Clinicians’ Experiences in Transgender Healthcare: The Impact of Sexology Training on Roles, Challenges, and Solutions

Abstract Despite the critical role of clinicians in facilitating access to healthcare by transgender and gender diverse (TGD) people, their insight and practice-based knowledge have been underresearched. Also, they may complement TGD people's experiences by giving an insider perspective. This exploratory qualitative study, conducted online in a sample of 25 clinicians who work with TGD people (n = 11 clinical sexologists), explores how clinicians working with TGD people in Portugal perceive healthcare provision to TGD people, using a summative content analysis. Results showed that clinicians perceive their role to be all-encompassing, ranging from helping to cope with individual and interpersonal issues, and to cope with other health services. Participants highlighted the increase of TGD people’s visibility, awareness, and scientific knowledge, albeit more is needed as evidenced by several challenges derived from clinicians (e.g., lack of national guidelines, lack of training for standardized care, and lack of professional skills) and from the TGD clients (e.g., unrealistic expectations and lack of compliance). The proposed solutions include increasing the investment in specialized training and human resources, raising awareness within the healthcare system, and increasing interdisciplinary specialized care. Clinicians specialized in clinical sexology highlighted changes in scientific knowledge, more available evidence, and a need for socio-political changes and awareness raising. This study reveals that healthcare providers are self-critical but also reflect upon the difficulties of navigating between organizational, human, and personal constraints, claiming that to provide better healthcare there, policymakers must take concerted measures that can have a social impact.