Yıl: 2019 Cilt: 11 Sayı: 3 Sayfa Aralığı: 331 - 338 Metin Dili: Türkçe DOI: 10.5336/nurses.2018-63864 İndeks Tarihi: 08-05-2020

Trans Bireylerin Sağlığı ve Hemşirenin Rolü

Öz:
Biyolojik cinsiyeti hissettiği cinsiyetinden farklı olan kişileri tanımlamak için “trans” kavramı kullanılmaktadır. Trans bireyler, çocuk yaşlardan itibaren cinsiyetlerine yönelik bir huzursuzluk yaşarlar ve budurumu çeşitli şekillerde gösterirler. Çoğu trans birey, ergenlik dönemiyle birlikte bedenlerinde gözle görülür değişimler yaşayarak trans kimliğini doğrudan yansıtır. Bu durum, toplumda bir norm olarak kabul edilen erkek ve kadın kalıplarına uymadığı için bu bireyler, sosyal yaşamlarında çeşitli sorun ve ayrımcılık(etiketlenme, sözlü ve fiziksel saldırıya maruz kalma, toplumdan dışlanma ve iş bulmakta zorluk çekme vb.)ile karşı karşıya kalırlar. Trans bireylere yönelik bu olumsuz tutum “transfobi” olarak adlandırılmaktadır.Transfobi sadece toplumda görülmekle kalmayıp kurumlarda da bulunabilmektedir. Hukuk, eğitim, ordu vesağlık gibi kurumlarda var olan transfobi, trans bireyler için birçok ayrımcılığı doğurmaktadır. Özellikle sağlık alanında var olan transfobik tutumlar, bu kişileri sağlık hizmetlerine erişimden mahrum bırakabilmektedir. Bu olumsuz tutumlardan dolayı bireyler çoğu zaman sağlık haklarını kullanmaktan kaçınmaktadırlar.Bazı trans bireyler, cinsiyet hoşnutsuzluklarına, cinsiyet değişim ameliyatı ile son vermek isterler. Cinsiyetgeçiş süreci de trans bireylerde büyük bir yük oluşturur. Cinsiyet geçiş süreci, içinde psikoterapi, hormon desteği ve cerrahi girişimi bulunduran ve birçok disiplinin birlikte çalışmasını gerektiren zor bir dönemdir.Hemşirelik literatüründe bu bireylerin sorunlarına, sağlıklarının korunup geliştirilmesine ve cinsiyet geçişsürecinin bu bireylerdeki yüklerine değinen çok az çalışma mevcuttur. Bu çalışmada, hemşirelerin trans bireyler hakkında farkındalık sahibi olmalarının, onların sorunlarını bilmelerinin önemini vurgulamak ve busorunlara yönelik hemşirelik müdahalelerini açıklamak amaçlanmıştır.
Anahtar Kelime:

Konular: Hemşirelik

The Health of Trans Individuals and the Role of Nurse

Öz:
The term “transgender” is used to identify those who have a difference between their gender and their gender. Transgender individuals experience a state of discomfort towards their gender from a child’s age and display this situation in a variety of ways. Most transgender individuals reflect the trans identity directly with their adolescence, with significant changes in their bodies. Since these conditions do not conform to the male and female patterns accepted as a norm in society, these individuals face various problems and discrimination in their social lives. These include labeling, exposure to verbal and physical assaults, exclusion from society and difficulty in finding a job. This negative attitude towards trans people is called “transphobia”. Transphobia is not only seen in the society but can also be found in institutions. The transphobia that exists in institutions such as law, education, army and health raises many discrimination for trans individuals. In particular, transphobic attitudes in the field of health may deprive them of access to health rights. Because of these negative attitudes, transgender individuals often avoid using health rights. Some transgender individuals want to end their gender dysphoria with sex reassignment surgery. The surgery process creates a huge burden on transgender individuals. Gender transition is a difficult period involving many disciplines, including psychotherapy, hormone support and surgical intervention. There are very few studies in the nursing literature that address the problems of these individuals, the protection and development of their health, and the burden of gender transition on these individuals. In thisreview, it is aimed to emphasize the importance of nurses to have awareness about trans people, to know their problems and to explain nursing interventions for these problems.
