Health care for transgender people in the hospital context: health workers' discourse
DOI:
https://doi.org/10.12957/reuerj.2024.84353Keywords:
Transgender Persons, Hospital Care, Integrality in Health, Health PersonnelAbstract
Objective: to understand the knowledge, based on health workers' discourse, regarding health care for transgender individuals in the hospital context. Method: descriptive study with a qualitative approach conducted at a federal university hospital in Alto Sertão Paraibano, Brazil. Data collection was carried out through semi-structured interviews with 19 health workers between September and November 2023. Data analysis was performed using the Collective Subject Discourse method. The research protocol was approved by the ethics committee. Results: four central ideas were identified: misconceptions about the concept of Gender Identity; sexual orientation as a synonym for sexual education; limited knowledge about transgender people; and a narrow view of the relationship between transgender individuals and physical body modifications. Conclusion: health workers' knowledge regarding the transgender population reveals significant weaknesses that can negatively impact the provision of qualified care, thereby exacerbating barriers to access to health services for this social group.
References
Ministério da Saúde (Br). Política Nacional de Saúde Integral de Lésbicas, Gays, Bissexuais, Travestis e Transexuais. Brasília (DF): Ministério da Saúde; 2013.
Cohen CR, Tilio R. Atendimentos em saúde na perspectiva de transexuais. Psicol. rev. Horizonte. 2021 [cited 2024 jan 15]; 27(1):165-84. DOI: http://dx.doi.org/10.5752/P.1678-9563.2021v27n1p165-184.
Warner DM, Mehta AH. Identifying and addressing barriers to transgender healthcare: where we are and what we need to do about it. J Gen Intern Med. 2021 [cited 2024 Jan 15]; 36(11):3559-61. DOI: https://doi.org/10.1007/s11606-021-07001-2.
Hegazi A, Pakianathan M. LGBT sexual health. Medicine. 2018 [cited 2024 Jan 13]; 46(5):300-3. DOI: https://doi.org/10.1016/j.mpmed.2018.02.004.
Florêncio LLF, Souza KR, Oliveira ECS, Cabral JR, Silva FP, Silva RA, et al. Therapeutic itinerary of transsexual people in light of human rights. Nursing Ethics. 2021 [cited 16 Jan 2024]; 28(5):704-13. DOI: https://dx.doi.org/10.1177/0969733020968864.
Jesus MKMR, Moré IAA, Querino RA, Oliveira VH. Transgender women’s experiences in the healthcare system: visibility towards equity. Interface (Botucatu). 2023 [cited 2024 Jan 14]; 27:e220369. DOI: https://doi.org/10.1590/interface.220369.
Lindsay S, Kolne K, Rezai M. Challenges with providing gender-sensitive care: exploring experiences within pediatric rehabilitation hospital. Disabil Rehabil. 2022 [cited 2024 Jan 14]; 44(6):892-900. DOI: https://doi.org/10.1080/09638288.2020.1781939.
Moura CO, Silva ÍR, Silva TP, Santos KA, Crespo MCA, Silva MM. Methodological path to reach the degree of saturation in qualitative research: grounded theory. Rev Bras Enferm. 2022 [cited 2024 May 1]; 75(2):e20201379. DOI: https://doi.org/10.1590/0034-7167-2020-1379.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007 [cited 2024 Feb 01]; 19(6):349-57. DOI: https://doi.org/10.1093/intqhc/mzm042.
Lefevre F, Lefevre AMC. Discourse of the collective subject: social representations and communication interventions. Texto contexto - enferm. 2014 [cited 2024 Feb 01]; 23(2):502–7. DOI: https://doi.org/10.1590/0104-07072014000000014.
Lefevre AMC, Crestana MF, Cornetta VK. A utilização da metododologia do discurso do sujeito coletivo na avaliação qualitativa dos cursos de especialização "Capacitação e Desenvolvimento de Recursos Humanos em Saúde-CADRHU", São Paulo - 2002. Saude soc. 2003 [cited 2024 Feb 01]; 12(2):68–75. DOI: https://doi.org/10.1590/S0104-12902003000200007.
Conselho Nacional de Saúde (Br). Resolução nº 466, de 12 de dezembro de 2012. Brasília (DF): Conselho Nacional de Saúde; 2012.
