1
|
Lifshitz D, Yaish I, Wagner-Kolasko G, Greenman Y, Sofer Y, Alpern S, Groutz A, Azem F, Amir H. Transgender men's preferences when choosing obstetricians and gynecologists. Isr J Health Policy Res 2022; 11:12. [PMID: 35148780 PMCID: PMC8840634 DOI: 10.1186/s13584-022-00522-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 02/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transgender men are a marginalized population with unique health care needs. However, their usage of health services is low because of considerable discrimination. A major factor in their avoidance is patient-provider interactions. METHODS This cross-sectional study included 102 transgender men who anonymously completed a 55-item questionnaire in clinic, between 10/2017 and 01/2019. In addition, 92 transgender women filled out the part about family physician's preferences. We examined which characteristics transgender men prefer in their obstetricians/gynecologists in order to promote their usage of healthcare services. RESULTS A small majority of the transgender men (54.1%) had no gender preference for their obstetrician/gynecologist, while 42.9% preferred a female obstetrician/gynecologist and 3.1% preferred a male obstetrician/gynecologist. Most transgender men with a same-gender preference preferred female obstetricians/gynecologists for both invasive procedures (e.g., pelvic examination, 97.4%) and non-invasive procedures (e.g., cesarean section, 60%). The reasons for preferences regarding invasive procedures were feeling comfortable, embarrassment and feeling that female obstetricians/gynecologists are gentler. Transgender men who preferred female obstetricians/gynecologists ranked ability (90.5%), sexual tolerance (92.9%) and gender identity tolerance (90.5%) as the top three desirable qualities of obstetricians/gynecologists, while the responders who did not prefer female ranked ability (94.6%), experience (92.9%) and knowledge (92.9%) as the top three qualities. Transgender men with female preferences considered female obstetricians/gynecologists to be more accepting of gender identity compared to the responders that did not prefer females (47.5% vs. 9.1%, P < .001).. CONCLUSION A small majority of the transgender men exhibited no gender preference when choosing an obstetrician/gynecologist, although 42.9% preferred females. The latter choice was associated with the assumption that female obstetricians/gynecologists are more tolerant towards their transgender men patients. Educating the medical staff about their special needs and establishing dedicated SGM centers staffed with high percentages of female healthcare providers are highly recommended.
Collapse
Affiliation(s)
- Dror Lifshitz
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel.
| | - Iris Yaish
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gal Wagner-Kolasko
- Department of Family Medicine, Clalit Gan-Meir LGBT Clinic, Tel Aviv District, Israel
| | - Yona Greenman
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Sofer
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Alpern
- Sara Racine IVF Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asnat Groutz
- Sara Racine IVF Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Foad Azem
- Sara Racine IVF Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hadar Amir
- Sara Racine IVF Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
2
|
Setoodefar M, Tabesh H, Tara F, Eslami S, Heshmati Nabavi F, Valizadeh Zare N, Taheri SH, Rajabzadeh Moghaddam MR, Etminani K. Measurement Model of Women's Preferences in Obstetrician and Gynecologist Selection in the Private Sector: Exploratory and Confirmatory Factor Analysis. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2020; 8:150-163. [PMID: 32309456 PMCID: PMC7153421 DOI: 10.30476/ijcbnm.2020.82278.1049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: The purpose of this study is to construct and validate a measurement model of women’s preferences in Obstetrician
and Gynecologist (OB/GYN) selection in the private sector of non-clinical parameters. Methods: This methodological study included 462 respondents in OB/GYN’s offices to a researcher-made questionnaire.
The patients visited 57 offices of OB/GYNs in the city of Mashhad in Iran and completed women’s preferences in OB/GYN selection
questionnaire over a 2-month period from January to February 2018. Exploratory Factor Analysis (EFA) was conducted to verify the
instrument’s construct validity. Confirmatory Factor Analysis (CFA) was used to test whether the data fit our hypothesized model obtained from EFA model. Results: The first draft of the questionnaire was prepared with 118 items based on literature review. The outcome of content validity
assessment was a 51-item questionnaire. Scale-Content Validity Index (S-CVI) turned out to be 0.80. The results of EFA yielded
an instrument with 33 items in six domains, which explained 52.657% of the total variance of the questionnaire. With performing
CFA, the 6-factor model with 29 items demonstrated a good fit with the data (CFI=0.952, CMIN/DF=1.613, RMSEA=0.036).
