Transgender, Gender-Diverse, and Nonbinary Experiences in Physical Therapy: A Descriptive Qualitative Study.

IF 3.5 4区 医学 Q1 ORTHOPEDICS Physical Therapy Pub Date : 2024-10-02 DOI:10.1093/ptj/pzae086
Madelaine Aird, Julie L Walters, Alex Ker, Megan H Ross
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Abstract

Objective: The objective was to explore experiences with and identify barriers and facilitators of utilizing physical therapy for people who identify as transgender, gender diverse, and nonbinary (TGNB).

Methods: A qualitative descriptive design was employed using semistructured interviews conducted in New Zealand. Eligible participants were individuals who were 12 years old or older, who self-identified as TGNB, and who had accessed physical therapy at a community-based clinic that also provides a gender-affirming service. Participants were recruited via email invitation to the clinic database. Interview data were analyzed using reflexive thematic analysis. Demographics are reported descriptively.

Results: Seventeen individuals (15-64 years old and identifying as 11 different genders) participated. All participants reported physical therapy experiences relating to 1 or more of the following 4 themes: challenging cisnormativity at policy, environmental, clinic, and therapist levels; safety and trust throughout the clinical experience, including clinic credibility for being a safe provider, clinic displays of TGNB inclusivity, implementation of safe clinic processes, and respectful therapist interactions; inclusive experiences in a clinic that provided affordable care and took active steps to understand and affirm TGNB identities and with physical therapists who had a high level of knowledge of TGNB-specific health issues and took a biopsychosocial approach to care; and sensitivity to body discomfort or dysphoria triggers. Barriers to and facilitators of care were identified at policy, environmental, clinic, and therapist levels.

Conclusion: People who identify as TGNB face challenges to accessing safe and culturally sensitive physical therapy. However, there are achievable areas for improvement at policy, environmental, clinic, and physical therapist levels to gain trust and engagement in care for the TGNB community.

Impact: This study provides a detailed exploration of TGNB physical therapy experiences and identifies specific areas of improvement for TGNB physical therapy care to provide clinicians and physical therapy clinics insights into the provision of safe and culturally sensitive physical therapy.

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物理治疗中的变性、性别多元化和非二元体验:描述性定性研究。
目的目的是探索变性者、性别多元化者和非二元性者(TGNB)使用物理疗法的经验,并确定使用物理疗法的障碍和促进因素:方法:采用定性描述设计,在新西兰进行半结构式访谈。符合条件的参与者年龄在 12 岁或以上,自我认同为 TGNB,并在社区诊所接受过物理治疗,该诊所还提供性别确认服务。参与者通过诊所数据库的电子邮件邀请进行招募。访谈数据采用反思性主题分析法进行分析。结果:17 人(15-64 岁,自称 11 种不同性别)参加了访谈。所有参与者都报告了与以下 4 个主题中的一个或多个相关的理疗师经历:在政策、环境、诊所和治疗师层面挑战顺性别规范;整个临床经历中的安全和信任,包括诊所作为安全提供者的信誉、诊所对 TGNB 的包容性展示、安全诊所流程的实施以及尊重治疗师的互动;在提供负担得起的医疗服务、采取积极措施理解和肯定 TGNB 身份的诊所,以及在对 TGNB 特定健康问题有高度了解并采取生物心理社会方法进行护理的理疗师那里获得的包容性体验;以及对身体不适或焦虑症诱因的敏感性。从政策、环境、诊所和治疗师等层面确定了护理的障碍和促进因素:结论:被认定为 TGNB 的人在获得安全且具有文化敏感性的物理治疗方面面临挑战。然而,在政策、环境、诊所和理疗师层面都有可以改进的地方,以赢得对 TGNB 群体的信任并使其参与到护理中来:本研究详细探讨了 TGNB 物理治疗师的经验,并确定了 TGNB 物理治疗护理需要改进的具体领域,为临床医生和物理治疗诊所提供了提供安全且具有文化敏感性的物理治疗的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Physical Therapy
Physical Therapy Multiple-
CiteScore
7.10
自引率
0.00%
发文量
187
审稿时长
4-8 weeks
期刊介绍: Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.
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