Anahtar Kelime:

Konular: Hemşirelik
Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
  • 1. Veltman A, Chaimowitz G. Mental health care for people who ıdentify as lesbian, gay, bisexual, transgender, and (or) queer. Can J Psychiatry. 2014;59(11):1-7.
  • 2. Beauregard TA, Arevshatian L, Booth JE, Whittle S. Listen carefully: transgender voices in the workplace. The International Journal of Human Resource Management. 2018;29(5): 857-84. [Crossref]
  • 3. Barbir LA, Vandevender AW, Cohn TJ. Friendship, attitudes, and behavioral intentions of cisgender heterosexuals toward transgender individuals. Journal of Gay & Lesbian Mental Health. 2017;21(2):154-70. [Crossref]
  • 4. Costa PA, Davies M. Portuguese adolescents' attitudes toward sexual minorities: transphobia, homophobia, and gender role beliefs. J Homosex. 2012;59(10):1424-42. [Crossref] [PubMed]
  • 5. Costa PA, Almeida R, Anselmo C, Ferreira A, Pereira H, Leal I. University students’ attitudes toward same-sex parenting and gay and lesbian rights in Portugal. J Homosex. 2014;61(12):1667-86. [Crossref] [PubMed]
  • 6. Yadegarfard M, Meinhold-Bergmann ME, Ho R. Family rejection, social isolation, and loneliness as predictors of negative health outcomes (depression, suicidal ideation, and sexual risk behavior) among Thai male-tofemale transgender adolescents. Journal of LGBT Youth. 2014;11(4):347-63. [Crossref]
  • 7. Ritterbusch AE, Correa Salazar C, Correa A. Stigma-related access barriers and violence against trans women in the Colombian healthcare system. Glob Public Health. 2018;13(12): 1831-45. [Crossref] [PubMed]
  • 8. Gordon D, Pratama MP. Mapping discrimination experienced by Indonesian trans* FtM persons. J Homosex. 2017;64(9):1283-303. [Crossref] [PubMed]
  • 9. Xavier J, Bradford J, Hendricks M, Safford L, McKee R, Martin E, et al. Transgender health care access in Virginia: a qualitative study. Int J Transgender. 2013;14(1):3-17. [Crossref]
  • 10. Shipherd JC, Green KE, Abramovitz S. Transgender clients: identifying and minimizing barriers to mental health treatment. Journal of Gay & Lesbian Mental Health. 2010;14(2):94- 108. [Crossref]
  • 11. Lindroth M, Zeluf G, Mannheimer LN, Deogan C. Sexual health among transgender people in Sweden. Int J Transgender. 2017;18(3): 318-27. [Crossref]
  • 12. Safer JD, Coleman E, Feldman J, Garofalo R, Hembree W, Radix A, et al. Barriers to health care for transgender individuals. Curr Opin Endocrinol Diabetes Obes. 2016;23(2):168-71. [Crossref] [PubMed] [PMC]
  • 13. Nowaskie DZ, Sowinski JS. Primary care providers' attitudes, practices, and knowledge in treating LGBTQ communities. J Homosex. 2018:1-21. [Crossref] [PubMed]
  • 14. Klotzbaugh R, Spencer G. Magnet nurse administrator attitudes and opportunities: toward improving lesbian, gay, bisexual, or transgender-specific healthcare. J Nurs Adm. 2014;44(9):481-6. [Crossref] [PubMed]
  • 15. Dorsen C. An integrative review of nurse attitudes towards lesbian, gay, bisexual, and transgender patients. Can J Nurs Res. 2012;44(3):18-43.
