Ethical Discourse of Psychiatrists About Gender Identity and Sexual Orientation: A Qualitative Study.

Abstract

In Turkey, the studies that aim to elaborate on the experiences of people with gender identities and sexual orientations incongruent with social norms are limited both in bioethics and in psychiatry. The general aim of this study is to provide a deeper understanding about the value based problems related to the gender identity and sexual orientation of the patients who seek medical advice in psychiatry practice. In this study, psychiatrists' discourse on gender identity and sexual orientation is discussed from an ethical perspective based on their experiences in providing healthcare to LGBT individuals. In-depth interviews with 35 Psychiatry residents and specialists were conducted in the context of a qualitative field study. The data received from in-depth interviews were evaluated using the thematic content analysis method. The raw data received from the in-depth interviews with psychiatrists were analyzed and the themes and the contexts were derived. Discrimination, LGBTs access to healthcare services, counselling practice, beneficence, non-maleficence, being empathic, self-improvement, communicating with the family and interaction with LGBTs are the main themes that emerged. These main themes were handled within the contexts of providing healthcare services, professional responsibility of the psychiatrists, physician-patient/client and family relations. The relationship between the themes and the contexts were interpreted from an ethical perspective. The results of the study show that in the absence of comprehensive and adequate education on gender identity and sexual orientation, psychiatrists may tend to adopt scientifically debatable METHODS in diagnosis, observation and treatment of LGBT patient/ counselee.