Comparative study of trans* healthcare models in Catalonia

加泰罗尼亚跨性别医疗保健模式的比较研究

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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, such as socio-demographics information, and mental health outcomes. All data was 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. Nevertheless, the prevalence of mental health problems were much higher than expected in general popupation, both groups presented depression rates of 35 % and 25.7 %, and anxiety rates of 45 % and 41.9 % (BMM and BPSM, respectively). Furthermore, these differences were also found when comparing to general population in Catalonia. Therefore, there is a pressing need to shift away from paternalistic medical roles and move towards informed decision-making and progressive autonomy. Perceiving the trans* experience as an individual desease, rather than an effect of societal norms on dissident bodies, has detrimental effects for the community. Additionally, the scientific community should listen to the demands of the trans* community and create space for trans* researchers in the production of knowledge.

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