Despite an increasing demand for gender affirming surgeries in recent years, the research revealed that most participants reported experiencing troubling incidents, including being deadnamed or mis-gendered, while in healthcare settings. Delays in obtaining approval, funding, and referrals for their procedures also negatively impacted their overall journeys. Negative experiences can create a hostile environment for members of the TGD community, often deterring them from seeking necessary medical care.
“Unfortunately, I can’t say that these results surprised me. The way we treat TGD people in healthcare can, at times, be unacceptable and abysmal,” Gianni says.
However, TGD participants also highlighted the positive impact of effective communication, empathy, and compassion by caregivers in healthcare. One participant recounted an uplifting experience with a nurse who consistently visited and conversed with them while they were recovering from a procedure in the hospital. They noted that the interactions helped relieve feelings of loneliness during a vulnerable time.
“The findings reveal that TGD people want to be viewed holistically, with consideration given to their lived body, lived time, lived space, and lived human relations,” adds Gianni. “Interpersonal interactions, technology, and liminal spaces were crucial in shaping their experiences. Participants also reported positive experiences when effective communication, empathy, and compassion were present."
As it relates to the crucial issues of long wait times and limited capacity for gender-affirming surgeries, Gianni believes that there are some ways to lessen the impact on members of the TGD community.
“Colleges that have oversight over physicians’ competencies need to be a part of the change by establishing core competencies that are focused on TGD health and cultural sensitivity so that physicians are ready for practice.
“Increasing the number of practitioners who provide gender-affirming care and allocating funding for procedures are also two ways of increasing capacity. Centralizing referral processes could help reduce wait times, although wait times are a barrier not only unique to gender-affirmation surgery. Finally, costs related to travel and accommodation can be subsidized.”
Gianni is entering his sixth year of a flex-time PhD in critical social theory at the Institute of Health Policy, Management, and Evaluation at the University of Toronto. His research employs institutional ethnography to study accountability circuits within institutions and explores how sex and gender minorities experience equity, diversity, and inclusion work, discrimination, and harassment. He hopes that his research will help provide meaningful help and support for people from numerous equity-deserving groups.
“Our goal is to create healthcare environments where TGD people don’t experience discrimination, stigmatization, or transphobia. At the end of the day, everyone wants to be valued and understood, particularly by healthcare providers,” Gianni says.
A recent paper has revealed a link between preoperative depression and the significantly higher risk of developing postoperative delirium in surgical patients.
