Transgender/Trans* Health Health Care Provider Education

Summary of Outcomes for Trans Health Care Provider Education Working Group defined standards of care to be the most up to date version of the WPATH. Definition for Health Care Provider: Generally publicly funded, holding professional association membership, and consisting of Medical Doctors, Nurses, Pharmacists, may also include social workers, councillors 1. Increase health provider knowledge of trans* Standards of Care This may be broken out into two specific areas of focus Monitoring of already initiated therapy ; Initiation of the therapy by the provider. Potentially, GPs may be more comfortable with supporting already initiated therapy as opposed to initiating the therapy themselves. The overall goal is for improvement in both areas. 2. Increase GP & NP comfort/knowledge/ability in initiating and monitoring hormone therapy in adults (link with Primary Care Access/Consultation) Healthcare provider” should also include Social service Provider, supporting staff, and Students in Health Vision for “Trans Cultural Competency “Modules” to target specific groups and subject matter. 3. Increase health care provider understanding of trans* inclusive policy and practice (including non-binary gender identities

The Group Reviewed and Ranked Current and New Education methods High Impact = Highly Scalable + Effective Education Method The Working Group Focused on improving and developing the High Impact Education Methods TCS Med School Online “HUB” Race Line TCC & List Service

Summary of Recommendations for Trans Health Care Provider Education 1. Trans Cultural Safety Online Education Modules 2. Inclusion Trans Education into Medical School Curriculum 3. Central online “Hub” of Clinical Leaning information 4. Improvements to Race Line 5. Trans Clinical Care Group & List Service

Interrelationships between Outcomes and Recommendations 1. Increase health provider knowledge of trans* Standards of Care 1. Trans Cultural Safety Online Education Modules 2. Inclusion of Trans Education into Medical School Curriculum 2. Increase GP & NP comfort/knowledge/ability in initiating and monitoring hormone therapy in adults (link with Primary Care Access/Consultation) 3. Central online “Hub” of Clinical Leaning information 4. Improvements to Race Line 3. Increase health care provider understanding of trans* inclusive policy and practice (including non-binary gender identities 5. Trans Clinical Care Group & List Service

1.Trans Cultural Safety (TCS) Online Education Model Initial General Education More Specific for Health Providers Specific Trans Health Subjects for care providers Webinars Links to External Content Basic Clinical Trans Cultural Safety “101” WHAT are the components: Adv. Clinical Basic Social HOW its delivered: Facilitated online learning as part of cohort Optional for non facilitated learning to remove barriers to access Use of discussion board and other collaborative online tools. Modules followed by group discussion. Supported by central/remote facilitation. Guided learning with Homework Mandatory for some PHSA staff Live and interactive Archived Webinars Address Specific Clinical content and details Links to External content from community groups / clinical associations. Any links to external learning objects.

1. Trans Cultural Safety (TCS) Guidelines for TCS Cultural Safety Intersects all models of the TCS Messages from the basic models are reinforced throughout Can be made available beyond PHSA Provides a place to go back to after the structured learning has been completed. (a central Hub) Able to access discreet modules without the need to complete prerequisites ( remove the barriers ) Builds an Archive of content for more specific / targeted topics (webinars) Provide links to External learning objects. Links to a central Hub of learning.

1. Trans Cultural Safety (TCS) Curriculum and Content Development Requires Curriculum mapping exercise: map out the learning objectives to existing and non existing content Must have community involvement Ensure Culturally Safe and appropriate What do Community Members like/not like about current content Leverage Existing Content Focus on Educational Structure and Design elements Requirement for Content Experts Include experiential evidence as well as medical evidence. Include input from multiple regions / areas.

1. Trans Cultural Safety (TCS): Team Development: Delivery and Ongoing Support Considerations for building the Team. Intersectional Lens from key people involved in development Team with equal balance of Experience and Education Medical + Experiential expertise. DEVELOPMENT TEAM Project Manager Instructional Designer Content Experts IT support / Development Community Members Focus Groups PR / Marketing Support Content Testers ONGOING SUPPORT TEAM IT support / Development Educators / Facilitators Webinar Presenters Admin Support

1. Trans Cultural Safety (TCS): Next Steps Further Development and refinement of the education model. Develop Preliminary Schedule for Development and Phases for development. Investigate Existing PHSA Platforms Develop Budget for Delivery and ongoing support

2. Inclusion of Trans Education into Medical School Curriculum Recommendation: Interdisciplinary Course in Trans Care included in Med School Curriculum Leverage the TCS modules for further education Actions: Identify inclusion opportunities into existing courses. Mandate the inclusion of diverse genre identities in current courses. Identify opportunities in Nurse Practitioner Education Identify opportunities in Social support education programs.

3. Central online “Hub” of Clinical Leaning information Recommendation: Need to be Clinical Focussed (THIP is more info only) Linked to THIP but separate from THIP. Clinical Resource Repository Links to TCS modules (discussion groups, cohort, learning objects/artifacts.) Actions: Further develop the structure and purpose of the “Hub” Develop in conjunction with and as part of the TCS online modules

3. Central online “Hub” of Clinical Leaning information Recommendation: Need to be Clinical Focussed (THIP is more info only) Linked to THIP but separate from THIP. Clinical Resource Repository Links to TCS modules (discussion groups, cohort, learning objects/artifacts.) Actions: Further develop the structure and purpose of the “Hub” Develop in conjunction with and as part of the TCS online modules

5. Improvements to Race Line usage Recommendation: Increase awareness and usage of RACE line for Trans support Link and of the information / content developed for HUB / TCS to Refer to Race line as Widen the scope of use by targeting existing groups and forums to increase awareness. Actions: Include in broader educational project and marketing Liaise with RACE Line partners to discuss increasing awareness of Trans info being provided on the RACE line. Investigate compensation model for Doctors using the RACE line

6. Trans Clinical Care Group & List Service Recommendation: Expand Regional Membership and create break away sub groups Remove barriers to enable people to get onto List service Increase awareness of the group Use the “Hub” to promote Actions: Link with CPATH – trying to create a community of practice Identify care providers in other areas Identify opportunities to promote involvement in the TCCG Link with Training programs in areas Investigate a partly subsidised moderator role to support and promote the group.

Complexity and Impact Matrix EASY RACE LINE 1-12m 4 5 TCCG 1-12m Clinical Knowledge /learning HUB 3 Ease of Implementation 1 1 1 1 1 2 TCS Online modules w/ facilitated learning (12-24m) 1 Med School Curriculum HARD LOW Impact of change. HIGH