日本男女同性恋、双性恋和变性者群体的医疗需求和经历

Hiroyuki Otani, Tatsuya Morita, Hongja Kim, Kaori Aso, Misuzu Yuasa, Hideyuki Kashiwagi, Kiyofumi Oya, Akemi Shirado Naito
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摘要

本研究全面考察了日本女同性恋、男同性恋、双性恋、变性人/跨性别者和同性恋/疑问者(LGBTQ)人群(也称作性少数群体)的医疗需求和经历。该项目旨在弥补目前在了解 LGBTQ 群体就医经历方面存在的差距,并为未来的医疗改革提供参考。2022 年 11 月,我们针对日本全国曾在医疗机构就诊过的 LGBTQ 群体开展了一项基于网络的横断面匿名调查。参与者是通过一家私营网络调查公司招募的。纳入标准包括年龄在 20 岁或以上、有就医记录、经历过与性别认同、性别或性取向相关的困扰或不适。调查项目是根据之前的研究和初步访谈制定的,目的是评估人口特征、医疗护理经验和临终关怀偏好。共有 103 名来自日本各地的不同人口特征的受访者参与了调查。据报告,在性别认同与其出生分配不同的性少数群体中,他们面临着巨大的挑战,包括与指定病房相关的痛苦经历以及进入某些医疗部门的困难。非异性恋取向的 LGBTQ 也面临着伴侣参与医疗决策和护理的障碍。这项研究强调,有必要进行医疗改革,以应对日本 LGBTQ 所面临的挑战。医疗服务提供者应为所有人(无论其性取向或性别认同如何)创建一个更加公平和平等的医疗保健系统。
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Medical care needs and experiences of LGBTQ populations in Japan
This study comprehensively examines the medical needs and experiences of the lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) population—also referred to as sexual minorities—in Japan. It aims to bridge the existing gap in understanding the experiences of LGBTQ populations in accessing healthcare, and inform future healthcare reforms. In November 2022, a cross-sectional, web-based, anonymous survey was conducted targeting LGBTQ populations across Japan who had previously visited a medical institution. Participants were recruited through a private, web-based, survey company. Inclusion criteria included being 20 years old or above, having a record of medical visits, and experiencing distress or discomfort related to gender identity, gender, or sexual orientation. Survey items were developed based on previous research and preliminary interviews, to assess demographic characteristics, experiences with medical care, and preferences for end-of-life care. A total of 103 respondents with a diverse demographic profile from across Japan participated in the survey. Among sexual minorities whose gender identity differed from their birth assignment, significant challenges were reported, including distressful experiences related to assigned hospital rooms and difficulties accessing certain medical departments. LGBTQ individuals with non-heterosexual orientations also faced barriers to partner involvement in medical decision-making and care. This study underscores the need for healthcare reforms to address the challenges faced by LGBTQ individuals in Japan. Healthcare providers should create a more equitable and affirming healthcare system for all individuals, irrespective of sexual orientation or gender identity.
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