Bulletin of Semashko National Research Institute of Public HealthBulletin of Semashko National Research Institute of Public Health2415-84102415-8429FSSBI «N.A. Semashko National Research Institute of Public Health»304610.25742/NRIPH.2023.04.005Научная статьяSatisfaction and barriers in access to healthcare for transgender people in Eastern Europe and Central AsiaKirey-SitnikovaYanayana.kirey.sitnikova@gmail.comEurasian Coalition on Health, Rights, Gender and Sexual Diversity, Tallinn, Estonia.151220234313720102025Copyright © 2023,2023Background. According to international data, transgender people frequently face inhuman treatment and low professionalism in healthcare. This study aims to assess satisfaction of transgender patients with healthcare in Eastern Europe and Central Asia in three areas: assessment for “transsexualism,” provision of hormone-replacement therapy (HRT) and gender-affirming surgeries. Materials and methods. Cross-sectional study using quantitative and qualitative methods among transgender people in Armenia, Georgia, Kyrgyzstan, Russia, and Ukraine. Results. 56.4% respondents from Russia and 19.5% from Ukraine expressed satisfaction with diagnostics of transsexualism. Negative experiences included: incompetence of medical specialists, gender stereotypes, unpleasant questions, deadnaming and misgendering, hospitalization, corruption. The main barriers in access to HRT and surgeries were their cost, lack of competent specialists, and difficulties with obtaining the diagnosis. As a result, 41.4% respondents used HRT without consultation with an endocrinologist. Conclusion. Coverage of gender-affirming procedures by medical insurance and advanced training for doctors are necessary to improve the quality of medical care for transgender people.transgendertranssexualgender dysphoriagender incongruenceaccess to medical carepatient satisfactionтрансгендерностьтранссексуальностьгендерная дисфориягендерное несоответствиедоступность медицинской помощиудовлетворённость пациентов1.Sitzia J, Wood N. Patient satisfaction: a review of issues and concepts. Social science & medicine. 1997;45(12):1829—43.2.Hall JA, Dornan MC. Meta-analysis of satisfaction with medical care: description of research domain and analysis of overall satisfaction levels. Social science & medicine. 1988;27(6):637—44.3.Bockting W, Robinson B, Benner A, Scheltema K. Patient satisfaction with transgender health services. Journal of Sex & Marital Therapy. 2004;30(4):277—94.4.Кирей-Ситникова Я. Некоторые проблемы разработки клинических рекомендаций по гендерной дисфории и гендерному несоответствию. Проблемы стандартизации в здравоохранении. 2021;(9—10):47—53.5.Raosoft I. Sample size calculator by Raosoft. Raosoft. 2004.6.Kasianczuk M, Trofymenko O. Population size estimation for transgender people in Ukraine. SE “Center of Social Expertises named after Yu. Saenko” of the Institute of Sociology of the National Academy of Sciences of Ukraine; 2020.7.Pitts M, Couch M, Croy S, Mitchell A, Mulcare H. Health service use and experiences of transgender people: Australian and New Zealand perspectives. Gay and Lesbian Issues and Psychology Review. 2009;5(3):167.8.Linander I, Alm E, Hammarström A, Harryson L. Negotiating the (bio)medical gaze — Experiences of trans-specific healthcare in Sweden. Social Science & Medicine. 2017;(174):9—16.9.Ellis SJ, Bailey L, McNeil J. Trans people’s experiences of mental health and gender identity services: a UK study. Journal of Gay & Lesbian Mental Health. 2015;19(1):4—20.10.Макарова ЕВ, Соловьева НВ, Кременицкая СА. Проблема применения гормональной терапии, направленной на коррекцию пола, трансгендерными лицами по собственной инициативе. Проблемы эндокринологии. 2021;68(2):40—7.11.Чумаков ЕМ, Петрова НН, Ашенбреннер ЮВ, Азарова ЛА, Лиманкин ОВ. Социальные и медицинские аспекты практики трансгендерного перехода в России. Неврологический вестник. 2022;54(1):11—22.12.Baba T, Endo T, Ikeda U, Ikeda H, Ichihara K, Masumori N, et al. Self-administration of gender-affirming hormones and supratherapeutic dosing are relatively common in Japanese transgender women. Journal of Obstetrics and Gynaecology Research. 2022;48(8):2208—13.13.Liu Y, Xin Y, Qi J, Wang H, Hong T, Yang X, et al. The desire and status of gender-affirming hormone therapy and surgery in transgender men and women in China: A national population study. The Journal of Sexual Medicine. 2020;17(11):2291—8.14.Maschiao LF, Bastos FI, Wilson E, McFarland W, Turner C, Pestana T, et al. Nonprescribed sex hormone use among trans women: the complex interplay of public policies, social context, and discrimination. Transgender Health. 2020;5(4):205—15.