Primary care vor trans* people
Conditions
Interventions
Group 1: In this single-arm observational study, a multicentric, sequentially exploratory mixed-methods design is employed.
• Qualitative phase: Longitudinal interviews with trans* persons (t0, spotli
Sponsors
Medizinische Hochschule Hannover, Institut für Allgemeinmedizin und Palliativmedizin
Eligibility
Sex/Gender
All
Age
14 Years to No maximum
Inclusion criteria
Inclusion criteria: WP1 – Trans Persons (Qualitative Interviews and Survey)* • Self-identification as a trans* person, including non-binary, genderqueer, or gender-nonconforming individuals. • Age = 14 years. • Sufficient German language proficiency to participate in interviews conducted in spoken German (for WP1a). • Sufficient ability to understand the study information and provide informed consent. WP2 – Routinely Collected Health Insurance Data (AOK Niedersachsen) • Inclusion of anonymized data sets of insured individuals for whom an ICD-10 diagnosis F64.0 and/or a coded gender-affirming surgery (OPS) has been recorded since 2022. • No active recruitment of participants. WP3 – Primary Care Practice Teams • Employment as a physician or medical assistant in general practice, gynecology, or pediatrics. • Age = 18 years. • Involvement in at least one consultation or treatment of a trans* person within the past 12 months. • Sufficient German language proficiency to participate in interviews conducted in spoken German. • Sufficient ability to understand the study information and provide informed consent. WP4 – Individuals from the Social Environment of Trans Persons* • Persons identified by trans* participants as part of their social environment (e.g., family members, friends, partners, supporters, accompanying persons). • Age = 14 years. • Sufficient German language proficiency to participate in interviews conducted in spoken German. • Sufficient ability to understand the study information and provide informed consent. WP6 – Experts for Trans Health Care (Workshop and Delphi Survey)* • Documented expertise in the healthcare of trans* persons (e.g., clinical, scientific, policy, or community-based expertise). • Age = 18 years. • Sufficient German language proficiency to participate in the workshop and/or Delphi survey. • Sufficient ability to understand the study information and provide informed consent.
Exclusion criteria
Exclusion criteria: • Lack of adequate capacity to understand the study information and to provide informed consent to participate • Insufficient proficiency in German to participate in interviews conducted in spoken German
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Consensus-based recommendations for improving primary care for trans* individuals (Delphi consensus =75%). | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Reconstruction of trans* individuals’ care experiences, needs, and expectations in primary care based on longitudinal interviews (t0, spotlight interviews, t1), including the identification of positively and negatively perceived care episodes using the Critical Incident Technique. 2. Analysis of data from a nationwide online survey on experiences in primary care, alongside the assessment of health-related outcomes using standardized Patient-Reported Outcome Measures (PROMs). 3. Identification of comorbidity patterns through cluster analyses, compared with age- and gender-matched cis reference cohorts. 4. Exploration of perceived care needs and challenges from the perspective of non-specialized outpatient care teams. 5. Identification of challenges arising from role transitions, psychosocial stressors, and uncertainties within the healthcare system. 6. Systematic identification of gaps in undergraduate medical and nursing curricula, as well as in specialist postgraduate training, with regard to gender-affirming care. 7. Identification of recommendations with and without consensus to inform the final list of recommendations (consensus defined as =75% agreement). | — |
Countries
Germany
Contacts
Public ContactStephanie Stiel
Medizinische Hochschule Hannover, Institut für Allgemeinmedizin und Palliativmedizin
Outcome results
None listed