Nursing care as perceived by trans persons: a phenomenological approach
DOI:
https://doi.org/10.15649/cuidarte.3767Keywords:
Nursing Care, Nursing, Gender Identity, Qualitative Research, Transgender PersonsAbstract
Highlights
- Most trans people highlight the importance of using their social name as a sign of respect for their gender identity. However, to a lesser extent, some discriminatory attitudes on the part of nurses persist.
- Trans people face significant barriers to accessing adequate medical care, including the lack of specific services for their community.
- The perception of quality of care for trans people is influenced, among other factors, by the age of the nursing professionals who provide it.
- Nursing professionals show respect for the gender identity of their patients when providing care, however, a lack of knowledge on gender issues is identified.
Introduction: Trans persons require particular and specific care, as well as equitable and egalitarian treatment corresponds to an ethical obligation for nurses. In health centers, the care relationship between nurses and trans patients remains unexplored in its entirety. Objective: To unveil the nursing care perceived by trans persons in Chilean health centers. Materials and Methods: Qualitative study, based on a phenomenological design according to Alfred Schutz. The data were collected through an in-depth interview conducted through Google Meet, then for the analysis of the data, the guidelines suggested by social phenomenology were followed. To safeguard the credibility, consistency and accuracy of the results, Lincoln and Guba's criteria of rigor were used. Results: The data were saturated with 9 participants from different regions of Chile. Four themes emerged from the research that describe the perception of trans persons in relation to the nursing care received: characteristics of humanized care; care in an ethical-legal perspective; facilitating factors for care and hindering factors for care. Discussion: Findings exposed in other studies were found, such as the need for gender training for nurses and the challenges and structural barriers faced by trans people; on the contrary, competent trans care practices and with respect to gender identity that differ from those referred to by other studies are highlighted. Conclusions: Nursing care perceived by trans persons is a complex phenomenon, influenced by various personal factors, experiences, feelings and emotions that shape the perception and quality of care.
How to cite this article: Álvarez-Muñoz Edgardo, Barrios-Casas Sara. Nursing care as perceived by trans persons: A phenomenological approach. Revista Cuidarte. 2024;15(3):e3767. https://doi.org/10.15649/cuidarte.3767
References
Winter S, Diamond M, Green J, Karasic D, Reed T, Whittle S, Wylie K. Transgender people: health at the margins of society. The Lancet. 2016;388(10042):390–400. https://doi.org/10.1016/s0140-6736(16)00683-8
Organización de Naciones Unidas. Declaración Universal de Derechos Humanos. París: ONU; 1948. Consulta: Julio 15, 2023. Disponible en: https://www.refworld.org.es/docid/47a080e32.html
Comisión Interamericana de Derechos Humanos. Informe sobre Personas Trans y de Género Diverso y sus derechos económicos, sociales, culturales y ambientales. CIDH; 2020. Consulta: Julio 15, 2023. Disponible en: https://www.oas.org/es/cidh/informes/pdfs/PersonasTransDESCA-es.pdf
Comisión Internacional de Juristas. Principios de Yogyakarta. Principios sobre la aplicación de la legislación internacional de derechos humanos en relación con la orientación sexual e identidad de género. Yogyakarta: ICJ; 2007. Consulta: julio 15, 2023. Disponible en: https://www.refworld.org/cgi-bin/texis/vtx/rwmain/opendocpdf.pdf?reldoc=y&docid=48244e9f2
