Transgender Health

Transgender Health

 

Transgender Health

Transgender people face numerous health disparities as well as stigma, discrimination, and a lack of access to quality care. Some health disparities include an increased risk of HIV infection, especially among transgender women of color, and lower likelihood of preventative cancer screenings in transgender men. The webinars, publications, and other trainings found here are aimed at health care providers and other staff at health care organizations to help provide quality, inclusive, and welcoming care to transgender people.


Providing Mental Health Care for Youth with Non-Binary Gender Identities

Originally Presented On: November 30, 2016

Faculty: Alex Keuroghlian, MD, MPH, Associate Director of Education and Training, The Fenway Institute

Sponsors: LGBT Health Education Center, School-Based Health Alliance

Youth with non-binary gender identities do not identify as categorically male or female. They experience unique social determinants of health and have specific health care needs that are often underserved. These youth are more likely to engage in health care if they feel comfortable disclosing their non-binary gender identity in an affirming environment to providers with a basic understanding of gender diversity. In this webinar, Alex S. Keuroghlian, MD MPH, will review concepts and terminology related to non-binary gender identities, including correct names and pronouns. The webinar will also focus on best mental health clinical practices and how to create an inclusive and affirming health care environment for youth with non-binary gender identities.

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Sexual Health among Transgender People

Originally Presented On: January 25, 2017

Faculty: Alex Keuroghlian, MD, MPH, Associate Director of Education and Training, The Fenway Institute

Sponsors: LGBT Health Education Center, School-Based Health Alliance

Engaging transgender clients in exploring sexuality – including intersectionality with gender identity and shifts in attraction associated with medical affirmation—is integral to the larger, clinical goal of affirming transgender identities and providing competent care. In this webinar, Dr. Alex Keuroghlian, MD MPH, will review recent research as well as existing best behavioral health practices and therapeutic considerations for sexual health among transgender clients, including the following topics: sexual identities and fluidity, sexual satisfaction following medical affirmation, and relational health. Attention is given to providing a transgender-affirming frame and discussing sexual health risk within the context of psychosocial stressors, including challenges related to gender affirmation and experiences of transphobia.

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 Pre-Exposure Prophylaxis (PrEP) for HIV: The Basics and Beyond

Originally Presented On: October 19, 2017

Faculty: Kevin Ard, MD

In this interactive webinar, Dr. Kevin Ard will review how to prescribe and monitor PrEP. Using patient cases, he will discuss unique considerations that apply to PrEP management for transgender people, serodifferent couples, those who are pregnant or trying to conceive, and adolescents. Finally, through real-world examples, participants will learn how to incorporate PrEP into diverse clinic settings. This webinar will be useful for both clinicians who are new to PrEP and those who are experienced PrEP providers, as well as administrators interested in a creating a PrEP program.

Download the slides: PrEP for HIV – The Basics and Beyond

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Training Frontline Staff to Collect Data on Sexual Orientation and Gender Identity

Originally Presented On: July 13, 2016

Faculty: Amika Brewster, Director of Patient Services and Financial Assistance at Fenway Health ,Dr. Harvey Makadon, Director of Education and Training Programs at the Fenway Institute, and Chris Grasso, Associate Director of Director for Informatics & Data Services at the Fenway Institute.

Collecting sexual orientation and gender identity (SO/GI) data can lead to improvements in population health for lesbian, gay, bisexual, and transgender (LGBT) patients, a vulnerable population that experiences multiple health disparities. Now that HRSA requires SO/GI data be included in the Uniform Data System (UDS) reporting for CY 2016, health centers need to train their frontline staff to collect, quality check, and apply this data in a culturally sensitive and confidential manner. In this interactive webinar, experts in SO/GI data collection will discuss their recommendations for frontline staff, covering the topics of effective communication techniques, privacy and confidentiality, data quality, and addressing mistakes that inevitably occur.

Amika Brewster, Director of Patient Services and Financial Assistance at Fenway Health will be joined by Dr. Harvey Makadon, Director of Education and Training Programs at the Fenway Institute, and Chris Grasso, Associate Director of Director for Informatics & Data Services at the Fenway Institute to present the webinar.