  • 16. Roche K, Keith C. How stigma affects healthcare access for transgender sex workers. Br J Nurs. 2014;23(21):1147-52. [Crossref] [PubMed]
  • 17. Carabez RM, Eliason MJ, Martinson M. Nurses' knowledge about transgender patient care: a qualitative study. ANS Adv Nurs Sci. 2016;39(3):257-71. [Crossref] [PubMed]
  • 18. Paradiso C, Lally RM. Nurse practitioner knowledge, attitudes, and beliefs when caring for transgender people. Transgend Health. 2018;3(1):47-56. [Crossref] [PubMed] [PMC]
  • 19. Pan American Health Organization, World Health Organization. Promotion Sexual Health of Recommendations for Action. Antigua Guatemala, Guatemala; 2000. p.58.
  • 20. Dökmen ZY. Toplumsal Cinsiyet: Sosyal Psikolojik Açıklamalar. 8. Baskı. İstanbul: Remzi Kitabevi; 2009. p.17-40.
  • 21. Başar K, Yüksel Ş. [Gender identity issues from childhood to adulthood: appropriate evaluation and follow-up]. Türkiye Psikiyatri Derneği Sürekli Eğitim/Sürekli Mesleki Gelişim Dergisi. 2014;4(4):389-404.
  • 22. Başar K. [Diversity of sexual orientation and gender identity: appropriate approach in primary healthcare]. Türkiye Klinikleri J Fam Med-Special Topics. 2015;6(2):17-22.
  • 23. Wolf S. Sexuality and Socialism: History, Politics, and Theory of LGBT Liberation. Chicago: Haymarket Books; 2009. p.19-42.
  • 24. Johnson JL, Repta R. Sex and gender: beyond the binaries. In: Oliffe JL, Greaves L, eds. Designing and Conducting Gender, Sex & Health Research. Los Angeles: SAGE Publications; 2012. p.17- 37. [Crossref]
  • 25. Başar K. [Biological sex, gender idendity, sexual orientation]. Yüksel Ş, Yetkin N, editörler. Cinsel Eğitim Tedavi ve Araştırma Derneği Bilgilendirme Dosyası-10: Eşcinsellik. İstanbul: Senk Ofset Matbaacılık; 2013. p.13-7.
  • 26. Preves SE. Sexing the intersexed: an analysis of sociocultural responses to intersexuality. Signs. 2002;27(2):523-56. [Crossref]
  • 27. Duyar BK. Gender and as the Destruction of Identity “Queer”. Felsefelogos. 2012;46:94- 101.
  • 28. Ann O. Sex, Sex and Gender. Gender and Society. 1st ed. England: Routledge; 2015. p.115- 25.
  • 29. Baird V. The No-Nonsense Guide to Sexual Diversity. 1st ed. Oxford: New Internationalist Publications; 2007. p.85-97.
  • 30. Çolak Ö. [Human rights education program for the trainers handbook: elimination of discrimination against LGBTI]. Ankara: Uluslararası Af Örgütü Türkiye Şubesi; 2015.
  • 31. Scholz S. Hegemonic masculinity: an innovative concept or an empty discourse? Felsefelogos. 2012;46:71-82.
  • 32. Graham R, Berkowitz B, Blum R, Bockting W, Bradford J, de Vries B, et al. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Inderstanding. Washington, DC: Institute of Medicine; 2011. p.366.
  • 33. Kuper LE, Nussbaum R, Mustanski B. Exploring the diversity of gender and sexual orientation identities in an online sample of transgender individuals. J Sex Res. 2012;49(2-3):244-54. [Crossref] [PubMed]
  • 34. Başar K. [Different facets of sexual identity: sex, gender identity, gender role, and sexual orientation]. Toplum ve Hekim Dergisi. 2014;29(4):245-51.
  • 35. American Psychological Association. Key Terms and Concepts in Understanding Gender Diversity and Sexual Orientation Among Students. 2015. [Link]
  • 36. Başar K, Nil MŞ, Kaptan S. [Common false and scientific facts about homosexuality]. Erol A, Öztop N, editör. Homofobi Kimin Meselesi? Ankara: Ayrıntı Basımevi; 2010. p.68-77.
  • 37. Macionis JJ. Social inequality. Sociology. 14th ed. United States of America: Pearson; 2012. p.268-346.
  • 38. Berghan S. [Transfeminism]. Cogito. 2014; (65-66):140-9.
