Social Stigmatization Affecting Access to Healthcare Services and Service Satisfaction Among Transgender Persons: A Qualitative Study at Thai Red Cross AIDS Research Center - TANGERINE COMMUNITY HEALTH CENTER

Abstract

Background: Transgender has become an umbrella term to mean all those who transgress gender norms. There has been much progress in women's rights. The gay rights movement has come much more recently, and in many environments. Gender discrimination are primarily transsexuals, crossdressers, intersexual, and visibly "gay" men and women. Because they don't meet society's expectations for people born with their anatomy. Thailand is the place of highest incidence of transgender world-wide. Transgender were sometimes receiving different standard of service than the ordinary people. The access to healthcare services is basic need for every people in the community. The stigmatization among transgender still a barrier for transgender to access the healthcare service. In the US and Asia, proposed estimates of TG individuals range from 0.3 to 0.5% of the total population. In Thailand the estimated total TG population of Thailand is 314,340. There are several studies focus the problematic interact with negative impact on transgender patient and health providers. The stigma they experience heightens their risk for mental health problems. Method: Cross-Sectional descriptive and analytic design using qualitative method. Interviewed subject of those who used hormonal replacement therapy (HRT). Questionnaire were given to participants to fill in socio-demographic information and services satisfaction. In-depth interview with open ended “Life-Grid” interviewed. Face-to-face interviews were conducted using a structured life-grid table to fill information of life experiences. Results: 15 transgender clients with 11 female-to-male (FTMs) and 4 male-to-female (MTFs). 66.67% of the participants are in the age group of 20-30, 73.33% are female (gender at birth) taking hormonal replacement therapy services provide at Tangerine Center. From the study of interview, the participants with Life-Grid method, the transgender faced stigmatization occurred from their families, friends, workplace, government department and healthcare center. The stigmatization from family was because of their uncertain future such as hardship in finding jobs. Stigmatization in community level lead the transgender to avoid communication or interact with community. Stigmatize in workplace causes by the both supervisor and sub-coordinate were not trusting them to handle the job. Main reason of preventing transgender to access healthcare services was stigmatize inside the healthcare center. Searching for a new services provider was only result of solving problem. Services utilization and satisfaction of using services at TC-TRCAC was interview under 4a factor: accessibility, acceptability, availability and affordability. The most satisfaction is cost of services and the least satisfaction was period of waiting time. Conclusion: The transgender who have visited Tangerine Center faced stigmatization from other places included the healthcare area, but not from staffs at Tangerine Center. Transgender persons satisfied with the hormone services and other services provided at Tangerine Center. Transgender persons utilized the services by starting from peers or persons who are close to them. The information about the use of HRT also shared among the group of transgender persons. Transgender persons in Thailand tend to face less stigma from others compared to western countries. Further research would be recommended to expand the sample size and study area to be generalized. The population of this study should be separate FTM from MTF due to the different of hormone type.