"Just Like Any Other Patient": Transgender Stigma among Physicians in Puerto Rico

Abstract

Background.-Transgender women (TW) in Puerto Rico (PR) face social stigmatization. Physicians' transgender stigma can have detrimental consequences for TW's health. Purpose.-The objective of this study was to document physicians' knowledge, competencies, and attitudes towards TW in PR and study their associations with stigma towards TW. Methods.-We implemented an exploratory sequential mixed-methods study. We used in-depth interviews (n=30) and self-administered questionnaire (n=255). Results.-Qualitative results illustrated lack of recognition of the needs of TW; they also evidenced the impact of stigmatizing attitudes on clinical decisions. Quantitative results showed that more willingness and knowledge to provide health services to TW were negatively associated with stigma. Participants who reported history of training in working with TW presented significantly less stigma than participants who had not received such training. Conclusion.-In order to provide stigma-free services for TW in PR, specialized training regarding the particular needs of this population is needed.

Embodiment, Gender Transitioning, and Necropolitics among Transwomen in Puerto Rico

“…Regarding stigmatizing attitudes, 70% reported that they were against allowing boys to explore their feminine side, and nearly half (44%) said that they would not support gender reassignment surgery for a transgender patient. Over a third of participants (36%) agreed with the statement that people are "either men or women" with no middle ground, and nearly the same proportion (34%) believe that gender transitioning surgery is an affront to God (Rodríguez Madera et al 2019).…”

“…While Asencio and Ramirez do not engage directly with transwomen as research participants, their analyses provide a context for our team's research on violence among transwomen, who embody the most extreme transgression of public masculinity in Puerto Rico and therefore produce the most vehement backlash. Our broader research agenda has described the health vulnerabilities and social context of the transgender population in Puerto Rico with a view to public health applications and policy advocacy (Padilla et al 2018;Rodríguez Madera et al 2019). In our survey of transwomen on the island, we were able to provide some of the first quantitative data of their health and well-being (Rodríguez-Madera et al 2017).…”

“…Some prior research also emphasizes the intense stigmatization and neglect that transwomen experience in health-care settings in Puerto Rico. Our team conducted a mixed-method study of physician attitudes, practices, willingness to treat, and knowledge of transgender health issues for a formative study on physician stigmatization (Rodríguez Madera et al 2019). The concept for the study emerged primarily from transwomen's narratives themselves regarding their horrific experiences of stigmatization by medical personnel and their resistance to access clinical services as a result of high levels of medical stigmatization (Padilla et al 2016(Padilla et al , 2018.…”

“…Many, particularly those who are least able to publicly pass as cisgender women (individuals who maintain a gender identity and expression corresponding to the biological sex with which they were born), face arbitrary arrest and abuse by the authorities (Rodríguez-Madera et al 2017). Health-care environments are often fraught with fear and anxiety due to stigmatization by medical staff, a pervasive lack of empathy for transgender experience, and a lack of expertise in transgender health needs among medical personnel (Rodríguez Madera et al 2019). Following Halberstam, we conceptualize passing in Puerto Rico as an agentive response to transgender biography, an embodied process of self-realization, and a means to find certain avenues of social advancement in the context of everyday interpersonal and structural violence.…”

Transfobia y Religiosidad en Puerto Rico: Estudio Exploratorio en Profesionales de la Salud

“…Debido a que el sentido de identidad de las personas Trans difiere de la normativa social, ésta suele enfrentar diversidad de retos entre los que se destacan: discrimen, estigma, violencia agresiones físicas y sexuales, por mencionar algunas (James et al, 2016;Rodríguez-Madera et al, 2019;Socías et al, 2014). Estos retos se observan en distintas áreas como la laboral, médica, social, familiar, entre otras (James et al, 2016;Meléndez, 2014;Socías et al, 2014).…”