Negotiating the (bio)medical gaze – Care-users' experiences of trans-specific healthcare in Sweden

An increasing number of people in Sweden are seeking help from the healthcare in order to get access to gender confirming medical procedures. However, few studies have explored how people experience the Swedish trans-specific... [ view full abstract ]

An increasing number of people in Sweden are seeking help from the healthcare in order to get access to gender confirming medical procedures. However, few studies have explored how people experience the Swedish trans-specific healthcare. In this qualitative study with care-users, biomedicalisation (Clarke et al 2003) is used as a theoretical framework in order to analyse how technoscientific and neoliberal developments are parts of constructing specific experiences within the trans-specific healthcare.

The aim of this study is to explore and analyse care-user’s experiences of navigating and negotiating access to trans-specific healthcare in Sweden. [ view full abstract ]

The aim of this study is to explore and analyse care-user’s experiences of navigating and negotiating access to trans-specific healthcare in Sweden.

The material consists of 14 interviews, which are analysed with constructivist grounded theory (Charmaz 2014). The participants were contacted through networks for people with trans experiences in Sweden. The participants... [ view full abstract ]

The material consists of 14 interviews, which are analysed with constructivist grounded theory (Charmaz 2014). The participants were contacted through networks for people with trans experiences in Sweden. The participants consists of both both binary and non-binary identified people, their age ranged from 23 to 69 years and they lived in different parts of Sweden.

Not relevant for this qualitative study. [ view full abstract ]

Not relevant for this qualitative study.

Through analysing the participants’ experiences of trans-specific healthcare, we identified the categories “Being evaluated and dependent”, “Governed through time”, “Negotiating the expert-lay relationship”, and... [ view full abstract ]

Through analysing the participants’ experiences of trans-specific healthcare, we identified the categories “Being evaluated and dependent”, “Governed through time”, “Negotiating the expert-lay relationship”, and “Shifting responsibility of support”. In summary, the participants experienced trans-specific as difficult to navigate because of waiting times, lack of support, provider ignorance and relationships of dependency between healthcare-users and providers. To navigate and negotiate the access to care in relation to these barriers, the users to took responsibility for the care process themselves, through ordering hormones from abroad, acquiring medical knowledge and finding alternative healthcare providers and support.

Based on the participants’ experiences, we argue that the shift of responsibility from care-providers to users is connected to a lack of resources within trans-specific care, to neoliberal developments within the Swedish... [ view full abstract ]

Based on the participants’ experiences, we argue that the shift of responsibility from care-providers to users is connected to a lack of resources within trans-specific care, to neoliberal developments within the Swedish healthcare system, but also to discourses that frame taking charge of the care process as an indicator that a person is in need of or ready for care. Thus, the access to gender-confirming medical procedures becomes stratified, based on the ability and opportunity to adopt a charge-taking role and on economic and geographic conditions. Based on the results and discussion, we conclude that trans-specific care ought to focus on supporting the care seekers in their decisions and throughout the medical process, instead of the current focus on evaluating the need for care. There is also a need for increased knowledge and financial resources. A separation between legal and medical gender reassignment could contribute to a better relationship between care-providers and care-users and thus increase the quality of care.