Availability and Accessibility, Communicational Skills, Office Environment, Recommendation by Others, Special Services,
and Cost and Insurance were found to define the women’s preferences in OB/GYN selection in private sector, Iran. Conclusion: The developed measurement model considers the patient’s preferences that influence decision-making process on OB/GYN selection.
It can provide useful knowledge for OB/GYNs and policymakers to design appropriate and efficient marketing strategies according to the consumer preferences priority.
Collapse
Affiliation(s)
- Masood Setoodefar
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Tabesh
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Tara
- Patient Safety Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Eslami
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Heshmati Nabavi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Najmeh Valizadeh Zare
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyyed Hassan Taheri
- Department of Computer Sciences, School of Engineering, Khayyam University, Mashhad, Iran
| | | | - Kobra Etminani
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
3
|
Altered patient perceptions and preferences regarding male and female gynecologists: a comparison between 1997 and 2018. Arch Gynecol Obstet 2019; 300:1331-1341. [PMID: 31583460 DOI: 10.1007/s00404-019-05315-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 09/19/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The purpose of this investigation was to explore changes in patient preference regarding gynecologist's gender. METHODS Using a standardized questionnaire, distributed in 1997 and 2018, a total of 1000 women were interviewed about preferences in terms of their choice of gynecologist and perceptions regarding gender-dependency of gynecologist's qualifications, strengths and weaknesses. Data was correlated with sociodemographics and possible influencing factors. RESULTS Based on their own experience, an increasing majority did not express a preference for their gynecologist's gender (58-71%). However, the minority that still favors one gender demonstrated a significant decrease in preference of male gynecologists (14-5%), while about a quarter still generally prefer treatment by female physicians. Sub-analyses of emotional and technical treatment aspects generally confirm these trends in that more of today's patients are indifferent to their gynecologist's sex and that the remaining minority shifts towards favoring female doctors. If asked to definitely choose between female and male physicians based solely on the aspect of trust a significant change can be noted (69-30%) in favor of female doctors in 2018 as opposed to 1997 when patients were split in this regard (52%/48%). Overall bad personal experience regarding gynecological treatment has significantly decreased (36% reduction). CONCLUSION Over the last decades, patient preference and perception of the importance of their gynecologist's gender has changed. While an increasing majority attributes equal competence in emotional, professional and interpersonal aspects to both genders, the remaining proportion of patients demonstrates a significant shift towards favoring female doctors.
Collapse
|
4
|
Abstract
Patients' preferences in choosing obstetricians/gynecologists are widely investigated, but studies among traditional populations are lacking. Bedouins comprise a traditional Arab Muslim society in the Arabian Peninsula (Saudi Arabia), The Levant (Syria, Jordan and Israel) and North Africa (Egypt). Most of the Bedouins in Israel populate several villages, mostly in the southern part of the country. This cross-sectional study compared 200 Bedouin and 200 Jewish women who responded to an anonymous questionnaire. Queried on gender alone, more Bedouin responders preferred female obstetricians/gynecologists (59.5 vs. 33% Jewish responders, p value <0.0001). Bedouin women preferred a female obstetrician/gynecologist for intimate procedures [feeling more comfortable (66.3%) and believing that females were more gentle (50%)]. However, they and the Jewish participants ranked ability, experience and knowledge as the top 3 qualities of an obstetrician/gynecologist, putting reputation in 4th place and gender in 5th place. Bedouin women strongly preferred female obstetricians/gynecologists, although professional skills were an important factor in their choice of caregiver. The ideal obstetrician/gynecologist for Bedouin women would be a skilled, knowledgeable, and experienced female.
Collapse
|
5
|
Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing. Viruses 2018; 10:v10120729. [PMID: 30572620 PMCID: PMC6315375 DOI: 10.3390/v10120729] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/12/2018] [Accepted: 12/15/2018] [Indexed: 12/25/2022] Open
Abstract
Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.
