S U M M A R Y

Transgender/Trans* Health Steering Committee Date/Time: Thursday April 2, 13:00pm-15:30pm

Location: PHSA Corporate – 700-1380 Burrard St. Room A Barron, Vanessa R Hall, David (Dr) R McNabb, Anne Wolfe, Natasha

R Case, Laura Haworth, Gwen R Metzger, Daniel (Dr)

Coniglio, Connie R Kennedy, Theresa O’Dwyer, Julia

R Ganesan, Soma (Dr) Knudson, Gail (Dr) R Penner, Janice

Gareau, Fin Krystal, Arden (chair) Salander, Raven

Grieves, Lorraine Lane, Michele Tei, ChrYs

Work ing Group Facilitators: M ick Henry

ITEM ACTION

1.0

Action Log

- Reviewed as circulated.

- The action “Add information about accountability processes (Patient Care Quality Review Boards and MoH process) to website” will be added to the working group recommendations.

- Inquiry of whether health care cards can identify when someone is in transition (option other than Male/Female): Michele followed up and noted the BC Services Card is integrated with three Ministries (ICBC, Ministry of Technology, Innovation and Citizen’s Services), not just the Ministry of Health. This will not be included in the current recommendations.

2.0

Working Group Updates

Primary Care Access and Consultation

For implementation of these recommendations, resources required came back to a core project/program team.

For GPs an additional billing code for sessions >30 minutes would facilitate eligibility assessments and for physicians to take transgender patients into their practice. As an interim step, recommend increased funding to current assessors. The recommendation to increase the number of publicly funded assessors is also recommended by surgery group (includes other care providers as well as GPs). There is also a need to standardize the assessment and paperwork for eligibility assessment.

For access to providers through telehealth, Medio (available through PHSA) is preferred over Skype.

Health Care Provider Education

Discussed how to include trans education into other curriculums and mandate that. More work is needed in next phase to define the framework and guidelines for education. Funding is required for more detailed planning and to develop content to create the modules.

Hub development should be part of central trans website. Recommend that there is a multi-pronged approach to education and while on-line curriculum is being developed, that there is increased time/resources on in-person delivery.

For business case preparation will need to condense overlaps. Articulate the

Vanessa/Dan to follow-up re: time estimates for assessment (separate from treatment and intervention) and resources/funding implications.

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ITEM ACTION

one-time and on-going costs for a comprehensive program in phases. More detailed costing to be understood and developed through the next phase of detailed planning.

Community Support

Refined recommendations as per March 17. For facilitator training - ensure modules are constructed on one technology platform/website.

Support/resources will be needed to grow the community network, partner with non-government organizations and community stakeholder partnerships etc. Will need a system assessment in the first 6 months - quite a few gaps, particularly in remote areas.

Highlight in the MoH document, the importance of trans inclusive supports in communities to provide safe and meaningful engagement opportunities for those with lived experience. It is essential for this population to validate a sense of being ‘normal’ which is unique from other ‘chronic diseases/conditions’

Model of Care for Gender Affirming Surgery

Have added most of the considerations from March 17.

Responded to concern about whether matching diagnostic codes with procedures in SPR would create barriers in some facilities i.e. Providence Health Care. There are many populations which are not served by Providence Health Care due to the religious affiliation of the organization. Will continue with recommendation to improve SPR data for transparency of surgical wait times.

There are two aspects to wait time – eligibility assessment and surgery wait time. To track wait time for surgical eligibility assessment, will need a process to centralize this information. An excel template is in development.

Clinical resource nurse role discussed. May have clinics for follow-up after lower surgery, also work with local care providers, use telemedicine. Other examples would be home health.

This group still has work to do around information/data gathering to support the recommendations.

Next Steps

Consolidate overlaps, resource requirements, and financial estimates. Working groups have formally concluded; facilitators are supporting the resource/financial estimates and development of May 2 presentations.

Vanessa to change wording – survey is to capture patient experience around surgery.

Vanessa to follow-up re: defining role and deliverables.

Ask to community representatives, if they could get information from their networks on options for lower surgery outside of Montreal (LA and Arizona) such as average flight costs etc.

3.0

Process for MoH document development and expectations

The audience for the document will be the Ministry of Health. Now we will be pulling all of this work into one document and refining it over next couple of Steering Committee meetings.

Will not be sending it out in editable format for version control – will discuss

Vanessa will send a PDF version of the document a couple of days in advance of the next meeting for review. Committee members will not

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ITEM ACTION

revisions/refinements in SC meetings.

Importance of confidentiality highlighted – financial information will be included, and Ministry of Health approval will still be required. The Ministry will announce/communicate the approved changes.

Governance of this program is separate from the model. Not uncommon for PHSA to contract/commission service delivery through Health Authorities. Work around program structure, organizational requirements can happen over the summer and while the document is going through the Ministry of Health approval process.

distribute/disseminate.

4.0

Trans Health Future Directions – May 2

- Ensure there are various ways to communicate feedback.

- Discussed the difference between videoconferencing (determined not to be feasible in last meeting) versus live streaming.

- Video to be available on website post-event (opening and presentations)

- E-mail introduction developed on behalf of Arden and Vanessa with event invitation

- Unable to modify the invitation content today as this was developed in a program by the communications department (easier than word for viewing on devices) – would delay the sending of this until next week.

- Erica reviewed session design

- Have a table for information/pamphlets of services

- Social event planning to be supported by Morgane and there may be support through the Foundation of Hope for this – Vanessa has connected them

DECISIONS:

- Send invitation out today through networks.

- Planning group to determine how to allocate travel subsidy as responses come in.

- Ongoing marketing of event to be determined by planning group and based on responses.

- End the formal part of the day after Q&A.

Vinay to follow-up re: e-mail set up for questions/comments.

Vinay to investigate possibility of live-streaming the introduction and presentations.

Vinay to add Morgane to the event planning group.

Tash/Lorraine to consider other ways of getting feedback from other parts of the community (i.e. youth)

Erica to update design.

Next Meetings: Tuesday April 21, 1:00-4:00pm Trans Health Future Directions – May 2 Tuesday May 12, 1:00-4:00pm

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