Caring for Transgender and Gender Diverse Prehospital Patients: A NAEMSP Position Statement and Resource Document.

IF 2.1 3区 医学 Q2 EMERGENCY MEDICINE
Timothy Hong, Veronica Case, Andra M Farcas, Denise Whitfield, Gregory Muller, Shira A Schlesinger, Ameera S Haamid, Mikaela T Middleton, Amelia Breyre, Phudit Buaprasert, Kimberly Whitten-Chung, Kaia J C Lichtenbelt, Anjni P Joiner, Carolina Pereira, John Brown
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Abstract

Transgender and gender diverse (TGD) people have long faced significant barriers to safely accessing medical care-especially gender-affirming care, which has been shown to strikingly improve health outcomes like suicidality and depression. In the prehospital setting, gender-affirming care amounts to showing respect for the TGD patient's identified gender and maintaining a safe environment that fosters a positive therapeutic relationship throughout the encounter. This represents a challenge for many Emergency Medical Services (EMS) systems due to the lack of TGD-specific training for EMS clinicians, a paucity of TGD-specific research to inform EMS education and clinical care, and in some cases the resistance of EMS clinicians to such training. Transgender and gender diverse people are facing a regression in legal access to essential medical care. With this position statement, NAEMSP joins other professional medical societies in providing recommendations to improve care for TGD patients, thereby affirming TGD individuals' right to exist as their authentic selves, as well as their entitlement to the same high-quality prehospital medical care as their cisgender peers.

照顾跨性别和性别多样化的院前病人:NAEMSP 立场声明和资源文件。
长期以来,变性人和性别多元化(TGD)人士在安全获得医疗护理方面一直面临着巨大障碍,尤其是性别肯定护理,因为这种护理已被证明能够显著改善自杀和抑郁等健康状况。在院前环境中,性别肯定护理相当于尊重 TGD 患者所识别的性别,并在整个就医过程中维持一个能促进积极治疗关系的安全环境。这对许多紧急医疗服务(EMS)系统来说都是一项挑战,原因是缺乏针对紧急医疗服务临床医生的 TGD 培训,也缺乏针对 TGD 的研究来为紧急医疗服务教育和临床护理提供信息,在某些情况下,紧急医疗服务临床医生还抵制此类培训。变性人和性别多元化人群在合法获得基本医疗护理方面正面临着倒退。通过这份立场声明,NAEMSP与其他专业医学会一道,为改善对变性患者的护理提出建议,从而肯定变性者作为真实自我存在的权利,以及他们与顺性别者一样享有高质量院前医疗护理的权利。NAEMSP 建议:EMS 临床医生应保持与 TGD 群体相关的基本文化能力,包括熟悉与 TGD 相关的健康和医疗保健差异,将 TGD 群体视为未得到充分服务的群体,并了解污名化和变性恐惧症在造成差异方面的核心作用,以及使 TGD 日常生活复杂化的其他挑战。EMS 临床医生应表现出对 TGD 群体的文化谦逊,包括对知识差距的自我评估,以及对新的或不熟悉的想法、信息和来自不同生活经历者的建议持开放态度。EMS 临床医生应了解基本的 TGD 专用术语,并在直接护理患者、交接和记录时使用适当的语言,包括患者自称的姓名和代词。EMS 临床医生应将患者的 TGD 状态视为敏感的健康信息,并注意在未经患者明确许可的情况下不要无意中披露此信息。EMS 临床医生应基本了解社会转型和性别确认的医疗和手术治疗。EMS 临床医生在护理 TGD 患者时应采用创伤知情方法。EMS 教育和培训应纳入针对 TGD 患者综合护理的学习领域,教育内容应提供促进公平护理所需的具体知识和技能。未来的急救医疗研究应侧重于阐明 TGD 患者院前护理的差异和障碍,重点是患者体验和院前临床医生的教育。
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来源期刊
Prehospital Emergency Care
Prehospital Emergency Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.30
自引率
12.50%
发文量
137
审稿时长
1 months
期刊介绍: Prehospital Emergency Care publishes peer-reviewed information relevant to the practice, educational advancement, and investigation of prehospital emergency care, including the following types of articles: Special Contributions - Original Articles - Education and Practice - Preliminary Reports - Case Conferences - Position Papers - Collective Reviews - Editorials - Letters to the Editor - Media Reviews.
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