Perceptions of Trans and Gender Non-Conforming People on General Health Care in the Being LGBTQI+ in Ireland Study.

Abstract

AIM To examine if trans and gender non-conforming participants perceive greater healthcare inequities in their interactions with healthcare practitioners than cisgender sexual minority participants, and analyse free text responses from transgender and gender non-conforming participants to gain possible insight into causes of inequities. DESIGN A cross-sectional study. METHODS An anonymous online survey of over 2800 self-selecting LGBTQI+ participants, 30% of whom identified as trans and gender non-conforming. The research team devised closed and open-ended questions about perceptions of healthcare provision and analysed quantitative responses using SPSS and open-ended data through thematic analysis. RESULTS Over half of trans and gender non-conforming participants reported having had occasion to educate healthcare professionals about LGBTQI+ identities and a majority reported that healthcare professionals made incorrect assumptions about their LGBTQI+ identity. Invalidation and pathologisation of participants' trans and gender non-conforming identity and unhelpful therapeutic approaches were some of the negative health experiences cited. CONCLUSION Trans and gender non-conforming populations experience significant barriers to healthcare relative to their cisgender sexual minority peers. Cisnormative thinking in healthcare practice together with a lack of knowledge of trans and gender non-conforming people's experiences leads to substandard care and acts as a barrier to disclosure and help seeking. IMPLICATIONS Culturally responsive healthcare is critical to ending health inequities experienced by trans and gender non-conforming people. IMPACT Problem addressed: Healthcare inequities among trans and gender non-conforming participants. MAIN FINDINGS Trans and gender non-conforming participants reported more negative perceptions of their healthcare experiences compared to cisgender sexual minority participants. Where and on whom will the research have an impact? Healthcare educators/practitioners. REPORTING METHOD Strobe. PUBLIC OR PATIENT CONTRIBUTION Members of the LGBTQI+ community were part of the research advisory group and inputted into paper authorship. PAPER CONTRIBUTION TO THE WIDER GLOBAL CLINICAL COMMUNITY Highlights the need for training to increase cultural competency among healthcare providers.