Journal Article

\Flipped Examination Room\ - Ascriptions of Vulnerability Between Trans Patients and Their Healthcare Providers

Ihrig, Felix, Lóffelmann, Flora, Steininger, Jo

2025

Overview

Background: The history of pathologisation has left many traces in trans healthcare contexts, especially barriers to receiving healthcare. These can be explained with theories of biopower -the disciplining of non-normative bodies, which often results in breached boundaries and repudiation of agency. Aims: Our study connects to -applied transgender studies-, which centre aims to improve material conditions of trans, inter· and nonbinary (tin·) people's lives. In this exploratory phase of an ongoing research project, we investigated current practices and underlying beliefs about 'trans-sensitive healthcare' in Austria. We focus specifically on ascriptions of vulnerability as modes to gain back or hinder agency in healthcare contexts. Methods: Embedded in frameworks of Institutional Ethnography and Community-Based Participatory Research, we analysed recordings from one tin· Community Team discussion and one training session for healthcare providers (HCPs) with Charmaz' Grounded Theory. Results: By depicting tin· patients as vulnerable and themselves as the needed supporters, some HCPs practice benevolent 'pathologization,' a term we coined in combination of our findings and previous research on trans healthcare. Yet, negotiations of intimacy and responsibility as well as power imbalances can render both parties vulnerable. HCPs' own vulnerability frequently stems from knowledge gaps and expectations concerning expertise, responsibility and authority. Discussion: We argue that a caring and transparent approach to the contextual vulnerabilities in interactions between tin· patients and HPCs is paramount. The notion of caring encounters, where being uncertain is not a flaw but a mere fact of human existence, is a transformative perspective. For a future-oriented, ethical and sensitive approach to healthcare for marginalised, especially tin· people, a 'compassionate gaze' is crucial. This can not only equalize power imbalances but improve health outcomes. One can conclude that tin· people do not require 'special treatment', they require adequate treatment, e.g., medical assessments which are appropriately thorough but not intrusive.

• Publisher: MedStar Washington Hospital Center
• Subject: Non-binary gender