同志友善臨床護理能力

Clinical Competencies of Nursing Care for Sexual/Gender Minorities

徐志雲(Chih-Yun Hsu)

《臺大護理雜誌》 14卷1期 (2018/01) Pp. 6-17

https://doi.org/10.6740/NTUHJN.201801_14(1).0003

摘要

現今台灣社會中最常被定義為同志的族群包括：女同性戀、男同性戀、雙性戀、跨性別等，在醫學的定義可大約對應至「性少數／性別少數（性／別少數）」。同志族群並不少見，但其醫療需求與權益在就醫環境中卻很少被看見，本文援引美國兒童與青少年精神醫學會的臨床指引，介紹常見的性／別少數專有名詞，並以性／別少數壓力模型說明弱勢族群遭受壓力的樣貌，以闡述其臨床困境。本文並具體提出臨床護理對於同志友善的實務能力，包括不預設個案的性傾向、保持對於多元性／別敏感度、重視保密原則、注意稱謂及身體界線、了解性傾向無法改變、重視雙重弱勢的女同志就醫議題、掌握同志伴侶醫療權益最新訊息、熟悉性／別少數的社區相關資源等，藉此提升醫療人員對性別議題的敏感度，以因應醫療情境不斷演進的多樣性。

關鍵字

同志 ； 性／別少數 ； 護理能力

並列摘要

In Taiwan, ＂Tong-Zhi＂ means lesbian, gay, bisexual, and transgender (LGBT) people, which is approximately concordant to sexual/gender minorities in medical terms. LGBT people are not rare, but delicate healthcare for sexual/gender minorities has not been extensively discussed in clinical settings. We introduce the terminology of gender, according to ＂Practice Parameter on Gay, Lesbian, or Bisexual Sexual Orientation, Gender Nonconformity, and Gender Discordance in Children and Adolescents＂ published by the American Academy of Child and Adolescent Psychiatry in 2012, and elaborate the difficulties of LGBT healthcare in the context of the minority stress model. In this article, we suggest the major principles of treating sexual/gender minorities in clinical practice, which include: to avoid assuming the patient’s sexual orientation; exhibit sensitivity concerning diverse sex/gender; ensure confidentiality; be aware of appellations and physical boundaries; understand the inability to change the patients sexual orientation; pay attention to the dual underprivileged population of lesbian; follow recent information on medical rights of same-sex partners, and be familiar with the LGBT social resources. Throughout continuing nursing education, the core spirits of gender mainstreaming can be facilitated in this ever-changing medical environment.

並列關鍵字

LGBT ； sexual/gender minority ； nursing competency