Collapse
|
6
|
Groutz A, Amir H, Caspi R, Sharon E, Levy YA, Shimonov M. Do women prefer a female breast surgeon? Isr J Health Policy Res 2016; 5:35. [PMID: 27980717 PMCID: PMC5131538 DOI: 10.1186/s13584-016-0094-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 07/20/2016] [Indexed: 11/30/2022] Open
Abstract
Background Patient preferences regarding the gender of their physicians is a highly sensitive issue, which can be particularly salient in intimate medical situations. Previously published studies found that women tend to prefer female physicians, especially in the case of obstetricians and gynecologists. Data regarding other intimate specialties, such as breast surgery, are scarce. The present study was undertaken to assess gender preferences of women regarding their choice of a breast surgeon. Methods Five hundred and fifteen consecutive women who attended breast clinics in two university-affiliated tertiary hospitals were prospectively enrolled. A 25-item anonymous questionnaire was completed by women independently and used to assess their preferences in selecting their breast surgeon. Of the 515 women, 500 (97 % response rate; mean age 50.6 ± 15.4 years) completed the anonymous questionnaire. Results Overall, 160 (32 %) women preferred to undergo breast examination by a female breast surgeon, 296 (59 %) had no preference, and only 44 (9 %) preferred a male surgeon. A same-gender preference was significantly and independently associated with younger age of the patients (Odds Ratio = 0.978, 95 % Confidence Interval 0.962–0.994, P = 0.007) and being married (Odds Ratio = 0.563, 95 % Confidence Interval 0.347–0.916, P = 0.021). However, only small and equal numbers of patients preferred to undergo breast surgery by a female (14 %) or a male (13 %) surgeon, and most patients (73 %) had no gender preferences. Furthermore, the three most important factors, which affected in general the actual selection, were surgical ability (93 %), experience (91.2 %) and knowledge (78.6 %), rather than physician gender per se. Conclusions Overall, about a third of women prefer a female breast surgeon for their breast examination. Embarrassment during the examination was the major reason for same-gender preference. In contrast, when it comes to breast operations, preference for a female surgeon is less pronounced, with the professional skills of the surgeons becoming the predominant consideration. The fact that almost a third of the potential patients prefer female surgeons with regard to their breast examinations emphasizes the need to increase the number of female surgeons. Such an increase can be achieved through academic and economic changes that will enable more women to specialize in general surgery. Trial registration Trial registration is not required for this type of research.
Collapse
Affiliation(s)
- Asnat Groutz
- Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel ; Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel
| | - Hadar Amir
- Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Revital Caspi
- The Chaim Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Eran Sharon
- Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva, Israel
| | - Yifat Amir Levy
- Department of Medicine, University of California, La Jolla, San Diego, CA USA
| | - Mordechai Shimonov
- E. Wolfson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel
| |
Collapse
|
7
|
Amir H, Beri A, Yechiely R, Amir Levy Y, Shimonov M, Groutz A. Do Urology Male Patients Prefer Same-Gender Urologist? Am J Mens Health 2016; 12:1379-1383. [PMID: 27222116 DOI: 10.1177/1557988316650886] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There are several studies on patients' preference for same-gender physicians, especially female preference for same-gender gynecologists. Data regarding the preferences of urology patients, of whom the majority are males, are scarce. The objective of this study is to assess provider gender preference among urology patients. One hundred and nineteen consecutive men (mean age 57.6 years) who attended a urology clinic in one university-affiliated medical center were prospectively enrolled. A self-accomplished 26-item anonymous questionnaire was used to assess patients' preferences in selecting their urologist. Of the 119 patients, 51 (42.8%) preferred a male urologist. Patients exhibited more same-gender preference for physical examination (38.3%), or urological surgery (35.3%), than for consultation (24.4%). Most patients (97%) preferred a same-gender urologist because they felt less embarrassed. Four patient characteristics were identified to be significantly associated with preference for a male urologist: religious status, country of origin, marital status, and a prior management by a male urologist. Of these, religious status was the most predictive parameter for choosing a male urologist. The three most important factors that affected actual selection, however, were professional skills (84.6%), clinical experience (72.4%), and medical knowledge (61%), rather than physician gender per se. Many male patients express gender bias regarding their preference for urologist. However, professional skills of the clinician are considered to be more important factors when it comes to actually making a choice.
