Résumé
Contexte : Les membres de la communauté Trans* est victime de discriminations et d’un manque de reconnaissance sociale. Si certains soins médicaux tels que les chirurgies d’affirmation de genre leur sont proposés, les connaissances actuelles en physiothérapie restent rares. Cette revue vise à rassembler les connaissances sur les besoins en physiothérapie lors d’une chirurgie d’affirmation de genre homme à femme et les facteurs psychosociaux impactant la prise en charge.
Méthode : Un examen de portée (scoping review) a été réalisé. Les articles ont été sélectionnés dans les bases de données CINAHL complete, Cochrane Library, PubMed, Embase, Serval, OpenGrey et Google Scholar. La qualité des sources n’a pas été évaluée.
Résultats : Le contenu des interventions physiothérapeutiques et le contexte d’étude étaient variables. Cependant, les cinq sources identifiées s’accordent sur la pertinence d’une intervention physiothérapeutique en pré et/ou postopératoire. L’évaluation préopératoire permet d’identifier chez 77,5 % des patientes un dysfonctionnement du plancher pelvien. Les complications postopératoires surviennent chez 75 % des patientes.
Discussion : Les résultats obtenus sont hétérogènes et ne peuvent pas être extrapolés. Les outils de mesure validés spécifiques permettant d’évaluer la qualité des soins dispensés à cette population sont rares. Le niveau d’expertise des professionnels, l’accès à des établissements spécialisés et la durée du suivi influencent les interventions physiothérapeutiques.
Conclusion : La communauté Trans* est victime d’un processus d’ignorance. Produire du savoir contribue à diminuer les inégalités sociales de santé touchant particulièrement cette population. Cette revue est l’occasion d’ouvrir un questionnement plus large sur les devoirs de la profession envers les populations vulnérables.
Context: The transgender and nonbinary (trans*) community suffers from discrimination and a lack of social recognition. While gender-affirming surgery is available to them, current knowledge of physical therapy addressing the needs of these patients remains scarce. This review aims to gather knowledge of the physiotherapeutic needs of patients in cases of male-to-female gender-affirming surgery and of the psychosocial factors impacting care management. Method: A scoping review was conducted. Articles were selected from the CINAHL Complete, Cochrane Library, PubMed, Embase, Serval, OpenGrey, and Google Scholar databases. The quality of the sources was not assessed. Results: The content of the physiotherapeutic interventions and the context of the studies were variable. However, all five identified sources acknowledge the relevance of pre- and postoperative physiotherapeutic intervention. Preoperative evaluation identified pelvic floor dysfunction in 77.5% of patients. Postoperative complications occurred in 75% of patients. Discussion: The results obtained are heterogeneous and cannot be extrapolated. Specific validated measurement tools aimed at evaluating the quality of care provided to this population are rare. The level of professionals’ expertise, patients’ access to specialized care facilities, and the length of follow-up influence physiotherapeutic interventions. Conclusion: The trans* community is victimized by a process of ignorance. Generating knowledge contributes to reducing the social inequalities in health that particularly affect this population. This review is an opportunity to question the ethics of the profession.
Context: The transgender and nonbinary (trans*) community suffers from discrimination and a lack of social recognition. While gender-affirming surgery is available to them, current knowledge of physical therapy addressing the needs of these patients remains scarce. This review aims to gather knowledge of the physiotherapeutic needs of patients in cases of male-to-female gender-affirming surgery and of the psychosocial factors impacting care management. Method: A scoping review was conducted. Articles were selected from the CINAHL Complete, Cochrane Library, PubMed, Embase, Serval, OpenGrey, and Google Scholar databases. The quality of the sources was not assessed. Results: The content of the physiotherapeutic interventions and the context of the studies were variable. However, all five identified sources acknowledge the relevance of pre- and postoperative physiotherapeutic intervention. Preoperative evaluation identified pelvic floor dysfunction in 77.5% of patients. Postoperative complications occurred in 75% of patients. Discussion: The results obtained are heterogeneous and cannot be extrapolated. Specific validated measurement tools aimed at evaluating the quality of care provided to this population are rare. The level of professionals’ expertise, patients’ access to specialized care facilities, and the length of follow-up influence physiotherapeutic interventions. Conclusion: The trans* community is victimized by a process of ignorance. Generating knowledge contributes to reducing the social inequalities in health that particularly affect this population. This review is an opportunity to question the ethics of the profession.