Experiences of Transgender People in the Healthcare System: A Complex Analysis

2018 ◽  
Vol 8 (1) ◽  
pp. 56-61
Author(s):  
Kathryn Rotzinger

A nursing perspective following McIntyre and McDonald’s framework was used to unpack the complex issue of challenges faced by transgender people in the Canadian healthcare system, considering historical, ethical, legal, social, cultural, political, and economic perspectives. Transgender people have unique healthcare needs which are often misunderstood or unaddressed by healthcare professionals, leading to poorer outcomes and inequities. Issues concerning transgender people are becoming a focus and a higher priority for society. This literature review reveals the complexity of this issue as the roots in historical, ethical, legal, social, cultural, political, and economic contexts are explored. A variety of barriers and facilitators exist to addressing and resolving this issue, including transgender people avoiding healthcare, intolerance, lack of knowledge and understanding, lack of healthcare provider training, media representation, and economic costs. The analysis of this issue can be used to inform resolution strategies to utilize facilitators and overcome barriers, including increasing awareness and knowledge, improving education and healthcare provider competency, and utilizing nurse leaders as advocates, role models, and agents of change. Improving care of transgender people is a nursing leadership priority. By implementing the suggested resolution strategies, the healthcare system can begin to move towards a more inclusive, understanding, and holistic model of care to improve healthcare access and outcomes for transgender people.

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Naomi Tschirhart ◽  
Esperanza Diaz ◽  
Trygve Ottersen

Abstract Background Thai massage is a highly gendered and culturally specific occupation. Many female Thai masseuses migrate to Norway as marriage migrants and as such are entitled to the same public healthcare as Norwegian citizens. Additionally, anyone who is not fluent in Norwegian is entitled to have an interpreter provided by the public healthcare system. Norway and most other countries aspire to universal health coverage, but certain immigrant populations continue to experience difficulties accessing appropriate healthcare. This study examined healthcare access among Thai migrant masseuses in Oslo. Methods Guided by access to healthcare theory, we conducted a qualitative exploratory study in 2018 with Thai women working as masseuses in Oslo, Norway. Through semi-structured in-depth interviews with 14 Thai women, we explored access to healthcare, health system navigation and care experiences. We analyzed the data using thematic analysis and grouped the information into themes relevant to healthcare access. Results Participants did not perceive that their occupation limited their access to healthcare. Most of the barriers participants experienced when accessing care were related to persistent language challenges. Women who presented at healthcare facilities with their Norwegian spouse were rarely offered interpreters, despite their husband’s limited capacity to translate effectively. Cultural values inhibit women from demanding the interpretation services to which they are entitled. In seeking healthcare, women sought information about health services from their Thai network and relied on family members, friends and contacts to act as informal interpreters. Some addressed their healthcare needs through self-treatment using imported medication or sought healthcare abroad. Conclusions Despite having the same entitlements to public healthcare as Norwegian citizens, Thai migrants experience difficulties accessing healthcare due to pervasive language barriers. A significant gap exists between the official policy that professional interpreters should be provided and the reality experienced by study participants. To improve communication and equitable access to healthcare for Thai immigrant women in Norway, health personnel should offer professional interpreters and not rely on Norwegian spouses to translate. Use of community health workers and outreach through Thai networks, may also improve Thai immigrants’ knowledge and ability to navigate the Norwegian healthcare system.


Author(s):  
Gordon Moore ◽  
John A. Quelch ◽  
Emily Boudreau

Choice Matters: How Healthcare Consumers Make Decisions (and Why Clinicians and Managers Should Care) is a timely and thoughtful exploration of the controversial role of consumers in the U.S. healthcare system. In most markets today, consumers have more options and autonomy than ever before. Empowered consumers easily shop around for products and services that better meet their needs, and they widely share their reviews on social media to inform and influence other consumers. Businesses have responded with better experiences and prices to compete for consumers’ business. Though healthcare has lagged behind other industries in this respect, there is a rising tide of interest in consumer choice and empowerment in healthcare markets. However, most healthcare provider organizations, individual doctors, and health insurers are unprepared to consider patients as consumers. The authors draw upon the fields of medicine, marketing, management, psychology, and public policy as they take a substantive, in-depth look at consumer choice and point out its appropriate use, as well as its limitations. This book addresses perplexing issues, such as how healthcare differs from other consumer-driven markets, how consumers make healthcare decisions, and how increased consumer choice in healthcare can not only aid and empower American consumers but also improve the overall healthcare system.


