1. 'A little bubble of utopia': constructions of a primary care-based pilot clinic providing gender affirming hormone therapy.
- Author
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Ker, Alex, Fraser, Gloria, Fleming, Theresa, Stephenson, Cathy, da Silva Freitas, Anny, Carroll, Richard, Hamilton, Thomas K., and Lyons, Antonia C.
- Subjects
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GENDER affirming care , *HOSPITALS , *HORMONE therapy , *ATTITUDES of medical personnel , *PATIENT decision making , *PRIMARY health care , *PATIENTS' attitudes , *MEDICAL protocols , *INFORMED consent (Medical law) , *PHILOSOPHY of medicine , *DISCOURSE analysis , *HEALTH , *CLINICAL competence , *HOSPITAL care , *DECISION making in clinical medicine , *OUTPATIENT services in hospitals - Abstract
The provision of gender affirming hormone therapy for transgender and non-binary people is a rapidly developing area of gender affirming healthcare. While research indicates the benefits of providing gender affirming hormone therapy through interdisciplinary primary care-based models, less is known about how service users and providers construct their understandings of affirmative approaches. In this paper, we present findings from a discourse analysis of four service users' and four healthcare professionals' talk about a primary care-based pilot clinic providing gender affirming hormone therapy in Aotearoa New Zealand. Participants employed notions of pathologisation, time, and agency in their talk to construct the clinic as a personal setting which gave service users time to make their own health decisions, while constructing hospitals as impersonal with lengthy wait times. The assessment-driven nature of best practice guidelines that governed clinicians' decision-making was constructed as constraining users' agency. Findings highlight the ongoing importance of aligning gender affirming hormone therapy with other non-disease types of healthcare, and suggest new ways for achieving this through affirmative approaches to healthcare. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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