Structural competency in emergency medicine services for transgender and gender non-conforming patients

Bibliographic Data

ID4595694
AuthorsCathleen E Willging (0000-0001-6446-5083, Behavioral Health Research Center of the Southwest, corresponding author), Lara Gunderson (0000-0003-2007-4675, Behavioral Health Research Center of the Southwest), Dominick Shattuck (0000-0003-4689-863X, Behavioral Health Research Center of the Southwest), Daniel Shattuck, Robert Sturm (0000-0001-9036-7022, Behavioral Health Research Center of the Southwest), Adrien Lawyer, Cameron Crandall (0000-0002-4459-8409, University of New Mexico)
Year2019
Volume222
Pages67-75
Publication date2019-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2018.12.031
PMID30605801
OpenAlexW2905678717
LanguageEN
Citations received17
References cited38

In this formative qualitative research, we draw upon the concepts of structural vulnerability and structural competency to examine how transgender and gender non-conforming (TGGNC) patients and healthcare personnel experience service delivery in Emergency Departments (EDs), and how this experience can be improved upon. Between October 2016 and June 2017, we undertook 31 semi-structured interviews with TGGNC patients (n = 11) and physicians (n = 6), nurses (n = 7), and non-clinical staff (n = 7) in four community-based EDs in New Mexico. Our iterative coding and analysis process resulted in eight sets of findings: (1) reasons why TGGNC patients seek care from EDs; (2) perceptions about and experiences of TGGNC patients; (3) relevance of gender identity and sex at birth; (4) bureaucracy and communication; (5) spatial considerations; (6) preparing providers and staff to care for TGGNC patients; (7) the lack of resources for structural prescriptions; and (8) respect, humanity, and sameness. Findings suggest that structural issues adversely impact the health and wellbeing of TGGNC patients and service-delivery practices in the ED. We describe study implications for training ED personnel and modifying this practice setting to prevent delayed care and ensure appropriate services for TGGNC patients in need of structurally competent emergency medicine

Family medicine · Formative assessment · Qualitative research · Safeguarding · Service (business · Service delivery framework · Sociology · Transgender · African Sexualities and LGBTQ+ Issues · Feminist Theory and Gender Studies · LGBTQ Health, Identity, and Policy · Medicine · Nursing · Psychology

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