Author(s):  
Gitte Normann ◽  
Kirsten Arntz Boisen ◽  
Peter Uldall ◽  
Anne Brødsgaard

AbstractObjectivesYoung adults with cerebral palsy (CP) face potential challenges. The transition to young adulthood is characterized by significant changes in roles and responsibilities. Furthermore, young adults with chronic conditions face a transfer from pediatric care to adult healthcare. This study explores how living with CP affects young adults in general, and specifically which psychosocial, medical and healthcare needs are particularly important during this phase of life.MethodsA qualitative study with data from individual, semi-structured, in-depth interviews with six young adults with CP (ages 21–31 years) were transcribed verbatim and analyzed. The participants were selected to provide a maximum variation in age, gender, Gross Motor Function Classification System score and educational background. A descriptive thematic analysis was used to explore patterns and identify themes.ResultsThree themes were identified: “Being a Young Adult”, “Development in Physical Disability and New Challenges in Adulthood” and “Navigating the Healthcare System”. The three themes emerged from 15 sub-themes. Our findings emphasized that young adults with CP faced psychosocial challenges in social relationships, participation in education and work settings and striving towards independence. The transition to young adulthood led to a series of new challenges that the young adults were not prepared for. Medical challenges included managing CP-related physical and cognitive symptoms and navigating adult health care services, where new physicians with insufficient knowledge regarding CP were encountered.ConclusionThe young adults with CP were not prepared for the challenges and changes they faced during their transition into adulthood. They felt that they had been abandoned by the healthcare system and lacked a medical home. Better transitional care is urgently needed to prepare them for the challenges in young adulthood.


2017 ◽  
Vol 23 (4) ◽  
pp. 319
Author(s):  
Del Lovett ◽  
Bodil Rasmussen ◽  
Carol Holden ◽  
Patricia M. Livingston

Meeting men’s health needs by improving healthcare service access is a key objective of comprehensive primary health care. The aims of this qualitative study were to explore the perception of nurses in men’s health services and to describe men’s expectation of the nurse. The comparative component identifies the barriers and facilitators to improved access to health services. A purposive sample of 19 nurses and 20 men was recruited from metropolitan and regional settings in the state of Victoria, Australia, and each participant was interviewed individually or as part of three focus groups. The main findings were: nurses and men were unclear on the role of the nurse in men’s health; and health promotion provided by nurses was predominantly opportunistic. Both participant groups indicated barriers to healthcare access related to: the culture and environment in general practice; limitation of Australia’s Medicare healthcare financing system; out-of-pocket costs, waiting time and lack of extended hours; and men not wanting to be perceived as complainers. Facilitators related to: positive inter-professional relations; effective communication; personal qualities; and level of preparedness of nurse education. The findings demonstrate a need for the role to be better understood by both men and nurses in order to develop alternative approaches to meeting men’s healthcare needs.


Author(s):  
Stéfane M. Kabene ◽  
Melody Wolfe ◽  
Raymond Leduc

The Canadian healthcare system strives to serve a population altered by ever-changing demographics, cultural shifts, and diverse societal populations, and to serve those in rural communities with remote access to health care. The following chapter examines Canada’s current healthcare system and the effects on demand for services and the supply of healthcare providers created by the need to service rural populations, by limited access to medical schools, and by the introduction of foreign medical/health professionals. More specifically, the chapter reviews the symptoms of a strained medical system plagued by “brain waste” due to the non-use of qualified immigrant healthcare professionals, long wait times as a result of inadequate staffing and resources, and a school system that hinders the development of aspiring medical care professionals from rural and international areas. If Canada is to face these challenges with efficacy and vigour, effective human resources management techniques and competent human resources professionals are a necessary prologue. Medical knowledge and skill must be valued; healthcare professionals should be utilized more efficiently to improve healthcare access and minimize brain waste.


