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Cited by 17LGBTQ Health, Identity, and PolicyDiversity and Career in MedicineAdolescent and Pediatric Healthcare

Experiences of surgery readiness assessments in British Columbia

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Frohard-Dourlent, Hélène, MacAulay, Margaret, Shannon, Monica·2020·International Journal of Transgender Health
DOI 10.1080/26895269.2020.1742842PMC PMC7430474
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Abstract

Background: A surgical readiness assessment is a major step in the medical journey of trans people seeking gender-affirming surgery. Much of the peer-reviewed literature surrounding surgical readiness assessments emphasizes the perspectives of academics and clinicians, leaving the voices of trans and gender diverse patients largely unheard.Aims: This paper foregrounds patient experiences with surgery readiness assessments to discuss the tensions, challenges and opportunities they generate.Methods: We conducted a thematic analysis of 35 in-depth interviews with trans people who accessed or were seeking to access gender-affirming surgery in British Columbia.Results: We developed three main themes to capture participants’ narratives of their surgical assessment experiences. The first, assessments as gatekeeping, explores the stories of people who described their assessments as outdated and even discriminatory processes. The second, assessments as a barrier to care, discusses the informational missteps, bureaucratic regulations, economic issues, and geographic concerns that made assessments difficult to access. The third, assessments as useful, includes positive stories about assessments that often involved feeling supported by an assessor and feeling prepared for the next steps.Discussion: These narratives demonstrate how much variation exists among people’s experiences of readiness assessments for gender-affirming surgery. No matter how their actual assessment turned out, many participants approached their appointments with a great deal of anxiety and trepidation. We attributed this stress was to challenges ranging from lengthy wait times, arbitrary medical gatekeeping, a lack of access to knowledgeable and supportive providers, unclear or changing administrative processes, and insufficient communication. To address these challenges, it is crucial for the medical system to create more accessible pathways with centralized, up-to-date information for people trying to access assessments. Patients are best served by multi-disciplinary gender-affirming teams that provide individualized care.

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Cited by

Sorted by citations

Authors
Frohard-Dourlent, H., MacAulay, M., & Shannon, M.
Affiliations
  • School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
  • University of British Columbia (CA)
Venue
International Journal of Transgender Health
Publisher
Informa UK Limited
Published
2020-04-02
Volume
21
Issue
2
Pages
147-162
ISSN
2689-5269 (ISSN-L)
DOI
10.1080/26895269.2020.1742842
PMC
PMC7430474
OpenAlex
W3014130598
Cited by
17
References
2
Citations by year
2026: 4 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 2
FWCI
2.46
Type
journal article
Language
en
Open access
Locations
  • International Journal of Transgender Health (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Social Sciences › Gender Studies › Diversity and Career in Medicine
  • Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
Keywords
gender-affirming surgery, transgender people, patient experience, barriers to care, health care access, waiting time, administrative processes, provider support, multidisciplinary care, British Columbia

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