在信息披露的大环境中游刃有余:家长对医疗保健专业人员在支持双性儿童及其家庭方面所起作用的看法

IF 1.9 4区 医学 Q3 GENETICS & HEREDITY Journal of Genetic Counseling Pub Date : 2024-09-10 DOI:10.1002/jgc4.1962
Kayla Horowitz, Kimberly Zayhowski, Nicole Palmour, Darius Haghighat, Yann Joly
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引用次数: 0

摘要

双性人(Intersex)是一个总括性术语,指具有无法完全归类为男性或女性二元定义的性别特征的个体。由于医疗歧视和病理化的历史,双性人群体面临着缺乏社会能见度的问题,而这种歧视和病理化又是在未经儿童同意的情况下进行 "正常化 "生殖器手术所形成的。尽管人们努力改革临床实践,但以双性人群体及其家庭需求为中心的研究仍然很少。本研究探讨了家长对医疗保健专业人员(如遗传学专业人员)如何在家长首次得知其子女的双性变异时提供以患者为中心的教育和支持的看法,旨在为医疗保健专业人员提供建议,以促进家长的适应并保护双性儿童的自主权。我们对 14 名双性儿童的父母进行了 13 次半结构式定性访谈。在以机构为基础的双性人健康方法的框架下,通过反思性主题分析,归纳出了主题类别的概念,其中包括在早期披露环境中阻碍和促进保健医生敏感性和家长适应的因素。教育、宗教或医疗机构以及社会文化偏见和病理化语言是阻碍医疗保健人员提高敏感性的因素。影响家长适应的障碍包括对孩子未来的不确定性、社会文化中的性别规范以及不合适的信息提供。将父母的需求纳入信息披露环境可促进家庭的接受度,包括将性征变异(VSCs)正常化、加强医学教育、为患者导航提供便利以及优先考虑父母的社会支持需求。
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Navigating the disclosure landscape: Parents' perspectives on healthcare professionals' role in supporting intersex children and families
Intersex, an umbrella term, describes individuals with sex characteristics that cannot be exclusively categorized into binary definitions of male or female. The intersex community faces a lack of social visibility perpetuated by a history of medical discrimination and pathologization shaped by “normalizing” genital surgeries without the child's consent. Despite efforts to reform clinical practice, there remains a paucity of research centering the needs of the intersex community and their families. This study explored parents' perspectives on how healthcare professionals (HCPs), such as genetics professionals, can provide patient‐centered education and support when parents first learn of their child's intersex variation, with the aim of offering recommendations to HCPs to promote parental adjustment and protect intersex children's right to autonomy. Thirteen qualitative semi‐structured interviews were conducted with 14 parents of intersex children. Through reflexive thematic analysis, under the framework of an agency‐based approach to intersex health, thematic categories were inductively conceptualized, including barriers and facilitators to HCPs' sensitivity and to parental adjustment in the early disclosure environment. Barriers to HCPs' sensitivity were imposed by educational, religious, or medical institutions, along with sociocultural prejudices and pathologizing language. Barriers to parental adaptation included uncertainty regarding their child's future, sociocultural gender norms, and unsuitable information provision. Incorporating parental needs in the disclosure environment can facilitate familial acceptance, including normalization of variations of sex characteristics (VSCs), enhanced medical education, facilitation of patients' navigation, and prioritization of parents' social support needs.
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来源期刊
Journal of Genetic Counseling
Journal of Genetic Counseling GENETICS & HEREDITY-
CiteScore
3.80
自引率
26.30%
发文量
113
审稿时长
6 months
期刊介绍: The Journal of Genetic Counseling (JOGC), published for the National Society of Genetic Counselors, is a timely, international forum addressing all aspects of the discipline and practice of genetic counseling. The journal focuses on the critical questions and problems that arise at the interface between rapidly advancing technological developments and the concerns of individuals and communities at genetic risk. The publication provides genetic counselors, other clinicians and health educators, laboratory geneticists, bioethicists, legal scholars, social scientists, and other researchers with a premier resource on genetic counseling topics in national, international, and cross-national contexts.
期刊最新文献
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