Societal stigma and mistreatment in healthcare among gender minority people: a cross-sectional study

International Journal for Equity in Health

Research

Jae M. Sevelius¹  Carol Dawson-Rose²  Sandra J. Weiss³  Kristen D. Clark⁴  Jordon D. Bosse⁵  Micah E. Lubensky⁶  Annesa Flentje⁷  Juno Obedin-Maliver⁸  Mitchell R. Lunn⁹ 

[1] Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, 513 Parnassus Avenue, San Francisco, CA, USA;Center of Excellence for Transgender Health, Department of Medicine, University of California, 513 Parnassus Avenue, San Francisco, San Francisco, CA, USA;Department of Community Health Systems, School of Nursing, University of California San Francisco, 2 Koret Way, San Francisco, CA, USA;Department of Community Health Systems, UCSF Depression Center, University of California, San Francisco, 2 Koret Way, San Francisco, CA, USA;Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden;School of Nursing, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Ave, Boston, MA, USA;The PRIDE Study/PRIDEnet, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA;Department of Community Health Systems, School of Nursing, University of California San Francisco, 2 Koret Way, San Francisco, CA, USA;The PRIDE Study/PRIDEnet, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA;Department of Community Health Systems, School of Nursing, University of California San Francisco, 2 Koret Way, San Francisco, CA, USA;Alliance Health Project, Department of Psychiatry, School of Medicine, University of California, San Francisco, 1930 Market Street, San Francisco, CA, USA;The PRIDE Study/PRIDEnet, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA;Department of Epidemiology and Population Health, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA;Department of Obstetrics and Gynecology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA;The PRIDE Study/PRIDEnet, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA;Division of Nephrology, Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA;Department of Epidemiology and Population Health, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA;

关键词: Gender minority;    Stigma;    Discrimination;    Healthcare access;    Health disparity;   

DOI  :  10.1186/s12939-023-01975-7

 received in 2022-07-13, accepted in 2023-07-26,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundGender minority (GM; individuals whose gender is not aligned with that traditionally associated with the sex that was assigned to them at birth) people have widely reported mistreatment in healthcare settings. Mistreatment is enacted by individuals within society who hold stigmatizing beliefs. However, the relationship between healthcare mistreatment and societal stigma (i.e., the degree to which society disapproves of GM people) is unclear and not measured consistently.MethodsWe analyzed data from 2,031 GM participants in The Population Research in Identity and Disparities for Equality (PRIDE) Study’s 2019 Annual Questionnaire to determine whether societal stigma was associated with participants’ past-year reports of mistreatment (defined as denial of healthcare services and/or lower quality care) in medical or mental healthcare settings. We created a proxy measure of societal stigma by incorporating variables validated in existing literature. Participants reported whether they had experienced mistreatment in medical and mental health settings independently.ResultsHealthcare denial and/or lower quality care during the past year was reported by 18.8% of our sample for medical settings and 12.5% for mental health settings. We found no associations between the societal stigma variables and past-year reports of healthcare denial and/or lower quality care in medical or mental healthcare settings.ConclusionsAlthough a high proportion of GM people reported past-year healthcare mistreatment in both medical and mental health settings, mistreatment had no relationship with societal stigma. Factors other than societal stigma may be more important predictors of healthcare mistreatment, such as healthcare workers’ knowledge of and attitudes toward GM people. However, other measures of societal stigma, or different types of mistreatment, may show stronger associations. Identifying key factors that contribute to mistreatment can serve as targets for intervention in communities and healthcare settings.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 4