They Just Don't Get Me: A Qualitative Analysis of Transgender Women's Health Care Experiences and Clinician Interactions.
Dana D Hines, Esther R Laury, Barbara Habermann
PMID 31461741WHAT IT FOUND
Transgender women living with HIV distinguished clinicians who 'get' them, who provide gender-affirming care and willingness to learn, from those who 'don't', who misgender patients or refuse care.
Patients reported that misgendering and discomfort discouraged them from returning for future care.
Key findings
01Participants categorized clinicians into two types: those who provided gender-affirming care, were willing to learn, or shared social identities, and those who were aloof, uncomfortable, or refused care.
02Instances of misgendering were distressing and discouraged participants from returning for future care, with one participant stating a clinician's comment made her consider suicide.
03Participants reported unmet needs regarding breast and genitourinary health, often attributing this to clinician inexperience with transgender-specific anatomy and risks.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample size was small (18 participants), so not all clinician types or experiences may have been captured. All participants were living with HIV, so their experiences with stigma and care may differ from transgender women who are HIV-negative. The study did not capture the perspectives of the clinical staff themselves. Participants were recruited in Indiana, which may limit generalizability to other regions.
Declared interests
The authors report no real or perceived vested interests related to this article.
The easy way to misread this
Do not interpret the reported 'clinician types' as evidence that specific training interventions improve patient outcomes. This study describes patient perceptions and experiences; it does not test whether the recommended changes actually reduce disparities or improve health metrics.