Arayasirikul S, Turner C, Trujillo D, Sicro SL, Scheer S, McFarland W, Wilson EC. A global cautionary tale: discrimination and violence against trans women worsen despite investments in public resources and improvements in health insurance access and utilization of health care. Int J Equity Health. 2022;21(1):1–11. https://doi.org/10.1186/s12939-022-01632-5
Poteat T, Scheim A, Xavier J, Reisner S, Baral S. Global Epidemiology of HIV Infection and Related Syndemics Affecting Transgender People. J Acquir Immune Defic Syndr. 2016;72:210–9.https://doi.org/10.1097/qai.0000000000001087
Malta M, Cardoso R, Montenegro L, de Jesus JG, Seixas M, Benevides B, et al. Sexual and gender minorities rights in Latin America and the Caribbean: a multi-country evaluation. BMC Int Health Hum Rights. 2019;19(1):1-16.https://doi.org/10.1186/s12914-019-0217-3
Galaz C, Sepúlveda M, Poblete R, Troncoso L, Morrison R. Derechos LGTBI en Chile: Tensiones en la constitución de otredades sexualizadas. Psicoperspectivas. 2018;17(1):1–11. https://www.psicoperspectivas.cl/index.php/psicoperspectivas/article/viewFile/1165/743
Reconoce y da protección al derecho a la identidad de género, Ley n.º 21120. Diario Oficial, (10 de diciembre de 2018); Chile. Consulta: Julio 15, 2023. Disponible en: https://www.leychile.cl/Navegar?idNorma=1126480
Ministerio de Salud. Circular N°21: Reitera instrucción sobre la atención de personas trans en la red asistencial. Santiago de Chile: MINSAL; 2012. Consulta: Julio 15, 2023. Disponible en: https://diprece.minsal.cl/wrdprss_minsal/wp-content/uploads/2015/01/CIRCULAR-21-Reitera-Atenci%C3%B3n-de-personas-trans.pdf
Linker D, Marambio C, Rosales F. Informe sobre Encuesta T 1era encuesta para personas trans y género no-conforme en Chile. Santiago de Chile; 2017. Consulta: Julio 15, 2023. Disponible en: https://otdchile.org/wp-content/uploads/2020/05/Informe_ejecutivo_Encuesta-T.pdf
Duarte DD, Queluci G de C, Ferreira HC, Chiszostimo MM. A pespectiva do enfermeiro no cuidado diante da pessoa trans. Res Soc Dev. 2020;9(4):1–22. https://rsdjournal.org/index.php/rsd/article/view/2845/2262
Coleman E, Radix AE, Bouman WP, Brown GR, de Vries AL, Deutsch MB, et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal Transgender Health. 2022;23(1):1–259. https://doi.org/10.1080/26895269.2022.2100644
Suess-Schwend A. Trans health care from a depathologization and human rights perspective. Public Health Reviews. 2020;41(3):1–17.https://doi.org/10.1186/s40985-020-0118-y
García-Acosta JM, Castro-Peraza ME, Arias-Rodríguez MA, Llabrés-Solé R, Lorenzo-Rocha ND, Perdomo-Hernández AM. Atención sanitaria trans* competente, situación actual y retos futuros. Revisión de la literatura. Enfermería Glob. 2019;18(4):529–541. http://dx.doi.org/10.6018/eglobal.18.4.357621
Sherman A, Mcdowell A, Clark K, Balthazar M, Klepper M, Bower K. Transgender and gender diverse health education for future nurses: Students’ knowledge and attitudes. Nurse Educ Today. 2021;97:1–15.https://doi.org/10.1016/j.nedt.2020.104690
Consejo Internacional de Enfermeras. Código de Ética del CIE para las Enfermeras. Ginebra: CIE; 2021. Consulta: Agosto 10, 2023. Disponible en: https://www.icn.ch/system/files/2021-10/ICN_Code-of-Ethics_SP_WEB.pdf
Colegio de Enfermeras de Chile. Codigo de Ética del Colegio de Enfermeras de Chile. Santiago de Chile; 2008. Consulta: Agosto 10, 2023. Disponible en:https://www.enfermeriaaps.com/portal/?wpfb_dl=3611
Guelbert C. Nursing considerations for transgender men. Nursing. 2022;52(1):18–22. https://doi.org/10.1097/01.NURSE.0000803428.47117.80
Schutz A. A Construção significativa do mundo social: Uma introdução à sociologia compreensiva. Editora Vozes; 2018.
