Abuse in chilean trans and non-binary health care: results from a nationwide survey

Abstract

Abuse in health care (AHC) is an emerging concept used to describe healthcare practices and conduct that health services users find belittling and degrading. Such experiences, whose causes are not always voluntary but systematic and structural, have been described as one of the main barriers to the trans and non-binary population’s access to health care. To study this problem in Chile, the country’s first trans and non-binary health survey was conducted between January 2021 and June 2022 with the participation of 1116 people. Univariate statistical analyses were performed to calculate the frequencies (f) and percentages (%) of the different forms of AHC reported. Chi-squared tests (p < 0.01) and the Pearson correlation coefficients (r > 0.10) were used to identify statistically significant correlations between experiences of AHC, the health personnel reportedly involved, and participants’ responses to these experiences. About 84% of the participants who replied to questions on this subject said that they had experienced some form of AHC. The most frequently reported were inappropriate use of pronouns (65.9%) and stereotypical comments about genders (48.3%). These events occurred mostly in encounters with secretaries and receptionists, followed by psychologists and nurses. The most frequent response of participants to these situations was to change the medical staff responsible for their care, followed by ceasing to seek professional attention. A mainstreamed relational gender perspective is required to address the complexity of this problem.