血液学家为跨性别青年提供护理的舒适度和经验

Eric S. Mullins , Tanya L. Kowalczyk Mullins
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引用次数: 0

摘要

【摘要】先前存在血栓危险因素的跨性别和性别多样化(TG)人群在开始性别确认激素治疗(GAHT)之前可能需要进行血液学评估。由于没有关于血栓形成风险管理的正式指南,因此可能会出现管理上的差异。我们描述了血液学家在照顾TG青年方面的经验和舒适度,并探讨了在GAHT前推荐血栓预防的经验。在美国中西部从事护理年龄≤22岁青年的血液学家完成了半结构化访谈,评估人口统计学、实践特征、护理TG患者的舒适度、TG临床护理教育、改善舒适度的建议干预措施,以及在GAHT前推荐和/或开血栓预防处方的经验。在接受采访的15名血液学家中(12名儿科,2名成人,1名受过双重训练),几乎所有人都照顾过TG青少年(n = 12)或年轻人(n = 14)。参与者报告说,在询问名字、代词和性别转换过程的知识时,他们的舒适度各不相同。尽管大多数血液学家报告说他们接受过一些TG临床护理方面的教育,但这主要发生在正式培训完成之后。建议的干预措施包括教育血液学家关于性别护理的知识,改变电子医疗记录,以及更多与GAHT相关的血栓形成风险数据。三分之一的参与者在GAHT前推荐并开始了血栓预防。另外五名血液学家在GAHT前对年轻人进行了评估,但没有推荐血栓预防。由于血液学家在GAHT前评估患者潜在的血栓预防,因此需要对TG患者进行护理教育和血栓风险数据,以改善对这一人群的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hematologists’ comfort and experiences with providing care to transgender youth

Abstract

Transgender and gender-diverse (TG) people with preexisting risk factors for thrombosis may seek hematologic evaluation before starting gender-affirming hormone therapy (GAHT). Because no formal guidelines on management of thrombosis risk exist, variations in management are likely to occur. We characterized hematologists’ experience and comfort with caring for TG youth and explored experiences with recommending thromboprophylaxis before GAHT. Hematologists caring for youth aged ≤22 years and practicing in the midwestern United States completed semistructured interviews assessing demographics, practice characteristics, comfort with caring for TG people, education in TG clinical care, suggested interventions to improve comfort, and experiences with recommending and/or prescribing thromboprophylaxis before GAHT. Of the 15 hematologists interviewed (12 pediatric, 2 adult, and 1 dual trained), nearly all had cared for TG adolescents (n = 12) or young adults (n = 14). Participants reported variable comfort with asking about name and pronouns and knowledge about the gender transition process. Although most hematologists reported having had some education about TG clinical care, this primarily occurred after formal training was completed. Suggested interventions to increase comfort with caring for TG youth included educating hematologists about gender care, changes in the electronic medical record, and more data on thrombosis risk associated with GAHT. One-third of participants had recommended and started thromboprophylaxis for patients before GAHT. Five additional hematologists had evaluated youths before GAHT but had not recommended thromboprophylaxis. Because hematologists are evaluating patients for potential thromboprophylaxis before GAHT, education about caring for TG people and data about thrombosis risk are needed to improve care for this population.
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