跨性别美国人与过渡相关的手术程序的社会和系统障碍
Andrew A Marano1, Amitai S Miller2,3, Wendy Castillo4
1Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
LGBT health
|June 7, 2024
概括
跨性别和性别多元 (TGD) 个人的性别肯定手术的获取受到系统性障碍的限制. 改善接入需要解决法律保护,提供商的可用性和TGD人员的保险覆盖.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
- 健康 公平 卫生 公平
背景情况:
- 变性人和性别多元 (TGD) 个体在美国经历了严重的医疗保健准入障碍.
- 与过渡有关的手术是许多TGD个体性别肯定的一个关键组成部分.
- 了解手术障碍对于改善健康结果至关重要.
研究的目的:
- 为了比较经过性别确认手术的TGD个体的特征与没有经历过手术的TGD个体.
- 识别影响过渡期相关手术获取的社会和系统障碍.
- 根据人口统计和法律/保险因素,探索手术接入的差异.
主要方法:
- 来自2015年美国跨性别调查 (n≈28,000名TGD成年人) 的数据分析.
- 多变量后勤回归模型,以确定接受性别确认手术的相关性.
- 小组分析检查保险类型,手术保险和提供者网络.
主要成果:
- 21.7%的参与者报告经历过与过渡有关的程序.
- 接受手术的机会与年龄较大,收入较高,高等教育和生活在性别一致的环境有关.
- 障碍包括出生时分配的男性性别,识别为非二进制或性少数群体,缺乏知识博的提供者,以及居住在没有跨性别保护法律的州.
- 黑人,拉丁裔和其他种族/少数民族的TGD个人面临着更大的健康公平障碍.
结论:
- 性别确认手术的准入在人口统计和可修改因素之间分布不均.
- 需要采取干预措施,以增加跨性别健康专业提供者的数量和地理分布.
- 加强对TGD个人,特别是少数群体的法律保护和医疗保险准入至关重要.
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