Managing Ambiguity While Working in a Glass House: Provider Perspectives on Transgender Healthcare

• In Event: 030 - Regular Session. Health Care and Care Delivery

Abstract

Healthcare providers who work in transgender medicine must learn to balance their professional ethical responsibility for “doing no harm” while the notion of “harm” is ambiguously defined because of the lack of clear medical protocols or guidelines that ordinarily shape medical decision-making. Further, no clinical research has been conducted on the long-term health effects of transgender-specific medical interventions. Within this context of much ambiguity, providers deal with an extraordinary amount of scrutiny from stakeholders such as hospital administrators and insurance providers. Doctors must carefully negotiate these contentious terrains to maintain their livelihoods of practicing medicine. Using in-depth interviews with 23 healthcare providers, I found that with much uncertainty surrounding trans-medicine, healthcare providers deploy strategic and creative responses to assert their professional autonomy, serve clients’ needs, and manage ambiguity.

Author

• Stef M. Shuster, Duke University