Why do transgender individuals experience discrimination in healthcare and thereby limited access to healthcare? An interview study exploring the perspective of German transgender individuals
Abstract Background Transgender individuals experience limited access to healthcare. This results not least from experiences of discrimination to which they are exposed in the health system. These contribute to transgender individuals having poorer health than cis individuals, i.e. individuals whose...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12939-023-02023-0 |
| _version_ | 1797577381374853120 |
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| author | Tobias Skuban-Eiseler Marcin Orzechowski Florian Steger |
| author_facet | Tobias Skuban-Eiseler Marcin Orzechowski Florian Steger |
| author_sort | Tobias Skuban-Eiseler |
| collection | DOAJ |
| description | Abstract Background Transgender individuals experience limited access to healthcare. This results not least from experiences of discrimination to which they are exposed in the health system. These contribute to transgender individuals having poorer health than cis individuals, i.e. individuals whose sex assigned at birth is in line with their gender identity. It is an ethical duty to take effective measures to minimize inequalities in medical care. At best, such measures should also be assessed as appropriate from the perspective of those affected in order to be accepted and thus effective. It is therefore important to know whether measures touch on the subjectively assumed reasons for experiences of discrimination. Hence, to be able to take appropriate measures, it is important to identify the reasons that transgender individuals see as causal for their experiences of discrimination in healthcare. Methods We conducted semi-structured interviews with 14 German transgender individuals and asked them about their own experiences of discrimination in healthcare and their assumptions on the reasons for discrimination. We analyzed the responses using the method of structured qualitative content analysis. Results 13 transgender individuals reported experiences of discrimination in healthcare. These emanated from different professional groups and took place in trans-specific as well as general medical settings. We were able to identify a total of 12 reasons that transgender individuals see as causal for their experiences of discrimination: (1) internalized trans-hostility and “protection” of cis individuals, (2) lack of knowledge/uncertainties regarding transition, (3) “protection” of a binary worldview, (4) binary worldview in medicine, (5) structural deficits, (6) asymmetric interactions with specialists, (7) current political debate, (8) view of transgender individuals as a “burden for society”, (9) objectification, (10) homophobia, (11) misogyny/androcentrism and (12) discrimination as reaction to discrimination. Conclusions German transgender individuals have a very differentiated picture regarding their subjective reasons for experiencing discrimination in healthcare. Overall, disrespect regarding gender identity and a confrontation with foreignness seems to be seen as the decisive factor. Thus, it is not enough to focus only on measures that aim to remedy the information deficit on the part of medical providers. Measures must be taken that can create a granting and respectful attitude towards transgender individuals. |
| first_indexed | 2024-03-10T22:07:24Z |
| format | Article |
| id | doaj.art-7695c501731f4d6c8a6c19c6ba9ec4cf |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-03-10T22:07:24Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-7695c501731f4d6c8a6c19c6ba9ec4cf2023-11-19T12:44:23ZengBMCInternational Journal for Equity in Health1475-92762023-10-0122111310.1186/s12939-023-02023-0Why do transgender individuals experience discrimination in healthcare and thereby limited access to healthcare? An interview study exploring the perspective of German transgender individualsTobias Skuban-Eiseler0Marcin Orzechowski1Florian Steger2Institute of the History, Philosophy and Ethics of Medicine, Faculty of Medicine, Ulm UniversityInstitute of the History, Philosophy and Ethics of Medicine, Faculty of Medicine, Ulm UniversityInstitute of the History, Philosophy and Ethics of Medicine, Faculty of Medicine, Ulm UniversityAbstract Background Transgender individuals experience limited access to healthcare. This results not least from experiences of discrimination to which they are exposed in the health system. These contribute to transgender individuals having poorer health than cis individuals, i.e. individuals whose sex assigned at birth is in line with their gender identity. It is an ethical duty to take effective measures to minimize inequalities in medical care. At best, such measures should also be assessed as appropriate from the perspective of those affected in order to be accepted and thus effective. It is therefore important to know whether measures touch on the subjectively assumed reasons for experiences of discrimination. Hence, to be able to take appropriate measures, it is important to identify the reasons that transgender individuals see as causal for their experiences of discrimination in healthcare. Methods We conducted semi-structured interviews with 14 German transgender individuals and asked them about their own experiences of discrimination in healthcare and their assumptions on the reasons for discrimination. We analyzed the responses using the method of structured qualitative content analysis. Results 13 transgender individuals reported experiences of discrimination in healthcare. These emanated from different professional groups and took place in trans-specific as well as general medical settings. We were able to identify a total of 12 reasons that transgender individuals see as causal for their experiences of discrimination: (1) internalized trans-hostility and “protection” of cis individuals, (2) lack of knowledge/uncertainties regarding transition, (3) “protection” of a binary worldview, (4) binary worldview in medicine, (5) structural deficits, (6) asymmetric interactions with specialists, (7) current political debate, (8) view of transgender individuals as a “burden for society”, (9) objectification, (10) homophobia, (11) misogyny/androcentrism and (12) discrimination as reaction to discrimination. Conclusions German transgender individuals have a very differentiated picture regarding their subjective reasons for experiencing discrimination in healthcare. Overall, disrespect regarding gender identity and a confrontation with foreignness seems to be seen as the decisive factor. Thus, it is not enough to focus only on measures that aim to remedy the information deficit on the part of medical providers. Measures must be taken that can create a granting and respectful attitude towards transgender individuals.https://doi.org/10.1186/s12939-023-02023-0Transgender individualsDiscriminationStigmatizationAccess to healthcare |
| spellingShingle | Tobias Skuban-Eiseler Marcin Orzechowski Florian Steger Why do transgender individuals experience discrimination in healthcare and thereby limited access to healthcare? An interview study exploring the perspective of German transgender individuals International Journal for Equity in Health Transgender individuals Discrimination Stigmatization Access to healthcare |
| title | Why do transgender individuals experience discrimination in healthcare and thereby limited access to healthcare? An interview study exploring the perspective of German transgender individuals |
| title_full | Why do transgender individuals experience discrimination in healthcare and thereby limited access to healthcare? An interview study exploring the perspective of German transgender individuals |
| title_fullStr | Why do transgender individuals experience discrimination in healthcare and thereby limited access to healthcare? An interview study exploring the perspective of German transgender individuals |
| title_full_unstemmed | Why do transgender individuals experience discrimination in healthcare and thereby limited access to healthcare? An interview study exploring the perspective of German transgender individuals |
| title_short | Why do transgender individuals experience discrimination in healthcare and thereby limited access to healthcare? An interview study exploring the perspective of German transgender individuals |
| title_sort | why do transgender individuals experience discrimination in healthcare and thereby limited access to healthcare an interview study exploring the perspective of german transgender individuals |
| topic | Transgender individuals Discrimination Stigmatization Access to healthcare |
| url | https://doi.org/10.1186/s12939-023-02023-0 |
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