Needs and concerns of transgender individuals regarding interdisciplinary transgender healthcare: A non-clinical online survey

Abstract

This study investigates the needs and concerns transgender (short: trans) individuals have concerning trans healthcare (THC) in interdisciplinary THC centres. Trans individuals’ gender does not (fully/constantly) match their sex assigned at birth. To be able to live in their gender role and to prevent or minimise gender dysphoria, they might require a multidisciplinary set of transition related healthcare services. The current shift from the traditionally highly regulated, hierarchical and pathologising approach to THC towards a more patient-centred approach has highlighted the importance of trans patients’ satisfaction with treatment processes and results. As the still influential regulations have a negative effect on patient satisfaction, and might also keep trans individuals from seeking transition related treatment, it is crucial to investigate what trans individuals, whether patients or not, need and fear regarding transition related healthcare. Against the backdrop of mixed reactions received from the local trans community regarding the foundation of the Interdisciplinary Transgender Healthcare Centre Hamburg (ITHCCH), Germany, this study seeks to determine what trans individuals need with respect to THC in order to guarantee for high quality service provision at the ITHCCH. To this end, an online questionnaire was developed. The researchers employed a participatory approach to questionnaire development by involving a working group consisting of local trans support group representatives and (THC) specialists (N = 4). The sample consisted of N = 415 trans-identified individuals aged between 16 and 76. Most of them were based in Germany. 85.2% (n = 382) reported experience with transition related healthcare and 72.5% (n = 301) had (additional) treatments planned. Analysis revealed a need for communication and feedback opportunities. Furthermore, during the treatment process, addressing individual needs was considered crucial by participants. They agreed moderately with concerns towards THC centres. 96.5% of participants would like high decision-making power concerning treatment-associated decisions. The results demonstrate the importance of patient-centred THC that takes patients' individual needs and realities into consideration and involves patients in decision-making processes.

Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

“…Best practice TGD health services should be community-led and co-designed with the TGD community [4]. Previous small surveys have suggested that increased education of medical practitioners was needed to better engage with gender diverse clients [5].…”

Mapping key stakeholders’ position towards interdisciplinary transgender healthcare: A stakeholder analysis

“…It is the first and so far only ITHC in Germany. It maintains close links with other ITHCs internationally (Kreukels et al, ) as well as with local trans healthcare stakeholders (Eyssel et al, ), thereby complying with EU and German Alliance for Rare Diseases standards (NAMSE, ; Winten & Werner, ). The ITHC in Hamburg takes a client‐centred approach to trans healthcare (i.e.…”

“…For example online survey and community data show that expectations of rejection, self‐stigmatisation and discrimination are associated with distress (Timmins, Rimes, & Rahman, ), and that discrimination experiences related to identity, transition and disclosure of trans status are associated with a delayed accessing of healthcare (Cruz, ; Loos, Köhler, Eyssel, & Nieder, ). In order to minimise or prevent gender dysphoria, and to make living according to their gender possible or easier, trans individuals may access various transition‐related healthcare services, for example hormone treatment and surgeries (Murad et al, ; White Hughto & Reisner, ), which ideally work in close, interdisciplinary settings (Eyssel, Koehler, Dekker, Sehner, & Nieder, ).…”

“…In line with this, research projects have increasingly involved members of the trans community and trans health professionals in various aspects of research, including improving research questions, developing methods for data collection, implementation and evaluation of data and disseminating results (e.g. Eyssel et al, ; Quinn et al, ; Scheim & Bauer, ). Therefore, using the example of an existing ITHC, which is located in Hamburg, Germany, this paper outlines how a stakeholder analysis can enable strategic policy decisions to improve stakeholder relationships and service quality through an evidence‐based approach.…”

“…Voiced criticism from trans individuals and groups included, for example political and ethical concerns (e.g. limited freedom to choose local trans healthcare providers other than the ITHC; Eyssel et al, ), financial concerns (e.g. smaller local surgeries losing patients), or concerns regarding the lack of professional cooperation (e.g.…”