"I Should've Been Able to Decide for Myself, but I Didn't Want to Be Left Alone." A Qualitative Interview Study of Clients' Ethical Challenges and Norms Regarding Decision-Making in Gender-Affirming Medical Care.
Karl Gerritse, Casper Martens, Marijke A Bremmer, Baudewijntje P C Kreukels, Fijgje de Boer, Bert C Molewijk
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引用次数: 0
Abstract
This qualitative study aimed to map and provide insight into the ethical challenges and norms of adult transgender and gender diverse (TGD) clients in gender-affirming medical care (GAMC). By doing so, we seek to make an empirical and constructive contribution to the dialogue on and moral inquiry into what good decision-making in GAMC should entail. We conducted 10 semi-structured interviews with adult Dutch TGD people who received GAMC. In our thematic analysis, we (1) included both ethical challenges and norms, (2) differentiated between explicit and implicit ethical challenges and norms, and (3) ascertained the specific context in which the latter emerged. We identified the following themes: (1) clients should be in the lead, (2) harm should be prevented, and (3) the decision-making process should be attuned to the individual client. These themes arose in the context of (1) a precarious client-clinician relationship and (2) distinct characteristics of GAMC. Our findings highlight divergent and dynamic decisional challenges and normative views-both within individual clients and among them. We conclude that there is no single ideal model of good decision-making in GAMC and argue that elucidating and jointly deliberating on decisional norms and challenges should be an inherent part of co-constructing good decision-making.
期刊介绍:
The Journal of Homosexuality is an internationally acclaimed, peer-reviewed publication devoted to publishing a wide variety of disciplinary and interdisciplinary scholarship to foster a thorough understanding of the complexities, nuances, and the multifaceted aspects of sexuality and gender. The chief aim of the journal is to publish thought-provoking scholarship by researchers, community activists, and scholars who employ a range of research methodologies and who offer a variety of perspectives to continue shaping knowledge production in the arenas of lesbian, gay, bisexual, transgender (LGBT) studies and queer studies. The Journal of Homosexuality is committed to offering substantive, accessible reading to researchers and general readers alike in the hope of: spurring additional research, offering ideas to integrate into educational programs at schools, colleges & universities, or community-based organizations, and manifesting activism against sexual and gender prejudice (e.g., homophobia, biphobia and transphobia), including the promotion of sexual and gender justice.