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      Comprehensive Transgender Healthcare: The Gender Affirming Clinical and Public Health Model of Fenway Health

      brief-report

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          Abstract

          This report describes the evolution of a Boston community health center’s multidisciplinary model of transgender healthcare, research, education, and dissemination of best practices. This process began with the development of a community-based approach to care that has been refined over almost 20 years where transgender patients have received tailored services through the Transgender Health Program. The program began as a response to unmet clinical needs and has grown through recognition that our local culturally responsive approach that links clinical care with biobehavioral and health services research, education, training, and advocacy promotes social justice and health equity for transgender people. Fenway Health’s holistic public health efforts recognize the key role of gender affirmation in the care and well-being of transgender people worldwide.

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          Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

          Kate E. Coleman, W Bockting, M. Botzer … (2012)
          Article 0 comments Cited 726 times – based on 0 reviews     Review now
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            Experiences of transgender-related discrimination and implications for health: results from the Virginia Transgender Health Initiative Study.

            Judith Bradford, Sari Reisner, Julie Honnold … (2013)
            We examined relationships between social determinants of health and experiences of transgender-related discrimination reported by transgender people in Virginia. In 2005 through 2006, 387 self-identified transgender people completed a statewide health needs assessment; 350 who completed eligibility questions were included in this examination of factors associated with experiences of discrimination in health care, employment, or housing. We fit multivariate logistic regression models using generalized estimating equations to adjust for survey modality (online vs paper). Of participants, 41% (n = 143) reported experiences of transgender-related discrimination. Factors associated with transgender-related discrimination were geographic context, gender (female-to male spectrum vs male-to-female spectrum), low socioeconomic status, being a racial/ethnic minority, not having health insurance, gender transition indicators (younger age at first transgender awareness), health care needed but unable to be obtained (hormone therapy and mental health services), history of violence (sexual and physical), substance use health behaviors (tobacco and alcohol), and interpersonal factors (family support and community connectedness). Findings suggest that transgender Virginians experience widespread discrimination in health care, employment, and housing. Multilevel interventions are needed for transgender populations, including legal protections and training for health care providers.
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              Transgender health in Massachusetts: results from a household probability sample of adults.

              Kerith J Conron, Gunner Scott, Grace Sterling Stowell … (2012)
              Despite higher rates of unemployment and poverty among transgender adults (n = 131; 0.5% weighted) than among nontransgender adults (n = 28,045) in our population-based Massachusetts household sample, few health differences were observed between transgender and nontransgender adults. Transgender adults who are stably housed and participated in a telephone health survey may represent the healthiest segment of the transgender population. Our findings demonstrate a need for diverse sampling approaches to monitor transgender health, including adding transgender measures to population-based surveys, and further highlight economic inequities that warrant intervention.
              Article 0 comments Cited 135 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Sari L. Reisner: 617-927-6017 , sreisner@fenwayhealth.org
                Journal
                Journal ID (nlm-ta): J Urban Health
                Journal ID (iso-abbrev): J Urban Health
                Title: Journal of Urban Health : Bulletin of the New York Academy of Medicine
                Publisher: Springer US (New York )
                ISSN (Print): 1099-3460
                ISSN (Electronic): 1468-2869
                Publication date (Electronic): 17 March 2015
                Publication date PMC-release: 17 March 2015
                Publication date (Print): June 2015
                Volume: 92
                Issue: 3
                Pages: 584-592
                Affiliations
                [ ]The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215 USA
                [ ]Department of Epidemiology, Harvard School of Public Health, Boston, MA USA
                [ ]Department of Community Health Sciences, Boston University School of Public Health, Boston, MA USA
                [ ]Transgender Health Program, Medical and Behavioral Health Departments, Fenway Health, Boston, MA USA
                [ ]The Danielsen Institute, Boston University, Boston, MA USA
                [ ]Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA USA
                [ ]Executive Office, Fenway Health, Boston, MA USA
                [ ]Department of Global Health and Population, Harvard School of Public Health, Boston, MA USA
                Article
                Publisher ID: 9947
                DOI: 10.1007/s11524-015-9947-2
                PMC ID: 4456472
                PubMed ID: 25779756
                SO-VID: d124eea2-fc11-4c7e-be14-07bc866e407e
                Copyright © © The Author(s) 2015
                License:

                Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

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                Subject: Article
                Custom metadata
                issue-copyright-statement © The New York Academy of Medicine 2015

                ScienceOpen disciplines: Public health
                Keywords: health equity,health care,transgender
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: health equity, health care, transgender

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