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Meeting the Health Care Needs of Transgender People

Originally Presented On: December 11, 2012

Faculty: Sari Reisner, ScD, The Fenway Institute, Fenway Health, and Boston Children's Hospital

Sponsors: The National LGBT Health Education Center

This program discussed clinical issues and health disparities facing the transgender community, and suggested how they can be improved through educational and organizational change. Sample topics include developing a better understanding of transgender identities and lives; creating a welcoming and gender-affirming environment for transgender patients and staff; and learning ways to use and document patient names and pronouns in clinical records.

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Transgender Medical Care: Advanced Case Discussion

Originally Presented On: December 10, 2013

Faculty: Timothy Cavanaugh, MD, Medical Director, Transgender Health Program, Fenway Health, Boston, MA

Sponsors: The National LGBT Health Education Center

Dr. Tim Cavanaugh, Medical Director of Fenway Health’s Transgender Health Program, leads a case-based discussion on several of the medical risks, benefits, and complications encountered when providing hormones and/or surgical interventions to transgender patients. This advanced webinar is geared towards providers of transgender medical care and therefore assumes that participants will have, at minimum, a baseline understanding of transgender medical terms and care guidelines.

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Caring for Gender Dysphoric Children and Adolescents

Originally Presented On: October 28, 2014

Faculty: Stewart L Adelson, MD and Walter Bockting, PhD, LGBT Health Initiative, Columbia University, New York, NY

Sponsors: The National LGBT Health Education Center

A growing number of clinicians are facing the challenge of caring for pediatric patients with fluid gender identities and with dysphoria about discordance between their gender identity and birth sex. In this webinar, Dr. Stewart Adelson and Dr. Walter Bockting, both of Columbia University Medical Center’s new LGBT Health Initiative, focus on how clinicians can support children and adolescents with gender dysphoria. They review specific health and mental health needs in gender dysphoric children and adolescents, and will provide viewers with effective and innovative ways to support their gender dysphoric patients. Additional resources will be provided.

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Mental Health Care and Assessment of Transgender Adults

Originally Presented On: February 17, 2015

Faculty: Dan Karasic, MD, Health Sciences Clinical Professor of Psychiatry, University of California San Francisco

Sponsors: The National LGBT Health Education Center

Research suggests that the number of transgender people seeking gender affirming surgical procedures is increasing, and this is accelerating in the US with the lifting of insurance exclusions. Behavioral health providers are seeing more transgender patients seeking referrals to surgeons, and are seeking guidance on the standard practice with each patient. Dr. Dan Karasic of the University of California San Francisco will lead this webinar, describing the role of the behavioral health care provider during a person’s transition and how to assess and advise patients. Dr. Karasic will detail the WPATH Standards of Care and describe how to apply these standards in practice using case-based examples and anecdotes from his work at UCSF Alliance Health Project and the Transgender Life Care Program and Dimensions Clinic of Castro Mission Health Clinic in San Francisco.

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Understanding and Assessing the Sexual Health of Transgender Patients

Originally Presented On: June 10, 2014

Faculty: Timothy Cavanaugh, MD, Medical Director, Transgender Health Program, Fenway Health

Sponsors: The New England AIDS Education and Training Center and the National LGBT Health Education Center

In this webinar, Dr. Tim Cavanaugh, Medical Director of Fenway Health’s Transgender Health Program, will lead a discussion on how clinicians can provide effective sexual health care, including HIV prevention, for transgender and gender nonconforming people. The webinar will include videos of leaders in the transgender community who describe their perceptions of what high quality care means to them and ways in which providers can offer sexual health care and HIV prevention that is based on trust and understanding.

