L’accès aux services de fertilité pour les femmes lesbiennes, bisexuelles ou pansexuelles et les personnes queer, trans ou non-binaires : une revue rapide des écrits scientifiques
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Résumé
Introduction : Les femmes lesbiennes, bisexuelles ou pansexuelles (LBP) et les personnes trans, queer ou non-binaires (TQNB) dépendent souvent de la procréation médicalement assistée (PMA) pour fonder leur famille, mais n’y ont pas toujours accès. Actuellement, il ne semble pas exister d’écrits recensant, dans une perspective écosystémique, l’ensemble des facteurs principaux déterminant l’accès de cette population à la PMA.
Objectif : Cette revue rapide des connaissances vise à identifier, à partir d’une perspective écosystémique, les facteurs décrits dans la littérature comme influençant l’accès à la PMA des femmes LBP et des personnes TQNB.
Méthodes : Une recherche documentaire avec 11 moteurs de recherche a permis d’identifier 22 articles présentant des résultats d’études empiriques récentes (2018-2023), ayant différentes méthodologies. Les résultats pertinents ont fait l’objet d’une analyse thématique, et les facteurs identifiés ont été classés dans un modèle écosystémique.
Résultats : Les facteurs identifiés sont (1) au niveau microsystémique, le soutien du réseau social et du personnel sociosanitaire; (2) au niveau exosystémique, la sensibilisation du personnel sociosanitaire à la diversité sexuelle et de genre, l’adéquation de l’information et de la documentation, la logique organisationnelle des services de fertilité, le coût des services, la législation; (3) au niveau macrosystémique, l’hétérocisnormativité comme influence transversale.
Discussion et conclusion : Pour assurer l’accès des femmes LBP et des personnes TQNB à la PMA, une approche globale et multiniveau s’avère nécessaire. Des pistes pour les pratiques en santé et les politiques publiques sont proposées.
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