Yared YB, Melo SMM. Sexual option or sexual orientation? Teachers’ understandings of sexuality in a medical degree. RPE. 2018 [cited 2024 Jan 31]; 31(2):175-95. DOI: https://doi.org/10.21814/rpe.15350.
Hereth J, Pardee DJ, Reisner SL. Gender identity and sexual orientation development among young adult transgender men sexually active with cisgender men: 'I had completely ignored my sexuality … that's for a different time to figure out'. Cult Health Sex. 2020 [cited 2024 Jan 31]; 22(1):31-47. DOI: https://doi.org/10.1080/13691058.2019.1636290.
Guerra MP, Balaguer MG, Porras MG, Murillo FH, Izquierdo ES, Ario CM. Transsexuality: Transitions, detransitions, and regrets in Spain. Endocrinol Diabetes Nutr (Engl Ed). 2020 [cited 2024 Jan 16]; 67(9):562-7. DOI: https://doi.org/10.1016/j.endinu.2020.03.008.
Sommarö S, Andersson A, Skagerström J. A deviation too many? Healthcare professionals’ knowledge and attitudes concerning patients with intellectual disability disrupting norms regarding sexual orientation and/or gender identity. J Appl Res Intellect Disabil. 2020 [cited 2024 Nov 27]; 33(6):1199-209. DOI: https://doi.org/10.1111/jar.12739.
Cassiavillani TP, Albrecht MPS. Sex education: an analysis of brazilian legislation and official documents in different political contexts. Educ rev. 2023 [cited 2024 Jan 31]; 39:e39794. DOI: https://doi.org/10.1590/0102-469839794.
Ivanova O, Rai M, Michielsen K, Dias S. How Sexuality Education Programs Have Been Evaluated in Low-and Lower-Middle-Income Countries? A Systematic Review. Int J Environ Res Public Health. 2020 [cited 2024 Jan 31]; 17(21):8183. DOI: https://doi.org/10.3390/ijerph17218183.
McGlynn N, Browne K, Sherriff N, Zeeman L, Mirandola M, Gios L, et al. Healthcare professionals’ assumptions as barriers to LGBTI healthcare. Cult Health Amp Sex. 2019 [cited 2024 Nov 27]; 22(8):954-70. DOI: https://doi.org/10.1080/13691058.2019.1643499.
Braybrook D, Bristowe K, Timmins L, Roach A, Day E, Clift P, et al. Communication about sexual orientation and gender between clinicians, LGBT+ people facing serious illness and their significant others: a qualitative interview study of experiences, preferences and recommendations. BMJ Qual Amp Saf. 2023 [cited 2024 Nov 27]; 32:109–20. DOI: https://doi.org/10.1136/bmjqs-2022-014792.
Yu H, Ancheta AJ, Flores DD, Bonett S, Meanley S, Choi SK, et al. Nurse leaders’ recommendations for implementing LGBTQ+ inclusive practices in health systems: a qualitative descriptive study. Int J Nurs Stud Adv. 2024 [cited 2024 Nov 26]; 7(12):100262. DOI: https://doi.org/10.1016/j.ijnsa.2024.100262.
Ussher JM, Perz J, Allison K, Poder R, Hawkey A, Dowsett GW et al. Attitudes, knowledge and practice behaviours of oncology health care professionals towards lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) patients and their carers: A mixed-methods study. Patient Educ Couns. 2022 [cited 2024 Jan 31]; 105(7):2512-23. DOI: https://doi.org/10.1016/j.pec.2021.12.008.
Lange J, Bergen DD van, Baams L, Timmerman MC, Bos HMW. Experiences and needs of sexual and gender minority young adults with a history of suicidal ideation regarding formal and informal mental healthcare. Sex Res Soc Policy. 2021 [cited 2024 Nov 28]; 19:1829-41. DOI: https://doi.org/10.1007/s13178-021-00657-9.
Freton L, Khene ZE, Richard C, Mathieu R, Alimi Q, Duval E et al. Self-assessment of healthcare workers regarding the management of trans people in a university hospital. Prog Urol. 2021 [cited 2024 Jan 14]; 31(16):1108-14. DOI: https://doi.org/10.1016/j.purol.2021.03.008.
