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Breaking Down Barriers to Facilitate Access to Healthcare Among Transgender People

  • Maria Maddalena Sirufo
    Affiliations
    Department of Life, Health, and Environmental Sciences University of L’Aquila, L’Aquila, Italy
    Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis ASL Teramo Teramo, Italy
    Technical Group for the Coordination of Gender Medicine Regione Abruzzo, Italy
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  • Lina Maria Magnanimi
    Affiliations
    Department of Life, Health, and Environmental Sciences University of L’Aquila L’Aquila, Italy
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  • Lia Ginaldi
    Affiliations
    Department of Life, Health, and Environmental Sciences University of L’Aquila L’Aquila, Italy
    Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis ASL Teramo Teramo, Italy
    Technical Group for the Coordination of Gender Medicine Regione Abruzzo, Italy
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  • Massimo De Martinis
    Affiliations
    Department of Life, Health, and Environmental Sciences University of L’Aquila L’Aquila, Italy
    Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis ASL Teramo Teramo, Italy
    Technical Group for the Coordination of Gender Medicine Regione Abruzzo, Italy
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      To the Editor:
      We read with great interest the article by Boyer et al. “Binary and Nonbinary Transgender Adolescents' Healthcare Experiences, Avoidance, and Well Visits” recently published in the Journal [
      • Boyer T.L.
      • Sequeira G.M.
      • Egan J.E.
      • et al.
      Binary and nonbinary transgender adolescents’ healthcare experiences, avoidance, and well visits.
      ].
      The authors showed with stimulating elegance the differences between binary and nonbinary transgender adolescents in healthcare experiences, healthcare avoidance, and well-visit attendance and conclude with a call to action to prevent adverse experiences with a healthcare provider. The perception of the provider's knowledge has an impact on the utilization of healthcare facilities: even a small improvement in specific knowledge by health professionals has a huge impact on the likelihood of transgender people (TGD) using care services. Intriguing differences in the desire for gender affirming medical treatment between binary and nonbinary TGD demonstrate the need to deconstruct the treatment barriers for all TGD and individuals of different genders [
      • Kennis M.
      • Duecker F.
      • T’Sjoen G.
      • et al.
      Gender affirming medical treatment desire and treatment Motives in binary and non-binary transgender individuals.
      ]. To date, several studies confirm this. Around the globe in healthcare systems, there are gaps both in providing general healthcare to TGD and sexual minorities and in addressing their specific health needs. Failure to satisfy the desire for treatment worsens the general state of wellbeing.
      In this regard, it is also important to remember the specific care needs of TGD people who, following gender affirmation treatments, undergo various changes with clinical relevance [
      • D'hoore L.
      • T'Sjoen G.
      Gender-affirming hormone therapy: An updated literature review with an eye on the future.
      ]. It must be recognized that a majority of TGD patients desire healthcare that they are not receiving and that the first step in addressing this unmet need is for healthcare professionals to learn to provide humanistic, personalized care that meets the unique needs of these people [
      • Sirufo M.M.
      • Magnanimi L.M.
      • Ginaldi L.
      • De Martinis M.
      Strategies to optimise health in transgender individuals.
      ].
      The health needs of sex and gender minorities must be taken into account in the reshaping of the health systems [
      • Sirufo M.M.
      • Magnanimi L.M.
      • Ginaldi L.
      • De Martinis M.
      How to ensure better healthcare experiences for transgender people.
      ]. Research on the health problems of these groups of people are growing and this is a very positive and appreciable fact; however, one of the main problems remains the lack of adequate training and knowledge of healthcare professionals [
      • Sirufo M.M.
      • Magnanimi L.M.
      • Ginaldi L.
      • De Martinis M.
      Surgery for transgender and gender diverse people: The lack of education for health professionals.
      ]. We would like to urge the commitment of all health professionals and health institutions and academies to become aware of the need for change to break down certain barriers and develop all possible initiative to renew our daily activities, institutions, and the academies in which we operate while soliciting policy and administrative leaders to introduce these issues in the reshaping of health systems and in the training curricula of health professionals.
      Author contributions: All authors contributed equally to the work.

      Funding Sources

      This research received no funding.

      References

        • Boyer T.L.
        • Sequeira G.M.
        • Egan J.E.
        • et al.
        Binary and nonbinary transgender adolescents’ healthcare experiences, avoidance, and well visits.
        J Adolesc Health. 2022; (Epub ahead of print)
        • Kennis M.
        • Duecker F.
        • T’Sjoen G.
        • et al.
        Gender affirming medical treatment desire and treatment Motives in binary and non-binary transgender individuals.
        J Sex Med. 2022; (Epub ahead of print)
        • D'hoore L.
        • T'Sjoen G.
        Gender-affirming hormone therapy: An updated literature review with an eye on the future.
        J Intern Med. 2022; 291: 574-592
        • Sirufo M.M.
        • Magnanimi L.M.
        • Ginaldi L.
        • De Martinis M.
        Strategies to optimise health in transgender individuals.
        Emerg Med Australas. 2022; (Epub ahead of print)
        • Sirufo M.M.
        • Magnanimi L.M.
        • Ginaldi L.
        • De Martinis M.
        How to ensure better healthcare experiences for transgender people.
        Fam Pract. 2022; (Epub ahead of print)
        • Sirufo M.M.
        • Magnanimi L.M.
        • Ginaldi L.
        • De Martinis M.
        Surgery for transgender and gender diverse people: The lack of education for health professionals.
        Am Surg. 2022; (Epub ahead of print)

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