Comparative study of trans* healthcare models in Catalonia

Abstract

Stigma and discrimination against the trans* community have been shown to exacerbate mental health issues among its members. In Catalonia, the Gender Identity Unit at the Clinic's Hospital traditionally adhered to a biomedical model (BMM) of health for trans* individuals. However, a few years ago, the Transit Service introduced a biopsychosocial model (BPSM). This observational cohort study explores the mental health effects in BMM compared to BPSM centers for trans* individuals.A web-based survey was employed to gather essential data, and mental health outcomes for both groups were analyzed. Additionally, data on socio-demographics and evaluations of healthcare centers were provided. Data was collected and analyzed from the BPSM group (n=81) and the BMM group (n=21).The BPSM group exhibited statistically significant lower odds of experiencing emotional distress (p<0.001). Other mental health outcomes indicated a trend toward lower odds in the BPSM group compared to the BMM group, albeit with similar rates. However, the prevalence of mental health problems was much higher than expected in the general population. Both groups presented depression rates of 35% and 25.7%, and anxiety rates of 45% and 41.9% (BMM and BPSM, respectively).BPSM healthcare centers demonstrated a trend toward lower odds of mental health outcomes compared to BMM. Furthermore, the trans* community exhibited a higher prevalence of mental health problems than the general population in Catalonia. There is a pressing need to shift away from paternalistic medical roles and move towards informed decision-making and progressive autonomy. The scientific community should heed the demands of the trans* community and create space for trans* researchers in the production of knowledge.