Description
Introduction/Background
Access to healthcare for transgender and gender diverse individuals is marked by significant inequalities in France as well as elsewhere, notably due to stigmatization. The literature provides information on the difficulties and obstacles encountered by transgender individuals, attesting that few professionals are engaged in their healthcare which hinders access to care. However, some professionals have committed themselves to this support, and understanding their experience can inform us about ways to overcome these challenges and identify key drivers and recommendations.
Specific Aim
This contribution proposes an original analytical perspective by exploring the experiences, motivations, and strategies mentioned by professionals in the medical-social field engaged in supporting transgender health.
Materials and Methods
As part of FOREST, a community-based research done in collaboration between the Université Lyon 2, community- based organization (CBO) OUTrans and the Université de Lausanne, thirteen professionals trusted by the trans community were interviewed individually and then in a focus group. Data collection was done by trained researchers who are also members of the LGBTQIA+, using semi-structured guides. A thematic content analysis was conducted to identify improvement proposals to facilitate access to healthcare for transgender individuals, involving the participation of university and CBO members.
Results
The main drivers to their work identified by the interviewees include their professional posture marked by a horizontal approach to patients, a commitment to rectify perceived injustices, and working with teams committed to promote adequate care for transgender individuals. The primary barriers include the absence of formal training and official guidelines to inform their clinical practice, technical and administrative obstacles imposed linked to the healthcare system's organization, and apprehensions about exceeding their scope of expertise. The interviewees advocate for the formulation of recommendations regarding public health policies such as collaborative work with affected individuals and support for organizations representing affected individuals, the formulation of recommendations by the French High Authority of Health, and the production of robust scientific data. They also recommend implementing training on the subject in initial or continuing education, prioritizing co-constructed content with affected individuals. Regarding the support of healthcare journeys, participants assert that access inequalities will be reduced by increasing healthcare offerings and the number of professionals involved in this normalized support.
Conclusion
Enhancing healthcare access for transgender individuals in France requires a robust framework of official recommendations, grounded in scientific evidence and developed in collaboration with the transgender community, as well as expanding the pool of professionals working in this field. The lack of precise recommendations hinders both the practice of professionals committed to improving such access, and the number of healthcare providers willing to get involved in it. These recommendations for improving access to healthcare for transgender individuals could be beneficial for all individuals seeking care, as well as for professionals engaging in it, fostering more inclusive professional practices and attitudes.