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REDEFINING THE STANDARD WITH TRANSGENDER CLINICAL COMPETENCY
DiversityRX ConferenceMarch 13, 2013
Anand Kalra,Program Manager
Agenda
1. Introductions
2. Transgender People & Barriers to Health
3. Project HEALTH approach
4. Questions?
Intended Outcome
Increase knowledge about: Transgender people Social determinants of health disparities Successful methods for improving community
health
Getting to Know Me
Anand Kalra Project HEALTH Program Manager at the
Transgender Law Center Secret librarian agenda Transgender man
Getting to Know You
Who is new to the world of transgender issues?
Who has received training about transgender issues?
Who has worked with transgender patients?
Transgender Law Center
works to change law, policy, and attitudes so that all people can live safely, authentically, and free from discrimination regardless of their gender identity or expression.
Lyon-Martin Health Services
personalized healthcare and support services to women and transgender people who lack access to quality carebecause of their sexual or gender identity, regardless of their ability to pay.
Transgender Communities
Common Terms Gender Identity
A person’s internal, deeply-felt sense of being male, female, something other or in-between.
Gender Expression An individual’s characteristics and behaviors such as appearance,
dress, mannerisms, speech patterns, and social interactions that are perceived as masculine or feminine.
Transgender An umbrella term that can be used to describe people whose gender
expression is nonconforming and/or whose gender identity is different from their birth assigned gender.
Gender non-conforming A person who has, or is perceived to have, gender characteristics
and/or behaviors that do not conform to traditional or societal expectations.
What standard are we redefining?
Systemic Barriers Unemployment and under-employment
Transgender Californians are twice as likely to have a Bachelor’s Degree
And twice as likely to live under the poverty line Nearly 70% report experiencing discrimination or
harassment at work Lack of Access to Health Care
Denial of Private Insurance Exclusions of transition-related and gender-specific care Lack of Educated Providers
What standard are we redefining?
Key Findings – Health Care 19% were refused medical care 50% had to “teach my provider” about basic
transgender health 28% postponed medical care when sick or injured Four times the national average for HIV
Project HEALTH
Improves access to & quality of transgender health services through: Clinic Technical Assistance Student Clinical Rotation Policy Advocacy TransLine: Medical Consultation Service Outreach
Clinic Technical Assistance
Buy-in from key administrators and providers
Needs assessment Training:
Cultural competence Clinical competence Legal frameworks
Operations support EMR Intake forms Billing codes
Patient Satisfaction Survey
Student Clinical Rotation
Hosted at Lyon-Martin Practical curriculum Video lectures Final Exam More than 60 MD, NP, PA
students trained in 4 years
Policy Advocacy
Local: San Francisco: transition exclusions out of Health San
Francisco (public health coverage) Humboldt County: county-wide trans-inclusive
employment nondiscrimination policy Los Angeles: trans-inclusive nondiscrimination policy
in homeless shelters State:
Department of Insurance (PPOs) Department of Managed Health Care (HMOs)
Federal:
The National Transgender Medical Consultation Line
offers physicians and health care providers the latest transgender clinical information, and individualize expert case consultation across the broad range of clinical transgender issues.
Staffed by clinicians experienced in transgender medicine who can help provide the best possible care
65 questions answered since launch in September