  • 39. Mondimore FK. [Natural History of Homosexuality]. 1st ed. İstanbul: Sarmal Yayınevi; 1996.
  • 40. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). 5th ed. Arlington, VA: American Psychiatric Publishing; 2013. p.991.
  • 41. Coleman E, Bockting W, Botzer M, CohenKettenis P, DeCuypere G, Feldman J, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, Version 7. Int J Transgender. 2012;13(4):165-232. [Crossref]
  • 42. Köse E. [Medicine, sexuality and ”political body]. Erol A, editör. Anti-Homofobi Kitabı 3. 1. Baskı. Ankara. Ayrıntı Basımevi; 2011. p.31-5.
  • 43. Hill DB, Willoughby BLB. The development and validation of the genderism and transphobia scale. Sex Roles. 2005;53(7-8):531- 44. [Crossref]
  • 44. Chakraborti N, Garland J. Hate Crime: Impact, Causes & Responses. 2nd ed. London: SAGE Publications Ltd; 2015. p.72-89. [Crossref]
  • 45. Remafedi G. Lesbian, gay, bisexual, and transgender youths: who smokes, and why? Nicotine Tobacco Res. 2007;9(1):65-71. [Crossref] [PubMed]
  • 46. Glynn TR, van den Berg JJ. A systematic review of interventions to reduce problematic substance use among transgender idividuals: a call to action. Transgender Health. 2017;2(1):45-59. [Crossref] [PubMed] [PMC]
  • 47. Yang X, Wang L, Gu Y, Song W, Hao C, Zhou J, et al. A cross-sectional study of associations between casual partner, friend discrimination, social support and anxiety symptoms among Chinese transgender women. J Affect Disord. 2016;203:22-9. [Crossref] [PubMed]
  • 48. Bouman WP, Claes L, Brewin N, Crawford JR, Millet N, Fernandez-Aranda F, et al. Transgender and anxiety: a comparative study between transgender people and the general population. Int J Transgender. 2017;18(1):16- 26. [Crossref]
  • 49. Wolford-Clevenger C, Cannon CJ, Flores LY, Smith PN, Stuart GL. Suicide risk among transgender people: a prevalent problem in critical need of empirical and theoretical research. Violence and Gender. 2017;4(3):69- 72. [Crossref] [PubMed] [PMC]
  • 50. Martin-Storey A, Paquette G, Bergeron M, Dion J, Daigneault I, Hebert M, et al. Sexual violence on campus: differences across gender and sexual minority status. The Journal of Adolescent Health. 2018;62(6):701-7. [Crossref] [PubMed]
  • 51. Walters MA, Paterson J, Brown R, McDonnell L. Hate crimes against trans people: assessing emotions, behaviors, and attitudes toward criminal justice agencies. Journal of Interpersonal Violence. 2017:1-31. [Crossref] [PubMed]
  • 52. Aparicio-Garcia ME, Diaz-Ramiro EM, RubioValdehita S, López-Núñez MI, García-Nieto I. Health and well-being of cisgender, transgender and non-binary young people. Int J Environ Res Public Health. 2018;15(10):2133. [Crossref] [PubMed] [PMC]
  • 53. Mizock L, Lewis TK. Trauma in transgender populations: risk, resilience, and clinical care. Journal of Emotional Abuse. 2008;8(3):335- 54. [Crossref]
  • 54. Spicer SS. Healthcare needs of the transgender homeless population. Journal of Gay & Lesbian Mental Health. 2010;14(4):320-39. [Crossref]
  • 55. Yüksel Ş. [Principles of standard evaluation, decision making and maintenance of transgender and sex reassignment]. Erol A, editör. Uluslararası Homofobi Karşıtı Buluşma. 4. baskı. Ankara. Ayrıntı Basımevi; 2009. p.91- 4.
  • 56. Güngör A. [Guide of trans men]. Öteki Erkekler. 2nd ed. İstanbul: Sel Yayıncılık; 2015. p.182-7.