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If You Have It, Check It: Overcoming Barriers to Cervical Cancer Screening with Patients on the Female-to-Male Transgender Spectrum

Originally Presented On: July 16, 2014

Faculty: Jennifer Potter, MD, Sarah Peitzmeier, MPH, Sari Reisner, ScD, MA, Ida Bernstein, BA, The Fenway Institute, Fenway Health

Sponsors: The National LGBT Health Education Center

The majority of FTM transgender individuals retain a cervix and can therefore develop cervical cancer. Because of this, national guidelines recommend that transgender men with a cervix follow the same screening protocol as non-transgender women. However, a recent research study found that Fenway Health patients who identify on the female-to-male (FTM) transgender spectrum have over 10 times higher odds of having an inadequate Papanicolaou (Pap) test compared to female patients. In this webinar, experts in the fields of medicine and research will share primary and secondary cervical cancer prevention strategies and will identify strategies that providers can use to address barriers to optimal screening and prevention in FTM patients.

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Providing Care and Support for Transgender Rural Latino/as and Migrant Farmworkers

Originally Presented On: October 22, 2013

Faculty: Jennifer Hastings, MD, Planned Parenthood Mar Monte; and Anna Rick, Community Worker, California Rural Legal Assistance

Sponsors: Farmworker Justice and the National LGBT Health Education Center

This webinar represents a unique opportunity to learn about the health and support needs of transgender Latino/a migrant farmworkers and other rural Latino/a transgender persons. Dr. Jennifer Hastings of Planned Parenthood Mar Monte and Anna Rick of California Rural Legal Assistance, who both have extensive first-hand experience in caring for and assisting these populations, lead participants in understanding aspects of the life and health care experiences of their transgender patients and clients. Webinar participants will also learn methods for asking appropriate, sensitive questions about gender identity concerns, and strategies for providing sensitive, inclusive care based on cultural humility. Dr. Hastings and Ms. Rick will also explain their model of inter-agency collaboration that works to help clients find legal and community supports to enhance their health and well-being. This webinar is a collaboration of Farmworker Justice and the National LGBT Health Education Center, both National Cooperative Agreements with the Health Resources and Services Administration of the Bureau of Primary Health Care.

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Recent Breakthroughs in HIV Prevention for Transgender People and Men who Have Sex with Men

Originally Presented On: May 7, 2013

Faculty: Kevin Ard, MD, MPH, The Fenway Institute, Fenway Health, and Massachusetts General Hospital

Sponsors: The National LGBT Health Education Center

Health care providers now have an expanding number of effective HIV prevention tools at their fingertips, including behavioral and biomedical interventions. This session provides step by step guidance on how clinicians can be most effective at preventing new HIV infections in high-risk MSM and transgender patients. Included is a discussion of evidence-based High Impact HIV Prevention Programs as recommended by the CDC, and how best to optimize implementation of HIV prevention programs in patient centered medical homes (PCMH) and other primary care settings.

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Sexual Orientation, Gender Identity, and Mental Health in Children and Adolescents

Originally Presented On: October 9, 2013

Faculty: Stewart Adelson, MD, Assistant Clinical Professor at Columbia University’s College of Physicians & Surgeons Dept. of Psychiatry in the Divisions of Child & Adolescent Psychiatry and Gender, Sexuality & Health

Sponsors: The National LGBT Health Education Center

In this webinar, Dr. Stewart Adelson of Columbia University, will offer a foundation for understanding and addressing the mental health challenges and needs of LGBT children and adolescents. Participants will learn about how gender non-conformity, gender discordance/dysphoria, and sexual orientation are distinct yet related concepts, and how stigma, risk, resilience, and protective factors interact with these to influence youth development, health and mental health. Clinical options for addressing gender dysphoria in children and adolescents will also be discussed. The webinar will conclude with nine mental health practice principles for fostering the healthy psychosocial development of LGBT youth.

