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Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada

BACKGROUND: Those who detransition have received increased public and scholarly attention and their narratives are often presented as evidence of limitations with contemporary gender-affirming care practices. However, there are scant empirical studies about how this population experienced their own...

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Autores principales: MacKinnon, Kinnon R., Gould, Wren Ariel, Enxuga, Gabriel, Kia, Hannah, Abramovich, Alex, Lam, June S. H., Ross, Lori E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686467/
https://www.ncbi.nlm.nih.gov/pubmed/38019738
http://dx.doi.org/10.1371/journal.pone.0293868
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author MacKinnon, Kinnon R.
Gould, Wren Ariel
Enxuga, Gabriel
Kia, Hannah
Abramovich, Alex
Lam, June S. H.
Ross, Lori E.
author_facet MacKinnon, Kinnon R.
Gould, Wren Ariel
Enxuga, Gabriel
Kia, Hannah
Abramovich, Alex
Lam, June S. H.
Ross, Lori E.
author_sort MacKinnon, Kinnon R.
collection PubMed
description BACKGROUND: Those who detransition have received increased public and scholarly attention and their narratives are often presented as evidence of limitations with contemporary gender-affirming care practices. However, there are scant empirical studies about how this population experienced their own process of gaining access to gender-affirming medical/surgical interventions, or their recommendations for care practice. AIMS: To qualitatively explore the care experiences and perspectives of individuals who discontinued or reversed their gender transitions (referred to as detransition). METHODS: Between October 2021-January 2022, Canadian residents aged 18 and older with experience of stopping, shifting, or reversing a gender transition were invited to participate in semi-structured, one-on-one, virtual interviews. A purposive sample of 28 was recruited by circulating study adverts over social media, to clinicians in six urban centres, and within participants’ social networks. Interviews ranged between 50–90 minutes, were audio-recorded, and transcribed verbatim. Following constructivist grounded theory methodology, interview data were analyzed inductively and thematically following a two-phase coding process to interpret participants’ experiences of, and recommendations for, gender care. RESULTS: Participants were between the ages of 20–53 (71% were between 20–29). All participants identified along the LGBTQ2S+ spectrum. Twenty-seven out of 28 of the participants received medical/surgical interventions (60% were ages 24 and younger). A majority (57%) reported three or more past gender identities, with 60% shifting from a binary transgender identity at the time of initiating transition to a nonbinary identity later in their transition journey. To access medical/surgical interventions, most participants were assessed via the gender-affirming care model pathway and also engaged in talk therapy with a mental healthcare provider such as a psychologist or psychiatrist. Some participants experienced their care as lacking the opportunity to clarify their individual treatment needs prior to undergoing medical/surgical transition. Decisional regret emerged as a theme alongside dissatisfaction with providers’ “informed consent” procedures, such that participants felt they would have benefitted from a more robust discussion of risks/benefits of interventions prior to treatment decision-making. Overall, participants recommended an individualized approach to care that is inclusive of mental healthcare supports. CONCLUSIONS: To optimize the experiences of people seeking and receiving gender care, a thorough informed consent process inclusive of individualized care options is recommended, as outlined by the World Professional Association of Transgender Health, standards of care, version 8.
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spelling pubmed-106864672023-11-30 Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada MacKinnon, Kinnon R. Gould, Wren Ariel Enxuga, Gabriel Kia, Hannah Abramovich, Alex Lam, June S. H. Ross, Lori E. PLoS One Research Article BACKGROUND: Those who detransition have received increased public and scholarly attention and their narratives are often presented as evidence of limitations with contemporary gender-affirming care practices. However, there are scant empirical studies about how this population experienced their own process of gaining access to gender-affirming medical/surgical interventions, or their recommendations for care practice. AIMS: To qualitatively explore the care experiences and perspectives of individuals who discontinued or reversed their gender transitions (referred to as detransition). METHODS: Between October 2021-January 2022, Canadian residents aged 18 and older with experience of stopping, shifting, or reversing a gender transition were invited to participate in semi-structured, one-on-one, virtual interviews. A purposive sample of 28 was recruited by circulating study adverts over social media, to clinicians in six urban centres, and within participants’ social networks. Interviews ranged between 50–90 minutes, were audio-recorded, and transcribed verbatim. Following constructivist grounded theory methodology, interview data were analyzed inductively and thematically following a two-phase coding process to interpret participants’ experiences of, and recommendations for, gender care. RESULTS: Participants were between the ages of 20–53 (71% were between 20–29). All participants identified along the LGBTQ2S+ spectrum. Twenty-seven out of 28 of the participants received medical/surgical interventions (60% were ages 24 and younger). A majority (57%) reported three or more past gender identities, with 60% shifting from a binary transgender identity at the time of initiating transition to a nonbinary identity later in their transition journey. To access medical/surgical interventions, most participants were assessed via the gender-affirming care model pathway and also engaged in talk therapy with a mental healthcare provider such as a psychologist or psychiatrist. Some participants experienced their care as lacking the opportunity to clarify their individual treatment needs prior to undergoing medical/surgical transition. Decisional regret emerged as a theme alongside dissatisfaction with providers’ “informed consent” procedures, such that participants felt they would have benefitted from a more robust discussion of risks/benefits of interventions prior to treatment decision-making. Overall, participants recommended an individualized approach to care that is inclusive of mental healthcare supports. CONCLUSIONS: To optimize the experiences of people seeking and receiving gender care, a thorough informed consent process inclusive of individualized care options is recommended, as outlined by the World Professional Association of Transgender Health, standards of care, version 8. Public Library of Science 2023-11-29 /pmc/articles/PMC10686467/ /pubmed/38019738 http://dx.doi.org/10.1371/journal.pone.0293868 Text en © 2023 MacKinnon et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
MacKinnon, Kinnon R.
Gould, Wren Ariel
Enxuga, Gabriel
Kia, Hannah
Abramovich, Alex
Lam, June S. H.
Ross, Lori E.
Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada
title Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada
title_full Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada
title_fullStr Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada
title_full_unstemmed Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada
title_short Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada
title_sort exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in canada
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686467/
https://www.ncbi.nlm.nih.gov/pubmed/38019738
http://dx.doi.org/10.1371/journal.pone.0293868
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