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Education is key for gender-affirming health care

2 August 2019

Acceptance and willingness to learn are key behaviours that transgender and non-binary people are looking for in health professionals, says Dr Jaimie Veale, Senior Lecturer in Psychology at the University of Waikato.

Dr Veale was speaking to an audience of about 50 GPs and nurses at the Hawke’s Bay Primary Care Symposium, held in Napier in late August. Her presentation, “Equity and barriers to accessing primary care for transgender people in New Zealand: findings from the Counting Ourselves survey", provided insights on how health workers can be more responsive to clients who are transgender or non-binary.

More than a third of the 'Counting Ourselves' survey participants reported they had avoided seeing a doctor when they needed to because they were worried about being disrespected or mistreated as a transgender person, and more than a third had not visited a GP in the last 12 months due to cost. While almost half were uncomfortable or very uncomfortable discussing being transgender with their GPs, more than two thirds were uncomfortable or very uncomfortable discussing this with a new doctor they did not know.

More than half of participants who received gender affirming care did so through their GP. Since transgender people also need to access other types of care (not just gender-affirming care) from general practices and community clinics, upskilling the primary care workforce is important. Few formal education opportunities are currently available, with one GP noting that her knowledge was thanks to her clients and her own research/self-learning. This situation was indicated in the survey, where just under half of participants reported having to educate their practitioner about transgender or non-binary people so that they could receive appropriate care.

Dr Veale says that transgender clients don’t expect their GP or nurse to know everything and get things right all of the time. However, “by being humble and respectful, and showing you’re willing to learn, the trust and empathy will grow over time" and she looks forward to the future when transgender people are “just another demographic".

Ways to be more responsive:

  • Use correct pronouns and pronounce name correctly – ask if unsure!
  • Normalise transgender and non-binary people. An example is displaying posters in the clinic waiting-room relating to gender identity or advertising services relevant to transgender people.
  • Actively seek information and learning opportunities for gender-affirming care

Want more information?

  • The Counting Ourselves survey collected data from a sample of 1170 participants who were recruited through community organisations, social media, and health professionals. The community report with an overview of the findings from this survey will be launched on Monday 23 September -- go to the website http://countingourselves.nz to find out more.
  • The findings will also be published in academic journals, and the research team is hoping to do a follow-up Counting Ourselves survey, once further funding is secured, to track the changes in transgender people’s health.
  • Read the Guidelines document published by the University of Waikato.
  • Join the Professional Association of Transgender Health Aotearoa (https://patha.nz/), a group of people from across clinical, academic, community and legal professions working to promote the health, wellbeing and rights of transgender people.

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