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The Changing Rx of Transgender Adolescents: Impact of GnRHa Pubertal Blockade and Implications for Young Adults and Adults

Originally Presented On: December 16, 2015

Faculty: Norman Spack, MD, Co-Founder and Co-Director, Emeritus, Gender Management (GeMS) Service, Endocrine Division, Boston Children’s Hospital, and Associate Clinical Professor of Pediatrics, Harvard Medical School

Sponsors: The National LGBT Health Education Center

In this webinar, Dr. Norman Spack, the founder of the Gender Management Service (GeMS) clinic at Boston Children’s Hospital and an associate clinical professor of medicine at Harvard Medical School, will describe his journey caring for transgender children and adolescents. Dr. Spack will describe the creation of the GeMS clinic, will discuss recommended treatment for children and adolescents, and will explain how to integrate transgender care within primary care settings.

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Improving Health Care for Transgender People

This module will guide learners through the basics of transgender health care in four parts. Part 1 begins by defining transgender-related terminology, demographics, and health disparities. Part 2 focuses on providing affirmative health care to transgender patients. Part 3 discusses gender affirmation treatment, including hormonal and surgical care, and part 4 describes ways to create a more inclusive and welcoming environment for all patients.

This module will:

  1. Define terms related to transgender identity and health
  2. Identify strategies for effective primary care with transgender patients
  3. Explain the basic approaches to transgender medical and surgical treatment
  4. Describe ways to create a welcoming environment for transgender patients

This activity has been reviewed and is acceptable for up to 1.0 Prescribed credits by the American Academy of Family Physicians. Participants should claim only the credit commensurate with the extent of their participation in this activity.

You will need to or register to access the complete Learning Module content.

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Transgender Health Resources

TransLine: Transgender Medical Consultation Service

A free, online transgender medical consultation service, published by Lyon-Martin Health Services, offering answers to medical providers within two business days on questions related to gender-affirming surgery, hormone therapy, and improving services to transgender patients.

Medicare Benefits and Transgender People

An overview of Medicare and what it covers for transgender people, including an explanation of coverage for routine preventive care, hormone therapy, and gender affirmation surgery. The publication also covers how to change gender markers on Medicare cards, and what steps to take if Medicare does not cover a procedure.

Center of Excellence for Transgender Health

A program of University of California, San Francisco, offering an online learning center and information on providing routine care, HIV prevention, cultural competency, mental health, and policy for transgender individuals.

UCSF has many resources including protocols around gender affirming medical care for transgender patients, including protocols on Initiating Hormone Therapy and Vaginoplasty and Post-op Care.

World Professional Association for Transgender Health

WPATH promotes transgender health through increasing education and research on a national level. WPATH emphasizes a need for a stronger international understanding of gender dysphoria and its treatment.

Fenway Health: Transgender Health

Fenway Health’s Transgender Health department provides medical care, mental health care, and supportive services sensitive to the needs of people on the trans spectrum. This program offers transgender-focused groups, research, the Trans Masculine Sexual Health Collaborative, and more resources.

Transgender Health Information Program

Run by the Provincial Health Services Authority, the THIP aims to increase access to gender affirming healthcare in British Columbia until it is available to all transgender individuals living there. THIP’s website provides health and wellness information, resources to connect with peers, and education for providers, family members, friends, and loved ones around supporting transgender people in their lives.

National Center for Transgender Equality

NCTE offers a comprehensive introduction to transgender issues, including basic terminology, stories of transgender people, statistics, steps to take as a trans ally, and FAQs regarding the treatment of transgender people in the United States. The organization also offers opportunities to get involved with fighting anti-trans legislation.

Massachusetts Transgender Political Coalition (includes national resources)

MTPC aims to end discrimination and oppression against transgender people, by impacting law and policy in Massachusetts and bringing visibility around transgender issues to the larger population. The MTPC website offers information and resources on a wide variety of transgender-related political issues in Massachusetts.

I Am: Trans People Speak

A collection of short videos featuring transgender individuals and their allies, sharing lived experiences with the goal of empowering themselves and their communities. The website also features Trans 101.

Transgender 101: A Simple Guide to a Complex Issue

Author Nick Teich’s book, written primarily for social workers and other professionals who are curious about transgender issues and the discrimination faced by transgender people in the United States. The book features basic information around gender identity, and explores social relationships, diagnoses, and transition, among other topics. Teich also offers trainings and consulting.

