Health Care Experiences of Non-Binary Patients and Recommendations for Improvement Through an Intersectional Lens Restricted; Files Only
Gardner, Elliot Vann (Spring 2023)
Abstract
Background: Transgender and non-binary discrimination happens at all levels of the socio-ecological model, including in the healthcare industry. Compared to cisgender people, transgender people have worse health outcomes, and the health disparities of non-binary people are often under investigated. Non-binary people have largely been left out of public health literature, especially concerning their medical needs and recommendations for improving care. They are often lumped in with larger samples of binary transgender people or only make up a small proportion of the sample size. This ignores their unique health care needs and necessitates further investigation into their medical experiences. This study uses intersectionality as a theoretical frame to examine the specific social locations of participants and how their complex identities impact their care in addition to their non-binary gender identity.
Methods: This study conducted nine qualitative in-depth interviews with non-binary participants to gather and analyze data on the participants’ feelings about inclusive and exclusive medical practices, their positive and negative medical experiences, and their recommendations for improving care for non-binary patients. Data were then thematically analyzed using MAXQDA software.
Results: Participants described four areas related to their experiences with medical interactions: inclusive and exclusive medical practices, their intersecting marginalizations, provider experiences from participants who are providers, and recommendations for improving non-binary care from their perspectives. It was found that medical forms often lack areas for providing pronouns and gender identities, forcing patients to out themselves or withhold this information from providers, affecting the quality of their care. All participants were structurally marginalized on at least one more level than their gender identity, and this impacted the quality of their care. The non-binary provider participants described best practices for engaging with non-binary patients based on their own experiences and their education, mentioning empathy and continued learning about the community as key factors. Participants also recommended a number of measures for improving the care of non-binary patients concerning medical staff diversity, updating educational curricula, and trust in patient-provider relationships.
Conclusions: This study describes the experiences of non-binary patients interacting with the current medical system that is often ignorant of their needs. Recommendations from participants included inclusive medical forms and records, more diversity in medical staff, better medical school and continuing education courses on the non-binary community and their health needs, and fostering patient-provider relationships built on trust through providers being open about their lack of experience, providing holistic care, and breaking down power dynamics.
Table of Contents
CHAPTER I: Introduction.....1
Purpose and Research Questions .....3
CHAPTER II: Literature Review.....5
Transgender Health Experiences and Recommendations.....7
Theoretical Framework.....9
Conclusion.....11
CHAPTER III: Methods.....13
Description of Sample.....13
Sample and Recruiting.....15
Data Collection.....16
Coding and Analysis.....17
Ethics.....17
CHAPTER IV: Results.....19
Inclusive and Exclusive Practices.....19
Intersecting Marginalizations.....25
Race.....25
Sexuality.....29
Health and Disability.....29
Provider Experiences.....31
Participant Recommendations.....36
Diversity of Medical Staff.....36
Education on Non-binary Identities.....37
Patient-Provider Trust.....39
Conclusion.....41
CHAPTER V: Discussion, Implications, and Recommendations.....43
Strengths and Limitations.....45
Public Health Implications.....47
Recommendations.....49
Forms.....49
Diversification of Medical Staff.....50
Improved Medical Education.....51
Trust in Patient-Provider Relationships.....52
Conclusion.....53
REFERENCES.....54
APPENDIX A: In-depth Interview Guide.....57
APPENDIX B: Interview Reference Sheet.....59
About this Master's Thesis
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File download under embargo until 18 May 2025 | 2023-04-12 16:39:58 -0400 | File download under embargo until 18 May 2025 |
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