'Wouldn't it be easier if you continued to be a guy?' - a qualitative interview study of transsexual persons' experiences of encounters with healthcare professionals

Abstract

Aims and objectives: To describe transsexual persons' experiences of encounters with healthcare professionals during the sex reassignment process.

Background: Transsexual persons are individuals who use varying means to alter their natal sex via hormones and/or surgery. Transsexual persons may experience stigma, which increases the risk of psychological distress. Mistreatments by healthcare professionals are common. Qualitative studies addressing transsexual persons' experiences of healthcare are scarce.

Design: Qualitative descriptive design.

Methods: A Swedish non-clinical convenience sample was used, consisting of six persons who had been diagnosed as transsexual, gone through sex reassignment surgery or were at the time of the interview awaiting surgery. Semi-structured interviews were undertaken, and data were analysed using manifest qualitative content analysis.

Results: Three categories and 15 subcategories were identified. The encounters were perceived as good when healthcare professionals showed respect and preserved the transsexual person's integrity, acted in a professional manner and were responsive and built trust and confidence. However, the participants experienced that healthcare professionals varied in their level of knowledge, exploited their position of power, withheld information, expressed gender stereotypical attitudes and often used the wrong name. They felt vulnerable by having a condescending view of themselves, and they could not choose not to be transsexual. They felt dependent on healthcare professionals, and that the external demands were high.

Conclusions: Transsexual persons are in a vulnerable position during the sex reassignment surgery process. The encounters in healthcare could be negatively affected if healthcare professionals show inadequate knowledge, exploit their position of power or express gender stereotypical attitudes. A good encounter is characterised by preserved integrity, respect, responsiveness and trust.

Relevance to clinical practice: Improved education on transgender issues in nursing and medical education is warranted. Healthcare professionals should be aware of how their attitudes and their level of knowledge affect the care given during the sex reassignment surgery process.

Keywords: patients’ experiences; qualitative research; sex reassignment; transsexualism.