Patients’ perspectives on psychiatric consultations in the Gender Identity Clinic: Implications for patient-centered communication

Abstract Objective To explore transsexual patients’ perceptions of communication with psychiatrists in a Gender Identity Clinic and advance understanding of patient centered communication (PCC) in psychiatric, ‘gatekeeping’ settings. Methods 21 qualitative interviews with a convenience sample of cli...

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Bibliographic Details
Published in:Patient education and counseling 2013-06, Vol.91 (3), p.385-391
Main Authors: Speer, Susan A, McPhillips, Rebecca
Format: Article
Language:English
Subjects:
Adolescent
Adult
Clinical communication
Clinics
Female
Gender Identity
Health Communication
Humans
Internal Medicine
Interviews as Topic
Liking
Male
Nursing
Patient centered communication
Patient centredness
Patient-Centered Care
Perceptions
Physician-Patient Relations
Psychiatrists
Psychiatry
Qualitative Research
Referral and Consultation
Transsexualism
Young Adult
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Summary:Abstract Objective To explore transsexual patients’ perceptions of communication with psychiatrists in a Gender Identity Clinic and advance understanding of patient centered communication (PCC) in psychiatric, ‘gatekeeping’ settings. Methods 21 qualitative interviews with a convenience sample of clinic patients. Interviews were coded at a semantic level and subject to an inductive thematic analysis. Results Patients’ perceptions clustered into three themes: (1) aspects of communication that patients described liking; (2) aspects of communication that patients described disliking; and (3) aspects of communication that patients deemed challenging but necessary or useful. Conclusion Patients described liking or disliking aspects of communication that reflect existing understandings of PCC. However, a striking feature of their accounts was how they were able to rationalize and reflect pragmatically on their negative communication experiences, welcoming doctors’ challenges as an opportunity to consider their life-changing decision to transition from their natal gender. Practice implications In certain clinical settings, current operationalizations of PCC may not apply. Patients’ perceptions of communication may be enhanced if an analysis of their experiences formed part of the professional training of doctors, who could be invited to consider the functional specificity of communication across settings and the consequences (both immediate and post hoc) of their communication practices.
ISSN:0738-3991
1873-5134
DOI:10.1016/j.pec.2012.12.009