Rizo García M. Sociología Fenomenológica y Comunicología Histórica. La Sociología Fenomenológica y sus aportaciones al pensamiento en comunicación. Mediaciones Soc. 2009;(4):75-111 https://revistas.ucm.es/index.php/MESO/article/view/MESO0909120075A/21206
Cruz Riveros C. La naturaleza del cuidado humanizado. Enfermeria (Montev.). 2020;9(1):19–30.https://doi.org/10.22235/ech.v9i1.2146
Ramos Guajardo S, Ceballos Vasquez P. Cuidado humanizado y riesgos psicosociales: una relación percibida por profesionales de enfermería en Chile. Enfermeria (Montev.). 2018;7(1):12–25. https://doi.org/10.22235/ech.v7i1.1537
Schutz A. Fenomenología del Mundo Social: Introducción a la sociología comprensiva. Paidos S.A.I.C.F., editor. Buenos Aires; 1972. 274
Jesus MC, Capalbo C, Merighi MA, Oliveira DM, Tocantins FR, Rodrigues BM et al. A fenomenologia social de Alfred Schütz e sua contribuição para a enfermagem. Rev Esc Enferm USP. 2013;47(3):736–41. https://doi.org/10.1590/s0080-623420130000300030
Merighi MA, Carvalho GM, Suletroni VP. O processo de parto e nascimento: visão das mulheres que posuem convênio saúde na perspectiva da fenomenologia social. Acta Paul Enferm. 2007;20(4):434–40. https://doi.org/10.1590/s0103-21002007000400008
Vera MG, Merighi MA, Conz CA, Silva MH, Jesus MC, González LA. Primary health care: the experience of nurses. Rev Bras Enferm. 2018;71:531–7. https://doi.org/10.1590/0034-7167-2016-0244
Morse JM. The Significance of Saturation. Qual Health Res. 1995;5(2):147–9.https://doi.org/10.1177/104973239500500201
Do Prado ML, De Souza ML, Monticelli M, Cometto MC, Gómez PF. Investigación cualitativa en enfermería. Metodología y didáctica. Washington DC: OPS; 2013:255 Consulta: Agosto 28, 2023. Disponible en:. https://iris.paho.org/bitstream/handle/10665.2/51587/9789275318171_spa.pdf?sequence=3&isAllowed=y
Lincoln Y, Guba E. Naturalistic inquiry. Beverly Hills;SAGE Publications; 1985
Álvarez Muñoz, Edgardo; Barrios Casas, Sara (2024), “Cuidado de enfermería percibido por personas trans: Una aproximación fenomenológica. Base de datos”, Mendeley Data, V1.https://doi.org/10.17632/v2w93mkksn.1
Mikovits JC. “I don’t feel like I’m a person”: Nursing knowledge of transgender care through the lens of transgender people. J Adv Nurs. 2022;78(9):3012–3024.https://doi.org/10.1111/jan.15308
Eisenberg ME, McMorris BJ, Rider GN, Gower AL, Coleman E. “It’s kind of hard to go to the doctor’s office if you’re hated there.” A call for gender-affirming care from transgender and gender diverse adolescents in the United States. Heal Soc Care Community. 2020;28(3):1082–1089.https://doi.org/10.1111/hsc.12941
Reisner SL, Silva-Santisteban A, Salazar X, Vilela J, D’Amico L, Perez-Brumer A. “Existimos”: Health and social needs of transgender men in Lima, Perú. PLoS One. 2021;16(8):1–17.https://doi.org/10.1371/journal.pone.0254494
Johnson AH, Hill I, Beach-Ferrara J, Rogers B, Bradford A. Common barriers to healthcare for transgender people in the U.S. Southeast. Int J Transgenderism. 2019;21(1):70-78.https://doi.org/10.1080/15532739.2019.1700203
Samuels EA, Tape C, Garber N, Bowman S, Choo EK. “Sometimes You Feel Like the Freak Show”: A Qualitative Assessment of Emergency Care Experiences Among Transgender and Gender-Nonconforming Patients. Ann Emerg Med. 2017;71(2):1–13. https://doi.org/10.1016/j.annemergmed.2017.05.002
Muwanguzi P, Nabunya R, Karis V, Nabisere A, Nangendo J, Mujugira A. Nurses’ reflections on caring for sexual and gender minorities pre-post stigma reduction training in Uganda. BMC Nurs. 2023;22(1):1–17. https://doi.org/10.1186/s12912-023-01208-w
Núñez S, Donoso C, Parra-Villarroel J. Significado que otorgan las personas trans a sus experiencias en la atención en el sistema de salud chileno. Rev Chil Salud Pública. 2018;22(2):126–134. https://revistasaludpublica.uchile.cl/index.php/RCSP/article/view/53235/55923
