Occupational injustices experienced by trans people: Cross-perceptions of trans people and occupational therapists in Quebec-Canada Les injustices occupationnelles vécues par des personnes trans: Perception croisée de personnes trans et d’ergothérapeutes du Québec (Canada) En Fr

Résumé En Fr

It is increasingly discussed in Canada and other countries that trans people experiencesocial injustices that affect their daily lives (Abramovich et al., 2020; Davidson, 2015;Espineira and Thomas, 2022; Hana et al., 2021), including their journey through varioushealth systems (Wall et al., 2023; Zeeman et al., 2019). Nonetheless, few studies havefocused on the impact of these injustices on their occupations and the occupationalinjustices experienced on a daily basis from the perspective of trans people (Dowers etal. 2019; Mc Carthy et al., 2020; Swenson et al., 2022). The purpose of this research wasto explore the occupational injustices experienced by trans people in their daily lives,including those encountered in the Quebec healthcare system. To this end, four transpeople and eight occupational therapists (most of whom had personal or professionalexperience with trans people) took part in the study in order to triangulate experiential,professional and theoretical knowledge. Individual semi-structured interviews using aphoto-elicitation approach (Clark-Ibàñez, 2004) were conducted with trans people andtwo focus groups were conducted with occupational therapists. The results reveal thattrans people experience deprivation, alienation and occupational imbalances. Theseinequities affect five types of occupations: 1) occupations based on binary norms; 2)occupations performed in uncomfortable or hostile environments; 3) occupationsinfluenced by minority stress; 4) occupations related to restricted access to care; and 5)occupations performed in excess to support gender-sensitive care. The results of this studyare generally consistent with the literature, but for the first time specifically document theoccupational injustices experienced by trans people. As well, it highlights that occupationaland social injustices are intimately related and both stem from cisgenderism. Occupationaltherapists who wish to improve their practice with trans people will benefit fromunderstanding these injustices in order to better combat them and avoid perpetuating them.

On entend dire de plus en plus souvent, au Canada comme dans d’autres pays, que lespersonnes trans vivent des injustices sociales qui affectent leur quotidien (Abramovichet al., 2020; Davidson, 2015; Espineira et Thomas, 2022; Hana et al., 2021), incluant leurparcours dans divers systèmes de santé (Wall et al., 2023; Zeeman et al., 2019).Néanmoins, peu d’études se sont intéressées à l’impact de ces injustices sur leursoccupations et aux injustices occupationnelles vécues au quotidien du point de vue despersonnes trans (Dowers et al., 2019; Mc Carthy et al., 2020; Swenson et al., 2022).L’objectif de cette recherche était d’explorer les injustices occupationnelles vécues pardes personnes trans dans leur quotidien, incluant celles rencontrées dans le système desanté québécois. Pour ce faire, quatre personnes trans et huit ergothérapeutes (ayantpour la plupart une expérience personnelle ou professionnelle avec des personnestrans) ont pris part à l’étude afin de trianguler des savoirs expérientiels, professionnelset théoriques. Des entrevues individuelles semi-structurées suivant une approche dephoto-élicitation (Clark-Ibàñez, 2004) ont été conduites avec des personnes trans et deuxgroupes de discussion ont été menés avec des ergothérapeutes. Les résultats révèlent queles personnes trans vivent des privations, des aliénations et des déséquilibresoccupationnels. Ces injustices affectent cinq types d’occupations, soit : 1) les occupationsbasées sur les normes binaires; 2) les occupations réalisées dans des environnementsinconfortables ou hostiles; 3) les occupations influencées par le stress minoritaire; 4) lesoccupations en lien avec l’accès restreint à des soins; et 5) les occupations réalisées ensurplus pour favoriser des soins sensibles à la diversité de genre. Les résultats de la présenteétude rejoignent en général ceux des écrits sur le sujet, mais documentent pour unepremière fois de manière spécifique les injustices occupationnelles vécues par despersonnes trans. Aussi, ils mettent en lumière que les injustices occupationnelles et socialessont intimement liées, en ceci que celles-ci découlent du cisgenrisme. L’ergothérapeutesoucieux d’améliorer ses pratiques auprès des personnes trans aura avantage à comprendreces injustices pour mieux les déconstruire et éviter de les perpétrer. _____________________________ Occupational injustices experienced by trans people: Crossperceptions of trans people and occupational therapists in Quebec-CanadaIt is increasingly discussed in Canada and other countries that trans people experiencesocial injustices that affect their daily lives (Abramovich et al., 2020; Davidson, 2015;Espineira and Thomas, 2022; Hana et al., 2021), including their journey through varioushealth systems (Wall et al., 2023; Zeeman et al., 2019). Nonetheless, few studies havefocused on the impact of these injustices on their occupations and the occupationalinjustices experienced on a daily basis from the perspective of trans people (Dowers etal. 2019; Mc Carthy et al., 2020; Swenson et al., 2022). The purpose of this research wasto explore the occupational injustices experienced by trans people in their daily lives,including those encountered in the Quebec healthcare system. To this end, four transpeople and eight occupational therapists (most of whom had personal or professionalexperience with trans people) took part in the study in order to triangulate experiential,professional and theoretical knowledge. Individual semi-structured interviews using aphoto-elicitation approach (Clark-Ibàñez, 2004) were conducted with trans people andtwo focus groups were conducted with occupational therapists. The results reveal thattrans people experience deprivation, alienation and occupational imbalances. Theseinequities affect five types of occupations: 1) occupations based on binary norms; 2)occupations performed in uncomfortable or hostile environments; 3) occupationsinfluenced by minority stress; 4) occupations related to restricted access to care; and 5)occupations performed in excess to support gender-sensitive care. The results of this studyare generally consistent with the literature, but for the first time specifically document theoccupational injustices experienced by trans people. As well, it highlights that occupationaland social injustices are intimately related and both stem from cisgenderism. Occupationaltherapists who wish to improve their practice with trans people will benefit fromunderstanding these injustices in order to better combat them and avoid perpetuating them.