MacCormick H, Johnson LT, Burchell D, Munro A, Lorello GR, George RB, et al. Lived experiences of transgender and nonbinary people in the perioperative context: a qualitative study. Can Med Assoc J. 2024 [cited 2024 Nov 29]; 196(24):E806-15. DOI: https://doi.org/10.1503/cmaj.240061.
Queiroz ABA, Castro AM, Carvalho ALO, Pinto CB, Bezerra JF, Gonçalves DS, et al. Transsexuality and health demands: representations of nursing students. Rev Gaúcha Enferm. 2023 [cited 2024 Jan 13]; 44:e20220046. DOI: https://doi.org/10.1590/1983-1447.2023.20220046.en.
Ministério da Saúde (Br). Portaria n° 2.803 de 19 de novembro de 2013. Brasília (DF): Ministério da Saúde, 2013.
MacDonald TK, Walks M, Biener M, Kibbe A. Disrupting the norms: reproduction, gender identity, gender dysphoria, and intersectionality. Int J Transgender Health. 2020 [cited 2024 Nov 29]; 22(1-2)18-29. DOI: https://doi.org/10.1080/26895269.2020.1848692.
Liu Y, Xin Y, Qi J, Wang H, Hong T, Yang X et al. The desire and status of gender-affirming hormone therapy and surgery in transgender men and women in China: a national population study. J Sex Med. 2020 [cited 2024 Feb 2]; 17(11):2291-8. DOI: https://doi.org/10.1016/j.jsxm.2020.07.081.
Levine SB, Abbruzzese E, Mason JW. Reconsidering informed consent for trans-identified children, adolescents, and young adults. J Sex Marital Ther. 2022 [cited 2024 Feb 2]; 48(7):706-27. DOI: https://doi.org/10.1080/0092623X.2022.2046221.
Casas-Ramírez M, Martínez-Linares JM, Cortés-Martín JJ, López-Entrambasaguas OM. Trans people perceptions of care received from healthcare professionals - a phenomenological study. Heliyon. 2023 [cited 2024 Feb 2]; 10(1):e23328. DOI: https://doi.org/10.1016/j.heliyon.2023.e23328.
Anderson D, Wijetunge H, Moore P, Provenzano D, Li N, Hasoon J et al. Gender dysphoria and its non-surgical and surgical treatments. Health Psychol Res. 2022 [cited 2024 Jan 16]; 10(3):38358. DOI: https://doi.org/10.52965/001c.38358.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Anna Kalyne César Grangeiro Adriano, Jonathan Pereira de Sousa, Francisca Andreza Passos Silva, Teresa Noêmia Gomes de Vasconcelos, Isabela Lunara Alves Barbalho, Rayrla Cristina de Abreu Temoteo, Cícera Renata Diniz Vieira Silva, Marcelo Costa Fernandes
This work is licensed under a Creative Commons Attribution 4.0 International License.
When publishing in Revista Enfermagem UERJ, the authors declare that the work is their exclusive authorship and therefore assume full responsibility for its content.
Authors retain copyright to their article and agree to license their work using a Creative Commons Attribution International Public License (CC BY), thereby accepting the terms and conditions of this license (https://creativecommons.org/licenses/by/4.0/legalcode.en), which allows material created by the author to be distributed, copied and displayed by third parties. The original work must be cited and present a link to the article available on the website of the journal in which it was published.
The Copyright of the articles published in Revista Enfermagem UERJ belongs to their respective author(s), with the rights of first publication assigned to Revista Enfermagem UERJ, with the work simultaneously licensed under a Creative Commons License CC BY, which allows sharing of work with recognition of authorship and initial publication in this journal.
The authors grant Revista Enfermagem UERJ the right of first publication, to identify themselves as the original publisher of the work and grant the magazine a license of non-exclusive rights to use the work in the following ways:
- Sell and/or distribute the work in printed copies and/or electronic format;
- Distribute parts and/or the work as a whole with the aim of promoting the magazine through the internet and other digital and printed media;
- Record and playback work in any format, including digital media.
In line with the journal's policies, each published article will be assigned a Creative Commons Attribution (CC BY) license.
