Uncertain Expertise and the Limitations of Clinical Guidelines in Transgender Healthcare.
J Health Soc Behav
; 57(3): 319-32, 2016 09.
Article
in En
| MEDLINE
| ID: mdl-27601408
ABSTRACT
To alleviate uncertainty in the specialized field of transgender medicine, mental and physical healthcare providers have introduced the rhetoric of evidence-based medicine (EBM) in clinical guidelines to help inform medical decision making. However there are no diagnostic tests to assess the effectiveness of transgender medical interventions and no scientific evidence to support the guidelines. Using in-depth interviews with a purposive sample of 23 healthcare providers, I found that providers invoked two strategies for negotiating the guidelines. Some used the rhetoric of EBM and closely followed clinical guidelines to contain uncertainty. Others flexibly interpreted the guidelines to embrace uncertainty. These findings raise questions about the effectiveness of EBM and guidelines in medical decision making. While trans medicine involves an identity and not a biomedical illness, providers use the same strategies to respond to uncertainty as they may in other medical arenas.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Practice Patterns, Physicians'
/
Practice Guidelines as Topic
/
Evidence-Based Medicine
/
Transgender Persons
/
Clinical Decision-Making
Type of study:
Guideline
/
Prognostic_studies
/
Qualitative_research
Limits:
Female
/
Humans
/
Male
Language:
En
Journal:
J Health Soc Behav
Year:
2016
Document type:
Article
Affiliation country:
United States