2021 ◽  
pp. 456-472
Author(s):  
Liubovė Murauskienė

This chapter examines health politics and the compulsory health insurance system in Lithuania and traces the development of its healthcare system. Since the country declared independence from the Soviet Union in 1990, Lithuanian health politics have revolved around restructuring and rationalizing the overcapacities of the inherited healthcare system, increasing levels of public finance to those sufficient to meet healthcare needs, and making good on the patient rights implied by a universal system. Despite those efforts, high out-of-pocket payments remain an obstacle to health solidarity, healthcare provision—which is predominantly public—is overly dependent on inpatient care, and public financing measured as a share of GDP remains low. As the chapter outlines, other issues include low levels of satisfaction with and trust in the health system and the persistence of informal payments to ensure quality care.


2018 ◽  
Vol 46 (5) ◽  
pp. 632-655 ◽  
Author(s):  
Emmie Matsuno ◽  
Tania Israel

Transgender people experience disproportionately high mental and physical health risks. Minority stress theory identifies distal and proximal stressors that contribute to negative mental health outcomes for transgender people, and suggests that resilience factors can buffer the negative influence of these stressors. In this article, we aim to synthesize the psychological literature on resilience strategies among transgender people and position it within the minority stress framework and introduce an adapted model called the transgender resilience intervention model (TRIM). The TRIM suggests that social support, community belonging, family acceptance, participating in activism, having positive role models, and being a positive role model are group-level resilience factors. Self-worth, self-acceptance and/or pride, self-definition, hope, and transition are individual-level factors that promote resilience. Community, group, and individual interventions and their potential influence on resilience are discussed. The model calls for the development of additional interventions aimed at increasing resilience for transgender people.


2021 ◽  
Author(s):  
Dirk Lafaut

Abstract BackgroundUndocumented migrants experience multiple institutional and legal barriers when trying to access healthcare services. Due to such limitations, healthcare workers often experience ethical dilemmas when caring for undocumented migrants. This article aims to understand how individual healthcare workers who regularly take care of undocumented migrants deal with these dilemmas in practice. So far, the role of healthcare workers in this context has mainly been theorized through the lens of biopolitics, conceiving of healthcare workers as merely obedient instruments of humanitarian government or gatekeeping.MethodsBased on semi-structured, in-depth interviews and ethnographic observations with healthcare workers in Belgium, we explore how they ascribe meaning, reflect upon and give shape to care practices in relation to undocumented migrants. We use Foucault’s later work on care of the self to interpret the accounts given by the healthcare workers.ResultsHealthcare workers in clinical roles exercise a certain degree of freedom in relation to the existing limitations to healthcare access of undocumented migrants. They developed techniques such as purposefully being inattentive to the undocumented status of the migrants. They also try to master their affective responses and transform their bodily attitude towards undocumented patients. They perform practical mental exercises to remind themselves of their role or position in the wider healthcare system and about their commitment to treat all patients equally. These techniques and exercises are inspired by colleagues who function as role models, inspiring them to relate in an ethical way to limitations in healthcare access. The developed care practices sometimes reproduce, sometimes transform the legal and institutional limitations to care for undocumented migrants.ConclusionsThe findings nuance the biopolitical analysis regarding the role of healthcare workers in healthcare delivery to undocumented migrants that has been dominant so far. Theoretically this article provides a reconceptualization of healthcare ethics as care of the self, an ethical practice that is somewhat independent of the traditional professional ethics.Trial RegistrationMedical ethics committee UZ Jette, Brussels, Belgium – Registration date: 18/05/2016 – Registration number: B.U.N. 143201628279


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