Knowledge, attitudes and practices of health care workers related to treatment and care of transgender patients: A qualitative study in Kwazulu-Natal, South Africa

Abstract

The transgender population is stigmatised and they face a number of barriers when accessing health care. Additionally, they are subject to a number of health risks, such as increased risk of HIV infection, substance abuse and illicit use of cross gender hormones. Their health risks are further aggravated by a lack of targeted health programmes and limited number of health care workers (HCW) who are skilled in transgender health.The aim of the study was to uncover the knowledge, attitudes and practices of the HCW towards the transgender patients’ sexual and reproductive health. An exploratory, descriptive and contextual qualitative design was employed. This methodology was considered appropriate because little is known regarding what drives the observed actions of HCW towards the transgender patients in the South African health care setting. Thirteen HCW participated in one on one semi-structured interviews. Recruitment was stopped once data phases no longer contributed different themes or ideas to the analytical categories. Transgender health is not covered in the training of the HCW, thus knowledge and skills on transgender patients’ needs is limited. The HCWs approach the care of the transgender patient with uncertainty, resulting in alienation of patients through poor relations. There is a paucity of information and research on the transgender population, making it a challenge to design guidelines and programmes. Cultural and religious beliefs were put forward by HCW as part of the reasons for difficult interaction with the transgender patients. Transgender health must be included in the pre- and post-service training curriculum of HCW. The transgender population data must be part of the routine data collection and captured by the broader health care research agenda.

Keywords: Critical Ethnography, Transgender, Gender Identity, Sexual Health