Barriers and facilitating strategies for healthcare access and reception for transgender children and adolescents.
Juliana Cristina Pereira Silveira, Danton Matheus de Souza, Clarissa de Souza Cardoso and 1 others
PMID 40105646WHAT IT FOUND
Reported barriers included low clinician knowledge, hostile interactions, and assuming the young person is heterosexual.
Reported strategies included asking pronouns at admission, documenting them, apologizing for mistakes, and ongoing training.
Key findings
01Low professional knowledge, hostile professional interactions, and sexual presumption were the main barriers reported.
02Asking about gender and pronouns at admission and continuing education for healthcare professionals were the main strategies reported.
03The included studies were mainly qualitative, so the review cannot show the size of the barriers or whether strategies worked.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included eight studies, and the authors state that the qualitative focus does not allow showing the size of the impacts. Most included studies were conducted in the United States, so the barriers and strategies may not apply directly to every setting. The search was broadened by removing child and adolescent descriptors because the initial search yielded less than 100 articles, which may have widened the population captured. Three included studies involved transgender children and adolescents, and five involved adolescents, so the findings are not evenly based on both age groups. An included manuscript was an expert report rather than a study with participants.
The easy way to misread this
Do not read the listed strategies as proven to improve care. The review reports themes from qualitative studies and an expert report, and the authors state that this design does not allow demonstrating the magnitude of the barriers or strategies.