Experiences with psychiatrists
70% of participants had accessed a psychiatrist. Participants MAAB on average rated their experience as just below ‘positive’ (M = 3.65, SD = 1.25). People FAAB on average rated their experience as just below neutral (M = 2.73, SD = 1.25). To determine if these differences were significant, and given the age differences between the two cohorts, an ANCOVA was performed with satisfaction with psychiatrists as the dependent variable, assigned sex as the fixed factor, and age as the covariate. There was a significant effect of assigned sex on satisfaction with psychiatrists even when controlling for age, F(1,115) = 4.479, p < .05.
Analysis of open-ended responses (n = 110) suggested that positive experiences (n = 43) were marked by psychiatrists being, for example, “professional, helpful, knowledgeable” and being “a caring, humane practitioner”. Negative experiences (n = 67) were marked by a concern that seeing a psychiatrist was, for example, “a gatekeeping exercise”, or involved being “asked lots of ridiculous or offensive questions”. Participants MAAB were more likely to report positive experiences than were participants FAAB, X
2(1, N = 43) = 9.72, p < .01. Participants FAAB were more likely to report negative experiences than were participants MAAB, X
2(1, N = 67) = 8.64, p < .01.
Experiences with general practitioners
80% of participants had accessed a general practitioner. Participants on average were positive about feeling respected by general practitioners (M = 4.19, SD = 1.18), though some discrimination was reported (M = 1.70, SD = 1.22). Participants on average were neutral about the degree of comfort they felt with general practitioners (M = 3.61, SD = 1.53). There were no significant differences between ratings in terms of assigned sex.
There was a moderate positive relationship between feeling greater comfort with General Practitioners (GPs) and levels of self-reported mental wellbeing, r = .39, p < .001, and also a moderate positive relationship between feeling respect from GPs, and levels of self-reported positive mental wellbeing r = .41, p < .001. Conversely, there was a negative relationship between reported levels of discrimination from General Practitioners and levels of self-reported mental wellbeing, r = −.42, p < .001. Finally, there was a moderate positive relationship between the need to educate GPs and levels of discrimination, r = .31, p < .001, and a moderate negative relationship between the need to education GPs and feeling respected, r = −.38, p < .001.
Analysis of open-ended responses (n = 147) suggested that positive experiences (n = 85) primarily emphasised, for example, “being treated with respect”, whilst negative experiences (n = 62) involved feeling that physical healthcare can, for example, “be invasive and sometimes abusive” and that there was often a need “to educate them”. There were no significant differences between positive and negative responses in terms of assigned sex.
Experiences of surgery
Overall, 42.5% of participants had undertaken sex-affirming surgery. On average participants reported positive experiences with surgery (M = 4.27, SD = 0.89), as well as positive experiences of post surgery support (M = 4.34, SD = 0.68). On average participants felt that their surgeon had provided adequate information about the surgery (M = 4.64, SD = 0.73), and that they felt they had control over the surgery process (M = 4.49, SD = 0.74).
Participants MAAB who had surgery reported more positive experiences of surgery (M = 4.27, SD = 0.89) than did participants FAAB (M = 1.66, SD = 1.09), t(74) = 11.42, p < .001. Participants MAAB who had surgery also reported more positive experiences of post-surgery care (M = 4.34, SD = 0.68) than did participants FAAB (M = 1.84, SD = 1.16), t(74) = 11.73, p < .001. Participants MAAB were more likely to have undertaken surgery than were participants FAAB, X2 = 4.54, p < .05.
An ANCOVA was performed to assess the relationship between surgery and mental health, with age as the covariate. Having had surgery (M = 3.87, SD = 0.98) or not (M = 2.98, SD = 1.16) was a significant predictor of mental health, F(1, 167) = 3.738, p < .05. An ANCOVA with age as the covariate was also performed with physical health as the dependant variable. Those who had surgery reported higher levels of self-reported physical health (M = 4.00, SD = 0.90) than did those who had not undertaken surgery (M = 3.10, SD = .98), F(1, 167) = 4.531, p < .01.
Analysis of open-ended responses (n = 65) suggested that positive experiences (n = 40) were marked by surgeons being, for example, “willing to work with me to achieve my desired outcome”. Negative experiences (n = 25) of surgery involved occurrences such as “I was not adequately warned of the possible scarring”, and “some staff have shared my information without permission and it can be embarrassing”. Participants MAAB were more likely to report positive experiences than were participants FAAB, X
2(1, N = 40) = 10.42, p < .01. Participants FAAB were more likely to report negative experiences than were participants MAAB, X
2(1, N = 25) = 11.52, p < .01.