Transgender Explained For Those Who Are Not

Written by transgender woman Joanne Herman, this 2009 book offers in straightforward and accessible language a basic introduction to transgender concepts and issues.

Of What Am I Afraid?

A bisexual teacher of behavioral medicine explores her inability to understand the unique struggles and joys faced by transgender individuals.

Transgender Law Center

Based out of Oakland, CA, The Transgender Law Center aims to incite legal change in order to better the lives of transgender and gender non-conforming people. Featured resources of note include Organizing for Transgender Health Care and 10 Tips for Working with Transgender Patients.

Referral Directories

CenterLink LGBT Community Center Member Directory

A database containing information about LGBT Community Centers and their member affiliates, both in the United States and around the world.

Gay and Lesbian Medical Association (GLMA): Find a Provider

GLMA’s online Provider Directory, allowing users to search for primary care providers, specialists, therapists, dentists, and other providers by type and location.

World Professional Association for Transgender Health (WPATH): Find a Provider

WPATH’s online Provider Directory for transgender affirming providers, allowing users to search by first and/or last name, specialty, and location.

 

Hotlines

LGBT Helpline (Ages 25+)

(888) 340-4528 or (617) 267-9001

Hours: Monday – Saturday, 6:00 PM – 11:00 PM

Fenway Health’s anonymous and confidential hotline, offering help, information, referrals, and support for LGBT individuals who are age 25 or older. Call for support related to safer sex, coming out, where to find gay-friendly establishments, HIV and AIDS, depression, suicide, anti-gay/lesbian harassment and violence, or any other issues you are facing.

Peer Listening Line (Ages 25 and Under)

(800) 399-PEER or (617) 267-2535

Hours: Monday – Saturday, 5:30 PM – 10:00 PM

Fenway Health’s anonymous and confidential hotline, offering help, information, referrals, and support for LGBT individuals who are age 25 or under. Call for support related to safer sex, coming out, where to find gay-friendly establishments, HIV and AIDS, depression, suicide, anti-gay/lesbian harassment and violence, or any other issues you are facing.

Gay, Lesbian, Bisexual and Transgender National Hotline 

1-888-843-4564; Email: help@GLBThotline.org

Hours (Pacific Time): Monday – Friday, 1:00 PM – 9:00 PM; Saturday, 9:00 AM – 2:00 PM

Hours (Eastern Time): Monday – Friday, 4:00 PM – Midnight; Saturday, Noon – 5:00 PM

The GLBT National Helps Center’s private hotline for one-on-one chat and email peer-support. Call for support related to coming out, relationship concerns, bullying, workplace issues, HIV/AIDS anxiety, safer sex information, or any other issues you are facing.

GLBT National Youth Talkline (25 and Under)

1-800-246-PRIDE

Hours (Pacific Time): Monday – Friday, 1:00 PM – 9:00 PM; Saturday, 9:00 AM – 2:00 PM

Hours (Eastern Time): Monday – Friday, 4:00 PM – Midnight; Saturday, Noon – 5:00 PM

The GLBT National Help Center’s private hotline for one-on-one chat and email peer-support, servicing those up to age 25. Call for support related to coming out, relationship concerns, bullying, workplace issues, HIV/AIDS anxiety, safer sex information, or any other issues you are facing.

Online Peer-Support Chat

Hours (Pacific Time): Monday – Friday, 1:00 PM – 9:00 PM; Saturday, 9:00 AM – 2:00 PM

Hours (Eastern Time): Monday – Friday, 4:00 PM – Midnight; Saturday, Noon – 5:00 PM

The GLBT National Help Center’s confidential, one-on-one online chat support for LGBT and questioning people. Reach out for support related to coming out, relationship concerns, bullying, workplace issues, HIV/AIDS anxiety, safer sex information, or any other issues you are facing.

Trans Lifeline

(877) 565-8860

Visit the Trans Lifeline website for hours of availability.

A hotline run by Trans Lifeline, a non-profited centered around offering resources and support to transgender people, with the goal of preventing self harm. The line is intended for those in crisis, including those who are questioning their gender identity, and is run entirely by transgender volunteers.

