"flipped examination room" – ascriptions of vulnerability between trans patients and their healthcare providers

While healthcare providers play a major role in the lives of TINQA* (trans, inter*, nonbinary, agender and other genderqueer) people, providers are only partly familiar with their needs. Almost 75 % of 372 TINQA* people in an Austrian survey (Gaiswinkler et. al, 2022) have at least once experienced discrimination in healthcare settings. Marginalisation often puts people in a position of vulnerability – especially in cases where it is tied to their body, medical contexts can become sites where their social positioning is negotiated (cf. Appenroth & Castro Varela, 2019). In 2023, I was invited to two Austrian conferences and workshops for medical practitioners to talk about "dealing sensitively with trans patients". As part of my PhD project, I analyse how, in those situations, healthcare providers talk about TINQA* patients, using methods based in Institutional Ethnography and Grounded Theory. Another component of the project are TINQA* “community teams” discussing their healthcare needs. Together with my coauthors, we therefore contextualize the findings of the discourse amongst healthcare providers with TINQA* people’s expectations towards them. First insights show that general practitioners are aware of their knowledge gaps, which they want to overcome to ensure better treatment for their “vulnerable” TINQA* patients. The current situation in Austria, which forces trans people to go through three different assessments before they are allowed to get trans-affirmative healthcare, is viewed as not ideal but also politically vulnerable by most gynaecologists. In our discussions with both professional groups and TINQA* people, we could get a grasp on what “trans-sensitive healthcare” means – the recurring topics are respectful communication, a compassionate gaze (Ihrig, 2023) and the willingness to gather knowledge about realities of and treatment options for TINQA* people. TINQA* people trace their experiences of discrimination back to the affective positionalities of healthcare providers. Their lack of respect, pathologizing gaze and knowledge gaps are perceived as products of insecurity. We argue that this is a role reversal, where healthcare providers are depicted as vulnerable people, who should be taken care of by TINQA* people.