期刊
JOURNAL OF EMERGENCY MEDICINE
卷 61, 期 4, 页码 396-404出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jemermed.2021.04.013
关键词
transgender; gender nonbinary; emergency department; gender-affirming care; health care discrimination
资金
- Patient Centered Outcomes Research Institute (PCORI) Pipeline to Proposals Tier III award [3414216]
- Eugene Washington Engagement Award from PCORI [AWD00053393]
- Arkansas Center for Minority Health Disparities - National Center on Minority Health and Health Disparities at the National Institutes of Health (NIH)/National Institute on Minority Health and Health Disparities [5U54MD002329]
- University of Arkansas [DA022981]
- Translational Research Institute - NIH National Center for Advancing Translational Sciences [UL1 TR003107]
Transgender and gender nonbinary individuals in the United States face barriers to accessing healthcare due to discrimination, which can lead to avoidance or delays in seeking care. This study explored experiences of trans/NB individuals in emergency departments and highlighted the importance of improving clinician knowledge, ED policies, and electronic health record documentation for gender-affirming care.
Background: Transgender and gender nonbinary (trans/NB) individuals face many barriers to accessing health care in the United States due to systemic and clinician discrimination. Such experiences can lead to avoidance or delays in seeking care. These issues are relevant for emergency department (ED) clinicians and staff because trans/NB patients may use the ED in times of crisis. Objectives: The purpose of this study was to qualitatively explore experiences of trans/NB individuals accessing health care in the ED and provide recommendations for improvements. Methods: This study involved semi-structured qualitative interviews with nine trans/NB individuals living in Arkansas about their experiences when visiting local EDs. Results: Interviews revealed four main themes: 1) system and structural issues; 2) interactions with clinicians/staff influence care received; 3) perceptions of clinician knowledge and education about trans/NB health; and 4) impact on future health and health care access. Participants recommended education for current and future ED clinicians and staff to improve knowledge of best practices for trans/NB health care. Recommendations were also made to improve ED policy for inclusive and affirming intake processes, intake forms, and electronic health record (EHR) documentation, including documentation and use of patients' chosen name and pronouns. Conclusion: The negative experiences and discrimination reported by trans/NB patients in ED visits underscores the importance of improving ED clinician knowledge of gender-affirming care practices, ED intake policies and practices, and EHR documentation in EDs. Published by Elsevier Inc.
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