Collapse
Affiliation(s)
- Hadar Amir
- 1 Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avi Beri
- 1 Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ravit Yechiely
- 1 Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yifat Amir Levy
- 1 Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Asnat Groutz
- 1 Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
8
|
Morris M, Roberto K. Information-seeking behaviour and information needs of LGBTQ health professionals: a follow-up study. Health Info Libr J 2016; 33:204-21. [DOI: 10.1111/hir.12139] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 02/09/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Martin Morris
- Schulich Library of Science and Engineering; McGill University; Montréal Canada
| | - K.R. Roberto
- Graduate School of Library and Information Science; University of Illinois at Urbana-Champaign; Champaign IL USA
| |
Collapse
|
9
|
Amer-Alshiek J, Alshiek T, Amir Levy Y, Azem F, Amit A, Amir H. Israeli Druze women's sex preferences when choosing obstetricians and gynecologists. Isr J Health Policy Res 2015; 4:13. [PMID: 26034576 PMCID: PMC4450487 DOI: 10.1186/s13584-015-0013-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 03/09/2015] [Indexed: 11/10/2022] Open
Abstract
Background Consideration and better understanding of patients’ needs on the part of the healthcare system might help increase the number of people seeking necessary medical care. Many studies have been conducted on patients’ preferences in choosing their health care provider, but the majority of them were conducted in modern western societies, establishing a need to explore other populations. The present study was performed in the Israeli Druze community which is composed of a uniquely traditional and religious population. We assessed the sex preference of Israeli Druze women regarding obstetricians/gynecologists, and identify other features that affect their choice. Method We conducted a cross-sectional study that included 196 Israeli Druze women who anonymously completed a 36-item questionnaire between January-July, 2011. Results Most (63.8%) of the responders preferred female obstetricians/gynecologists, while 74.5% had no sex preference for their family physicians. 68.6% of the religious women preferred female obstetricians/gynecologists as compared to 51.76% of those women who self-identified as secular. Most of the women (65%) preferred female obstetricians/gynecologists for intimate procedures, such as pelvic examination and pregnancy follow-up. The main reasons given were: feeling more comfortable with a female practitioner (69.7%), the belief that females are more gentle (56.6%), and being more embarrassed with male obstetricians/gynecologists (45.4%). Three factors were associated with the responders’ preferences for female obstetricians/gynecologists: their age and religious status, and the sex of their regular obstetricians/gynecologists. Women who preferred a female obstetrician/gynecologist assigned a lesser weight to the physician’s knowledge when choosing them. Older and religious women as well as those who attributed less weight to the physician’s professional knowledge were more likely to prefer a female obstetrician/gynecologist. Conclusions The majority of responders to our survey (Israeli Druze women), like those in other communities where religiousness and modesty are deeply rooted, prefer female obstetricians/gynecologists, with the overwhelming reasons given being feeling more comfortable and less embarrassed with females, and the notion that female obstetricians/gynecologists are more gentle during intimate procedures.
Collapse
Affiliation(s)
- Jonia Amer-Alshiek
- Department of Obstetrics and Gynecology, Sara Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv, 6423906 Israel
| | - Tahani Alshiek
- The Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Yifat Amir Levy
- Neuroimmunology Laboratory, Department of Neurology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel ; Departments of Medicine, University of California, La Jolla, San Diego, CA USA
| | - Foad Azem
- Department of Obstetrics and Gynecology, Sara Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv, 6423906 Israel
| | - Ami Amit
- Department of Obstetrics and Gynecology, Sara Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv, 6423906 Israel
| | - Hadar Amir
- Department of Obstetrics and Gynecology, Sara Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv, 6423906 Israel ; Departments of Medicine, University of California, La Jolla, San Diego, CA USA
| |
Collapse
|