The role of primary care physicians

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A new study highlights the importance of positive interactions between transgender people and their doctors. Nolwen Cifuentes/Getty Images
  • A new study that took place in New Zealand has shown that, for transgender people, negative experiences with healthcare professionals are associated with an increased risk of psychological distress and suicidal thoughts.
  • In contrast, positive or positive experiences with primary care physicians (PCPs) reduced the risk of these negative mental health outcomes.
  • This study highlights the importance of improving awareness and education of PCPs about transgender health care.

Studies have consistently shown that transgender people have a higher risk of mental health problems than cisgender people.

A new study has found that transgender people who reported having had supportive experiences with their PCP were less likely to have symptoms of anxiety or depression or to have suicidal thoughts.

However, only about half of those surveyed reported a positive experience with their PCP, highlighting the importance of training healthcare professionals to improve care for transgender people.

The study appears in the journal Family medicine.

Negative interactions with healthcare professionals are common among transgender people. A lack of awareness and education among medical personnel about the health needs of transgender people are some of the reasons for these negative health care experiences.

However, even small steps indicating respect for transgender people, such as using correct gender pronouns and current names, can contribute to a positive healthcare experience.

Previous studies showed that frequent negative healthcare experiences of transgender people are associated with a higher risk of depression and suicidal thoughts.

However, the current study is the first to assess the effects of positive or supportive healthcare experiences on mental health outcomes among transgender people in New Zealand.

The researchers used data from 2018 count survey, which collects information on the health of transgender people aged 14 or over residing in New Zealand.

The study included 948 transgender people who provided feedback about their negative and positive healthcare experiences and mental health.

The scientists used a standardized questionnaire to assess levels of psychological distress based on the anxiety and depressive symptoms the individuals had experienced over the previous 4 weeks.

The researchers also determined the number of self-harm attempts and the frequency of suicidal thoughts or behaviors over the previous 12 months.

Part of the questionnaire assessed the most common negative experiences people had when dealing with healthcare professionals, including doctors, nurses and administrative staff.

It revealed that 47% of participants had to educate healthcare professionals about transgender people to receive the necessary care.

Participants also reported that they frequently encountered unnecessary or intrusive questions from healthcare professionals. Another common experience of transgender people was that medical professionals admitted to a lack of adequate knowledge about gender-affirming treatments.

These negative health experiences were associated with increased psychological distress and a higher risk of self-harm or suicide.

Questions about supportive interactions assessed the positive experiences transgender people had with their PCP.

The survey found that only 57% of people felt their PCP treated them the same as other patients when they sought care for reasons unrelated to gender-affirming care.

Only 48% of survey participants perceived their PCPs as supportive of their gender-affirming healthcare needs.

Less than a quarter of PCPs had adequate knowledge about gender-affirming care, and about 43% showed a willingness to acquire the necessary knowledge about gender-affirming care.

Similarly, only 40% of PCPs used the correct gender pronouns and 47% used the person’s current name.

The researchers found that a higher number of supportive experiences with PCPs was associated with lower psychological distress and a reduced likelihood of a suicide attempt in the previous year.

Each additional positive experience with PCP reduced the risk of suicide attempt by 11%. Similarly, each negative experience was associated with a 20% increased risk of suicide attempt.

The co-author of the study, Dr. Gareth Treharneprofessor of psychology at the University of Otago in New Zealand, said Medical News Today:

“These findings demonstrate the importance of considering the protective effects of having primary care physicians supportive of the transgender patients they care for. These protective effects may counteract some of the harmful effects of negative health care experiences, but there is an urgent need to see improvements in the human rights aspects of supportive care for transgender people.

The authors note that medical training for primary care physicians in New Zealand does not include training in transgender health care.

The other co-author of the study, Dr. Rona Carrolllecturer in primary health care and general medicine at the University of Otago, said DTM:

“Medical schools have an important role to play in ensuring that our future physicians have the knowledge and confidence to provide supportive care to their transgender patients, and postgraduate general medicine training programs should integrate the care transgender health as a key competency in their curriculum. The positive impact this can have on patient outcomes is significant and the need is urgent.

Similarly, Dr. Treharne noted, “More training for primary care physicians is needed, and physicians must take responsibility for their own learning to meet the needs of transgender people. »

About Antoine L. Cassell

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