Transgender and Gender NonConforming in the Emergency Department: Power Inequity, Stigma and Self-Efficacy
Methods: This retrospective, anonymous, written (paper and online), national study started in June 2012 and closed December 2014. 236 responses were analysed using a conceptual framework based on well accepted health behavioural theories. A team of six investigators developed a codebook that emerged from the participants’ responses and was applied to responses using NVivo 10. A data display was created to organize coded data into positive or negative categories and examined for emerging overarching themes.
Results: Using the above methods, the themes of Respect, Self-Efficacy and Power Inequity surfaced. These themes exposed the tension between self-identified TGGNC patients and providers who lack training in nonbinary gender identities or histories. When providers had specific training about this population, participants reported positive care experiences.
Conclusions: The traditional provider-patient power dynamic and trust is disrupted by the exposure of gaps in provider education and training around TGGNC care. Data from this study indicates that systematic training of ED providers, on how to interact with and the specific health issues of this diverse group, is necessary to improve the care of this marginalized population.
Learning Areas:Advocacy for health and health education
Diversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Define the terms "transgender" and "gender nonconforming." Explain how lack of provider awareness and expected gender binary contribute to negative experiences for TGGNC patients in US EDs. List three recommendations, of TGGNC persons, for ED providers to improve the care of TGGNC patients.
Keyword(s): Gender, Emergency Medical Services
Qualified on the content I am responsible for because: study conception, development, implementation, data analysis, manuscript drafting
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.