Atención sanitaria trans competente, situación actual y retos futuros. Revisión de la literatura / Competent trans health care, current situation and future challenges. A review

Introducción: Conocemos como una persona trans a aquella que no se identifica con el sexo de nacimiento, este hecho aún recogido como patología por el actual manual diagnóstico y estadístico de enfermedades mentales (DSM-V) va a provocar que existan desigualdades y barreras significativas a la hora de la atención sanitaria. Objetivo: Explorar las dificultades para la asistencia sanitaria percibidas por las personas trans y por los profesionales que los atienden en centros sanitarios. Material y método: Revisión de la literatura. Resultados: Tanto los profesionales como las personas trans perciben barreras significativas. Se podrían agrupar en diversos temas: desigualdades en la atención sanitaria percibidas por los pacientes trans, prejuicios y discriminación sentida, riesgos específicos de salud, déficit de conocimientos de los profesionales y déficit de formación en los planes de estudio actuales. Por otro lado, enfermería ante los pacientes trans puede resultar un facilitador. Conclusiones: Existen numerosos factores que pueden ser modificables y que provocan que las personas trans no perciban una asistencia adecuada. La adecuada formación de los profesionales sanitarios es uno de los que adquiere mayor relevancia Los resultados encontrados aportan una información clave para el futuro diseño de intervenciones dirigidas a mejorar la calidad de la asistencia en este colectivo

Introduction: We know as a transgender person who is not identified with the sex of birth, this fact still collected as pathology by the current Diagnostic and Statistical Manual of Mental Illness (DSM-V) will cause inequalities and barriers At the time of health care. Objective: To explore the difficulties for health care perceived by trans people and by the professionals who assist them in health centres. Material and method: Literature review. Results: Both professionals and trans people perceive significant barriers. They could be grouped by diverse topics: healthcare inequalities noticed by trans patients, prejudices and felt discrimination, specific health risks, lack of professional knowledge and deficit of training in current curricula. On the other hand, nursing with trans patients may result in a facilitator. Conclusions: There are multiple factors which can be modified and which produce that trans people do not notice appropriate care. Appropriate training of health professionals is the one which acquires more relevance. The results found provide key information for the future design of interventions aimed at improving the quality of the assistance in this group

Midwifery Care for Transfeminine Individuals.

This article focuses on the provision of gender-affirming care and preventive care for transfeminine individuals-those assigned male at birth who identify as female or on the feminine spectrum. To meet the learning needs of health care providers less familiar with gender-affirming care, this article begins with an overview of gender identity concepts. Initiation and management of feminizing gender-affirming hormone therapy is then covered in detail, including common gender-affirming medications and their adverse effects, diagnostic criteria, psychosocial evaluation, initial physical examination and laboratory work, and recommendations for follow-up visits and laboratory monitoring. Lastly, the article briefly reviews health care of transfeminine individuals before and after surgical gender-affirming interventions and details best practices for transfeminine preventive care.