한국 성소수자 건강 연구: 체계적 문헌고찰 = LGBTQI Health Research in South Korea : A Systematic Review

국문 초록 (Abstract)

본 연구는 한국에서 진행된 성소수자 건강에 대한 연구들을 체계적으로 검토하고 향후 필요한 연구들의 방향을 제시하는 것을 목적으로 한다. 이를 위해 2013년 12월 31일까지 출판된 성소수자의 건강 관련 연구들을 검색하였다. 검색엔진으로는 국외 웹 데이터베이스인 Medline, Embase와 국내 웹 데이터베이스인 Koreamed, RISS를 사용하였다. 검색어는 성소수자를 가리키는 모든 용어를 포함하고자 했으며, 검색결과 총 2,131편의 논문이 검색되었다. 그 중 다음의 4가지 조건을 모두 만족시킨 논문은 총 123편이었다: (1) 사람을 대상으로 한 연구, (2) 건강 관련 변수 또는 결과를 가지고 있는 연구, (3) 성소수자를 연구 대상으로 한 연구, (4) 한국에서 진행된 연구. 이 논문들은 임상적 연구 98편과 사회적 건강 연구 25편으로 분류되었다. 또한 이 논문들의 인용문헌을 검토했을 때 기존의 검색어로 찾을 수 없었던 임상적 연구 3편, 사회적 건강 연구 2편을 추가하여 총 128편의 논문을 분석하였다. 101편의 임상적 연구는 3가지 유형, 즉 사례보고(58편), 임상검사(22편), 그리고 임상수술(21편)으로 나뉘었다. 임상적 연구는 1980~1990년대 가장 활발하게 진행되었으며, 이후 줄어드는 경향을 보였다. 인구집단 별로는 간성(Intersex)에 대한 연구가 74편(73.3%)으로 가장 많았고, 트랜스젠더 연구가 22편(21.8%)으로 뒤를 이었다. 27편의 사회적 건강 연구는 주제별로 13편이 정신건강, 4편이 성적행동, 2편이 폭력피해에 관한 연구였으며, 기타 주제의 논문이 8편이었다. 13편의 정신건강 연구 중 9편은 성소수자 정체성과 관련된 스트레스가 정신건강에 미치는 영향을 다루고 있었다. 27편의 사회적 건강에 대한 연구 중 26편(96.3%)이 2000년 이후에 출판되었고, 24편(88.9%)이 남성 동성애자를 대상으로 하였으며, 20편(74.1%)이 양적 연구였다. 한국 성소수자의 건강 연구 128편을 체계적으로 검토한 결과에 비추어볼 때, 기존 연구들은 다음과 같은 한계를 가지고 있다. 첫째, 임상적 연구의 경우 트랜스젠더의 성전환 수술이나 간성의 사례보고에, 사회적 건강 연구의 경우 동성애자 정체성과 관련한 스트레스에 제한적으로 초점이 맞추어져 있었으며, 만성질환을 비롯한 다른 건강결과에 대한 연구는 매우 드물었다. 둘째, 성소수자의 규모와 건강상태를 파악하기 위한 국가 단위의 연구가 부재했다. 셋째, 성소수자들의 의료접근성, 즉 의료보장과 관련된 정책적 연구나 의료서비스를 받는 과정에서 겪게 되는 차별에 대한 연구가 없었다. 넷째, 성소수자들이 겪을 수 있는 차별, 낙인 등의 부정적인 사회경험이 건강에 대해 미치는 영향에 대한 연구가 부족하였다.

다국어 초록 (Multilingual Abstract)

Background Despite a growing global concern about health conditions of lesbian, gay, bisexual, and transgender, questioning, and intersex (LGBTQI) populations, the topic has not been systematically discussed in South Korea. Methods This research sought to conduct a systematic review of public health studies on LGBTQI populations in South Korea which have been published until 2013. Online academic databases in English (Medline and Embase) and in Korean (Koreamed and RISS) were used to find those articles by applying a variety of keywords including all possible terms indicating LGBTQI population. We identified relevant articles based on the following four inclusion criteria: (1) human subjects, (2) health related researches, (3) LGBTQI population as study participants, and (4) studies from South Korea. Results Among 2,131 articles from the online databases, 123 met the four inclusion criteria. After examining the references of the 123 articles, we added 5 more articles. We analyzed 101 clinical studies and 27 social health studies (non-clinical research) in total. Clinical researches include case reports (N=58, 57.4%), clinical test (N=22, 21.8%), and surgery (N=21, 20.8%). The majority of clinical articles were about intersex (N=74, 73.3%) and transgender (N=22, 21.8%). Among the 27 social health studies, 13 were about mental health, 4 about sexual behaviors such as condom use, 2 about experience of violence, and 8 about other topics. Most of social health studies (N=25, 92.6%) were about gay and lesbian. Conclusion The findings of this study identified several critical knowledge gaps of the previous health studies among LGBTQI population in South Korea. First, only a few health conditions have been explored in the previous research. Most of clinical studies were about case reports of intersex or sex reassignment surgeries for transgender people, whereas social health studies mainly focused on the stress related to homosexual identity. Few articles dealt with other relevant health conditions such as chronic diseases among LGBTQI populations. Second, no national-level survey on LGBTQI populations has been conducted in South Korea, which makes it difficult to have a comprehensive picture of their health status. Third, we could not find any previous research about healthcare accessibility of the LGBTQI populations. Finally, few researches were found related to the health impact of negative social experiences (e.g. discrimination and stigmatization) among LGBTQI populations in South Korea.

목차 (Table of Contents)

• Ⅰ. 서론 Ⅱ. 연구 방법 Ⅲ. 연구 결과 Ⅳ. 논의 Ⅴ. 결론 참고문헌 abstract

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