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Voices from a Multidisciplinary Healthcare Center: Understanding Barriers in Gender-Affirming Care—A Qualitative Exploration

Author

Listed:
  • Maeghan B. Ross

    (Department of Plastic Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands
    Amsterdam Public Health Institute, 1081 BT Amsterdam, The Netherlands)

  • Hiba Jahouh

    (Department of Plastic Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands)

  • Margriet G. Mullender

    (Department of Plastic Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands
    Amsterdam Public Health Institute, 1081 BT Amsterdam, The Netherlands)

  • Baudewijntje P. C. Kreukels

    (Amsterdam Public Health Institute, 1081 BT Amsterdam, The Netherlands
    Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands)

  • Tim C. van de Grift

    (Department of Plastic Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands
    Amsterdam Public Health Institute, 1081 BT Amsterdam, The Netherlands
    Department of Medical Psychology and Psychiatry, Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands)

Abstract

When seeking gender-affirming care, trans* and gender-diverse individuals often describe experiencing barriers. However, a deeper understanding of what constitutes such barriers is generally lacking. The present research sought to better understand the barriers trans* and gender-diverse individuals experienced, and their effects, when seeking gender-affirming care in the Netherlands. Qualitative interviews were conducted with trans* and gender-diverse individuals who sought care at a Dutch multidisciplinary medical center. Twenty-one participants were included, of which 12 identified as (trans) male, six identified as (trans) female, one as trans*, and one as gender-nonconforming (GNC)/non-binary. The interviews were mostly conducted at the homes of the participants and lasted between 55 min and 156 min (mean = 85 min). Following data collection and transcription, the interviews were analyzed using axial coding and thematic analysis. A total of 1361 codes were extracted, which could be classified into four themes describing barriers: lack of continuity: organizational and institutional factors (n codes = 546), patient–staff dynamics (n codes = 480), inadequate information and support (n codes = 210), and lack of autonomy in decision making (n codes = 125). Within our study, trans* and gender-diverse individuals described encountering multiple and diverse barriers when seeking gender-affirming care in the Netherlands. Future studies are needed to evaluate whether individualized care, the decentralization of care, and the use of decision aids can improve the experienced barriers of trans* and gender-diverse individuals seeking gender-affirming care within the Dutch healthcare system.

Suggested Citation

  • Maeghan B. Ross & Hiba Jahouh & Margriet G. Mullender & Baudewijntje P. C. Kreukels & Tim C. van de Grift, 2023. "Voices from a Multidisciplinary Healthcare Center: Understanding Barriers in Gender-Affirming Care—A Qualitative Exploration," IJERPH, MDPI, vol. 20(14), pages 1-20, July.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:14:p:6367-:d:1194886
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    References listed on IDEAS

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    1. Bradford, J. & Reisner, S.L. & Honnold, J.A. & Xavier, J., 2013. "Experiences of transgender-related discrimination and implications for health: Results from the Virginia transgender health initiative study," American Journal of Public Health, American Public Health Association, vol. 103(10), pages 1820-1829.
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