Nuevos modelos de atención sanitaria para las personas transgénero en el Sistema Sanitario Español: demandas, controversias y reflexiones
2020
Health care for transgender people in Spain has been
progressively established since 1999 when the first multidisciplinary
unit for the treatment of sex reassignment
was created in Andalusia. In this document, the social
changes, the demands and debates of users and professionals,
the new models of health care for trans people, and
reflections on the current situation, have been analysed.
The social openness in Spain regarding sexual and
gender diversity has evolved quite positively. The health
demands of the transgender users are not uniform and do
not always match with the criteria of the professionals. In
some Spanish regions, health care is distancing itself from
the internationally recommended multidisciplinary model.
The new healthcare models have been established under
the aegis of primary care and/or endocrinologist in the
area, without a required psychological assessment. The
main contributing factors for this change of model have
been the pressure from some associations with demands
for “depathologization” and “decentralization”.
The professionals of gender units, while recognizing
the need for a broader vision of trans reality, warn of the
risk of treating trans people without the involvement of
mental health specialists or by professionals in proximity
with little experience. Moreover, the decentralization
would not allow acting on large cohorts, which hinders
the advance of knowledge and contrasted evaluations with
neighbouring countries. In summary, the new health models,
although intended to facilitate care through proximity,
do not guarantee improvements in quality and difficult
to make a comparative evaluation of the results.
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