  • 57. Radix AE, Erickson-Schroth L, Jacobs LA. Transgender and gender nonconforming individuals. In: Eckstrand KL, Potter J, eds. Trauma, Resilience, and Health Promotion in LGBT Patients: What Every Healthcare Provider Should Know. Switzerland: Springer International Publishing; 2017. p.105-11. [Crossref]
  • 58. VandenBos GR, American Psychological Association. APA Dictionary of Psychology. 2nd ed. Washington, DC: American Psychological Association; 2015. p.1204.
  • 59. Keskin N, Yapça G, Tamam L. [Transsexualism: clinical features and legal issues]. Psikiyatride Güncel Yaklaşımlar. 2015;7(4):436-47.
  • 60. Rager Zuzelo P. Improving nursing care for lesbian, bisexual, and transgender women. J Obstet Gynecol Neonatal Nurs. 2014;43(4): 520-30. [Crossref] [PubMed]
  • 61. Zunner BP, Grace PJ. The ethical nursing care of transgender patients: an exploration of bias in health care and how it affects this population. Am J Nurs. 2012;112(12):61-4. [Crossref] [PubMed]
  • 62. Yüksel Ş, Bıkmaz S, Ertekin BA. [Transsexuals and hormone use]. Erol A, editör. Uluslararası Homofobi Karşıtı Buluşma. 4. baskı. Ankara: Ayrıntı Basımevi; 2009. p.95-7.
APA Soner G, Altay B (2019). Trans Bireylerin Sağlığı ve Hemşirenin Rolü. , 331 - 338. 10.5336/nurses.2018-63864
Chicago Soner Güven,Altay Birsen Trans Bireylerin Sağlığı ve Hemşirenin Rolü. (2019): 331 - 338. 10.5336/nurses.2018-63864
MLA Soner Güven,Altay Birsen Trans Bireylerin Sağlığı ve Hemşirenin Rolü. , 2019, ss.331 - 338. 10.5336/nurses.2018-63864
AMA Soner G,Altay B Trans Bireylerin Sağlığı ve Hemşirenin Rolü. . 2019; 331 - 338. 10.5336/nurses.2018-63864
Vancouver Soner G,Altay B Trans Bireylerin Sağlığı ve Hemşirenin Rolü. . 2019; 331 - 338. 10.5336/nurses.2018-63864
IEEE Soner G,Altay B "Trans Bireylerin Sağlığı ve Hemşirenin Rolü." , ss.331 - 338, 2019. 10.5336/nurses.2018-63864
ISNAD Soner, Güven - Altay, Birsen. "Trans Bireylerin Sağlığı ve Hemşirenin Rolü". (2019), 331-338. https://doi.org/10.5336/nurses.2018-63864
APA Soner G, Altay B (2019). Trans Bireylerin Sağlığı ve Hemşirenin Rolü. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi, 11(3), 331 - 338. 10.5336/nurses.2018-63864
Chicago Soner Güven,Altay Birsen Trans Bireylerin Sağlığı ve Hemşirenin Rolü. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi 11, no.3 (2019): 331 - 338. 10.5336/nurses.2018-63864
MLA Soner Güven,Altay Birsen Trans Bireylerin Sağlığı ve Hemşirenin Rolü. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi, vol.11, no.3, 2019, ss.331 - 338. 10.5336/nurses.2018-63864
AMA Soner G,Altay B Trans Bireylerin Sağlığı ve Hemşirenin Rolü. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi. 2019; 11(3): 331 - 338. 10.5336/nurses.2018-63864
Vancouver Soner G,Altay B Trans Bireylerin Sağlığı ve Hemşirenin Rolü. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi. 2019; 11(3): 331 - 338. 10.5336/nurses.2018-63864
IEEE Soner G,Altay B "Trans Bireylerin Sağlığı ve Hemşirenin Rolü." Türkiye Klinikleri Hemşirelik Bilimleri Dergisi, 11, ss.331 - 338, 2019. 10.5336/nurses.2018-63864
ISNAD Soner, Güven - Altay, Birsen. "Trans Bireylerin Sağlığı ve Hemşirenin Rolü". Türkiye Klinikleri Hemşirelik Bilimleri Dergisi 11/3 (2019), 331-338. https://doi.org/10.5336/nurses.2018-63864