Trevor Lifeline (Youth)

(866) 488-7386

Hours: 24/7

The Trevor Project’s hotline for LGBT young people who may be in crisis, or who may just need a safe, non-judgmental place to talk. The Trevor Project also offers TrevorText (Text the word “Trevor” to 1-202-304-1200, Thursdays & Fridays, 4:00 PM – 8:00 PM ET; 1:00 PM – 5:00 PM PT) and TrevorChat.

Optimizing Transgender Health: A Core Course for Healthcare Providerstransgender health training

 

TransTalks is an online training series on the health care needs of the transgender community for medical professionals.  This series features presentations given by nationally-recognized experts at Fenway’s annual Advancing Excellence in Transgender Health Conference and covers topics critical to the foundation of quality care for the transgender community, and and will provide free continuing education credits for medical professionals.

Sessions from the 2017 Advancing Excellence in Transgender Health Conference, coming soon!

 

Sessions from the 2016 Advancing Excellence in Transgender Health Conference:

Assessment and Care for Transgender Clients in the Setting of Severe Mental Illness or Trauma with Dr. Alex Keuroghlian

This session will help participants assess, diagnose, and treat transgender clients with co-occurring severe mental illness or posttraumatic stress symptoms, in the context of the adverse effects of everyday discriminatory experiences.

Transgender People and HIV with Dr. Asa Radixasa-screenshot

This session will help participants understand how the HIV epidemic affects transgender people by examining the barriers to care for those newly diagnosed, specific strategies for medication adherence, and gender-affirmation strategies to improve health care experiences.

Gender Affirmative Health Care with Dr. Ruben Hopwood and Dr. Sari Resiner

This session will help participants to develop a common core of knowledge and Ruben Screen Grabunderstanding of transgender community demographics, terminology, and unique barriers to care the transgender community faces.

Cross Sex Hormone Therapy with Dr. Tim Cavanaugh

This session will help participants to identify the risks & benefits of cross sex hormone therapy, and be able to design a plan of care that incorporates established guidelines.

Surgical Gender Affirmation with Dr. Tim Cavanaugh and Dr. Ruben Hopwood

This talk will allow participants to become familiar with the variety of options available for gender affirming surgeries, and provide insight into the benefits, risks, and outcomes possible.

Primary and Preventative Care with Julie Thompson, PAJulie T Screen Grab

This session provides insight into the unique primary and long-term preventative care needs unique to transgender patients; such as cancer risks, cardiovascular risks, and sexual health needs.

Caring for Gender Non-conforming Youth in Pediatrics and Primary Care with Dr. Michelle Forcier

This session offers strategies for providers to provide inclusive, welcoming care to gender diverse children, teens, and young adults. Dr. Forcier reviews developmental models, discusses how providers can explore gender expansiveness with youth and their parents, reviews pubertal blockade options, and discusses the importance of parental support of gender nonconforming children.

 

Sessions from the 2015 Advancing Excellence in Transgender Health Conference:

Panel Screen Grab

Case Scenarios and Q&A

This session was filmed live during the Advancing Excellence in Transgender Health Conference in October 2015. A panel of providers discusses several cases, listed here by the patient’s name. The Q&A session immediately followed the case discussions, and is available separately here.

Cases

Q&A Session [Video] 

Featuring: Timothy Cavanaugh, MD, Sara Eley, LICSW, Alex Gonzalez, MD, Tfawa Haynes, LICSW, Jennifer Potter, MD, Norman Spack, MD, and Ralph Vetters, MD.

*Please Note: The videos on this page are hosted by Vimeo. Having issues? Please see the Vimeo FAQs.

TransTalks from National LGBT Health Education on Vimeo.

Each year, Fenway Health hosts “Advancing Excellence in Transgender Health.” The two-day event serves as a comprehensive training on the health care needs of the transgender community for health care providers, as well as members of health care teams in community health centers, safety-net organizations and student health clinics. For more information on upcoming conferences, sign up for our mailing list.

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