PDF(Pubmed)
Abstract：
UNASSIGNED: Access to gender-affirming medical care has life-saving effects on transgender and gender diverse (TGD) individuals. An increasing number of TGD individuals seek care which led to waiting times of years. We assessed the duration and effects of excessive waiting for gender-affirming care.
UNASSIGNED: In this mixed-methods cross-sectional population study, conducted in the Netherlands between June and August 2019, all TGD individuals with experiences with receiving/applying for gender-affirming medical care could participate. Data of participants waiting for care was primarily analyzed. Demographic characteristics and requested care (multiple-choice questions) and the effects of waiting on health were surveyed (open-ended questions). Descriptive statistics were calculated per treatment, and differences in participant characteristics between those waiting for and already in care were assessed through Chi squared tests and post-hoc testing of residuals. Open text answers were thematically analyzed.
UNASSIGNED: Of all 975 participants, 431 (44.2%) waited for gender-affirming medical care. For 10 out of 20 treatment modalities, the median waiting period was more than a year. Participants already in care were on average higher educated and less-frequently non-binary. Subjective effects of waiting were (very) negative for most treatments. Qualitative findings showed that long waiting was associated with a range of psychosocial distress, poorer health, increasing healthcare consumption, and increased inequality between TGD individuals.
UNASSIGNED: Findings confirm that TGD individuals encounter long waiting times in multiple stages of their gender-affirming medical care. Waiting affects both physical and psychosocial health. Individual resilience and resources can mitigate these experiences, which increase inequality within this already marginalized group.
UNASSIGNED: Ministry of Health, Welfare and Sport of the Netherlands and Zorgverzekeraars Nederland (Healthcare Insurers Netherlands).
UNASSIGNED: In this mixed-methods cross-sectional population study, conducted in the Netherlands between June and August 2019, all TGD individuals with experiences with receiving/applying for gender-affirming medical care could participate. Data of participants waiting for care was primarily analyzed. Demographic characteristics and requested care (multiple-choice questions) and the effects of waiting on health were surveyed (open-ended questions). Descriptive statistics were calculated per treatment, and differences in participant characteristics between those waiting for and already in care were assessed through Chi squared tests and post-hoc testing of residuals. Open text answers were thematically analyzed.
UNASSIGNED: Of all 975 participants, 431 (44.2%) waited for gender-affirming medical care. For 10 out of 20 treatment modalities, the median waiting period was more than a year. Participants already in care were on average higher educated and less-frequently non-binary. Subjective effects of waiting were (very) negative for most treatments. Qualitative findings showed that long waiting was associated with a range of psychosocial distress, poorer health, increasing healthcare consumption, and increased inequality between TGD individuals.
UNASSIGNED: Findings confirm that TGD individuals encounter long waiting times in multiple stages of their gender-affirming medical care. Waiting affects both physical and psychosocial health. Individual resilience and resources can mitigate these experiences, which increase inequality within this already marginalized group.
UNASSIGNED: Ministry of Health, Welfare and Sport of the Netherlands and Zorgverzekeraars Nederland (Healthcare Insurers Netherlands).
摘要：
■获得性别确认医疗服务对跨性别者和性别多样化（TGD）个体具有挽救生命的作用。越来越多的TGD个人寻求护理，这导致了多年的等待时间。我们评估了过度等待性别确认护理的持续时间和效果。
■在这项混合方法横断面人口研究中，2019年6月至8月在荷兰进行,所有有接受/申请性别确认医疗经验的TGD个人都可以参加.主要分析了等待护理的参与者的数据。调查了人口统计特征和要求的护理（多项选择题）以及等待对健康的影响（开放式问题）。每次治疗计算描述性统计数据，我们通过卡方检验和残差事后检验评估了等待和已经接受护理的参与者之间的参与者特征差异.对开放文本答案进行了主题分析。
■在所有975名参与者中，431人（44.2%）等待性别确认医疗。对于20种治疗方式中的10种，等待期中位数超过一年。已经接受护理的参与者平均受教育程度较高，非二进制的频率较低。等待的主观效果对于大多数治疗是(非常)负面的。定性研究结果表明，长时间的等待与一系列社会心理困扰有关，健康状况较差,增加医疗保健消费，以及TGD个体之间的不平等加剧。
研究结果证实，TGD个体在确认性别的医疗护理的多个阶段都会遇到很长的等待时间。等待影响身体和社会心理健康。个人的弹性和资源可以减轻这些体验，这加剧了这个已经被边缘化的群体内部的不平等。
■卫生部，荷兰和ZorgverzekeraarsNederland的福利和体育(荷兰医疗保险公司)。
■在这项混合方法横断面人口研究中，2019年6月至8月在荷兰进行,所有有接受/申请性别确认医疗经验的TGD个人都可以参加.主要分析了等待护理的参与者的数据。调查了人口统计特征和要求的护理（多项选择题）以及等待对健康的影响（开放式问题）。每次治疗计算描述性统计数据，我们通过卡方检验和残差事后检验评估了等待和已经接受护理的参与者之间的参与者特征差异.对开放文本答案进行了主题分析。
■在所有975名参与者中，431人（44.2%）等待性别确认医疗。对于20种治疗方式中的10种，等待期中位数超过一年。已经接受护理的参与者平均受教育程度较高，非二进制的频率较低。等待的主观效果对于大多数治疗是(非常)负面的。定性研究结果表明，长时间的等待与一系列社会心理困扰有关，健康状况较差,增加医疗保健消费，以及TGD个体之间的不平等加剧。
研究结果证实，TGD个体在确认性别的医疗护理的多个阶段都会遇到很长的等待时间。等待影响身体和社会心理健康。个人的弹性和资源可以减轻这些体验，这加剧了这个已经被边缘化的群体内部的不平等。
■卫生部，荷兰和ZorgverzekeraarsNederland的福利和体育(荷兰医疗保险公司)。