Zwickl S, Wong A, Bretherton I, Rainier M, Chetcuti D, Zajac JD, et al. Health needs of trans and gender diverse adults in Australia: A qualitative analysis of a national community survey. Int. J. Environ. Res. Public Heal. 2019;16(24):1–12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6950552/pdf/ijerph-16-05088.pdf
Von Vogelsang AC, Milton C, Ericsson I, Strömberg L. ‘Wouldn’t it be easier if you continued to be a guy?’ – a qualitative interview study of transsexual persons’ experiences of encounters with healthcare professionals. J Clin Nurs. 2016;25(23–24):3577–88. https://doi.org/10.1111/jocn.13271
Grant R, Smith AK, Nash M, Newett L, Turner R, Owen L. Health practitioner and student attitudes to caring for transgender patients in Tasmania. Aust J Gen Pract. 2021;50(6):416–421.https://www1.racgp.org.au/getattachment/a5460f3a-1f51-4150-b844-2e6cbfd9b876/Attitudes-to-caring-for-transgender-patients-in-Ta.aspx
Valenzuela-Valenzuela A, Cartes-Velásquez R. Salud comunitaria, la experiencia de salud trans en el Servicio de Salud Talcahuano, Chile. Psicoperspectivas. 2020;19(2):1–12. https://www.scielo.cl/pdf/psicop/v19n2/0718-6924-psicop-19-02-142.pdf
Ministerio de Salud. Vía Clínica para la adecuación corporal en personas con incongruencia entre sexo físico e identidad de género. Santiago de Chile: MINSAL; 2010. Consulta: Agosto 10, 2023. Disponible en: https://www.movilh.cl/documentacion/trans/Ord%2057%202988%20Env%C3%ADa%20v%C3%ADa%20cl%C3%ADnica%20para%20la%20adecuaci%C3%B3n%20corporal%20en%20personas%20con%20incongruencia-1.pdf
Ministerio de Salud. Circular B2/N°6: Sobre la protección de derechos de las personas en relación con la orientación sexual, identidad y expresión de género en la atención y cuidados de salud mental. Santiago; 2023. Consulta: Agosto 10, 2023. Disponible en: https://diprece.minsal.cl/wp-content/uploads/2023/11/CIRCULAR-B-2-N%C2%B0-6-Sobre-la-proteccion-de-derechos-en-relacion-con-la-OSIEG-en-salud-mental.pdf
Allison MK, Marshall SA, Stewart G, Joiner M, Nash C, Stewart MK. Experiences of Transgender and Gender Nonbinary Patients in the Emergency Department and Recommendations for Health Care Policy, Education, and Practice. J Emerg Med. 2021;61(4):396–405. https://doi.org/10.1016/j.jemermed.2021.04.013
Estay GF, Valenzuela VA, Cartes VR. Atención en salud de personas LGBT+: Perspectivas desde la comunidad local penquista. Rev Chil Obs Ginecol. 2020;85(4):351–7.https://www.scielo.cl/pdf/rchog/v85n4/0717-7526-rchog-85-04-0351.pdf
Sousa D, Iriart J. “Viver dignamente”: necessidades e demandas de saúde de homens trans em Salvador, Bahia, Brasil. Cad Saúde Pública. 2018;34(10):1–12. https://doi.org/10.1590/0102-311X00036318
Raile M. Modelos y teorías en enfermería. 8 ed. Barcelona: Elsevier; 2011. 797
Downloads
Published
How to Cite
Issue
Section
Categories
Altmetrics
Downloads
License
Copyright (c) 2024 Revista Cuidarte
This work is licensed under a Creative Commons Attribution 4.0 International License.
Journal Cuidarte, scientific publication of open access, is licensed under a Creative Commons Attribution (CC BY-NC), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Any other form of use such as reproduction, transformation, public communication or distribution, for profit, requires the prior authorization of the University of Santander UDES.
The names and e-mail addresses entered in the Journal Cuidarte will be used exclusively for the purposes stated by this magazine and will not be available for any other purpose or other person.
The articles published in the Journal Cuidarte represent the criteria of their authors and do not necessarily constitute the official opinion of the University of Santander UDES.
