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

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.

Psychiatric Diagnoses and Comorbidities in a Diverse, Multicity Cohort of Young Transgender Women

“…35 Improving access to culturally competent primary care, diagnostic screening, psychotherapy, and pharmacologic treatments, and retention in care in clinical community-based, pediatric, and adolescent and young adult medicine settings are urgently needed to address the adverse mental health and substance dependence disorders in this population, with attention to differences by race or ethnicity. 36–38 Further research is needed, particularly longitudinal studies that examine the antecedents and health sequelae of mental health, substance dependence, and psychiatric comorbidities across adolescent and young adult development to identify optimal timing and targets for psychosocial interventions in relation to gender affirmation and gender role transitions. 39,40 …”

Priorities for transgender medical and healthcare research

“…Preliminary outcomes research has been done on models of providing appropriate, effective care to transgender populations, and focusing on issues of provider “gatekeeping” access to transition related interventions [63]. Research has begun to explore effective clinical venues for care (LGBT specialty clinics versus general practice) [64], and the role of specialists and primary care providers in care [65]. …”

The inclusion of LGBT+ health issues within undergraduate healthcare education and professional training programmes: A systematic review

“…Although the review has highlighted important concerns for practice developments, some initiatives do exist, mainly in the United States (US), that address LGBT+ clinical competence training and education that is provided by community-based organisations and healthcare agencies. A good example is the National LGBT Health Education Center at the Fenway Institute where practitioners receive awareness, knowledge and skills training to work more effectively with LGBT+ client groups (Reisner et al, 2015).…”