“They just knew, and that makes all the difference”: understanding positive healthcare experiences among trans people in Canada

Abstract

Background Trans people face persistent systemic challenges and barriers in healthcare systems. Despite these obstacles, many trans people have had positive healthcare experiences, however little is known regarding their commonalities. Aims This study aims to better understand factors that influence positive healthcare experiences among trans people. Methods 33 longform interviews were conducted with trans individuals, with 29 being used for the final sample. Interviews were recorded, transcribed verbatim, and analyzed using NVIVO 12 software. Thematic analysis was conducted for the coding process with a combination of inductive and deductive approaches used to develop the coding frame. Results Four healthcare provider (HCP) characteristics and two patient attributes were identified as promoters of positive healthcare experiences. Positive HCP characteristics included having a provider who was 1) a member of the LGBTQ community, 2) knowledgeable, experienced, and willing to learn about trans health, 3) transparent and empowered patients regarding their medical decisions; and 4) sensitive, accepting, and validating of patients’ gender identities. The two patient attributes included: 1) engaging in self-advocacy regarding their care, and 2) being connected to a variety of supportive trans communities, both online and in-person. Discussion Better understanding these positive healthcare experiences can help in the development of curricula and policy to facilitate improved quality healthcare for trans people in Canada.