings and compared to the authors’ conceptual model. This detailed analysis reveals unique insights on healthcare navigation challenges and the traits, resources, and infrastructure needed to overcome these. Importantly, this paper reveals the critical need for more research with non-binary youth and research which includes the population in the design.

(Dis)advantaged positions in accessing gender-affirming healthcare in Finland: an intersectional qualitative study of foreign-origin transgender people

“…As trans people are often in the need of proving or performing their identities, or "need to prove their gender" to healthcare professionals to receive certain genderaffirming treatments [7,13,39]. In the Finnish context, the necessity of performing one's identity is mostly, but not entirely, connected to the currently practiced diagnostic processes.…”

O vivido de mulheres trans ou travestis no acesso aos serviços públicos de saúde

“…Estudos internacionais (27)(28) apontam que indivíduos transgêneros e com diversidade de gênero enfrentam barreiras ao tentar acessar os cuidados de saúde, desde discriminação à falta de acesso e de profissionais experientes, indicando a necessidade de educação adicional para os profissionais de saúde, especialmente àqueles que prestam atenção primária, sobre como oferecer cuidados com conhecimento, afirmação e interseccionalidade.…”

The experience of trans or transvestite women in accessing public health services

“…International studies (27)(28) indicate that transgender and genderdiverse individuals face barriers when trying to access healthcare, from discrimination to lack of access and experienced professionals, indicating the need for additional education for health professionals, especially those providing primary care, on how to provide care with knowledge, affirmation, and intersectionality.…”