Creating Digital Resources to Improve Health Outcomes for Trans and Gender-Diverse People
In March 2023, Howard Brown Health’s Center for Education, Research, and Advocacy was awarded opportunity to participate in the National Association of Community Health Center (NACHC) Health Center Innovation Incubator. Howard Brown was one of eight health centers tasked with developing an innovative initiative to improve health equity by addressing health literacy challenges using a human-centered design approach. Each health center was awarded initial seed funding to design and test these initiatives over the course of several months. At the end of this grant cycle, each health center presented their initiative to the funders in the hopes of attaining one of two additional funding awards to continue working on their projects. We used this funding to develop a digital resource hub to improve access to care for our trans and gender diverse (TGD) patients.
As a provider of gender-affirming care (GAC), we know that our TGD patients face numerous barriers in trying to access comprehensive and affirming healthcare. One major barrier is the overall lack of providers who are knowledgeable and educated about trans healthcare, which results in difficulty finding care and unsatisfactory care experiences. For example, 1 in 3 TGD patients reported that they had to educate their providers on trans healthcare in order to receive the appropriate care need. Along with lack of knowledgeable providers, TGD patients also experience higher rates of discrimination when seeking healthcare. According to the Center for American Progress, 28% of trans respondents reported postponing or avoiding necessary medical care and 40% of trans respondents reported postponing or avoiding preventive screenings due to experiences of discrimination. These access barriers for TGD patients have only compounded with the increasing number of GAC bans being passed across the country. Currently, 45% of trans youth live in states where they have lost or are at risk of losing access to GAC due to these discriminatory laws. Given all of these barriers, we decided to focus our Innovation Incubator funding into developing strategies to facilitate access to gender-affirming services, comprehensive health resources, and care coordination for TGD patients.
We worked with our trans health team to better understand the specific barriers that TGD patients experience in accessing care. We received consistent feedback from our providers and case managers about the need for more resources that explain gender-affirming care offered at HB, referrals for outside gender-affirming services in the Chicago area, and the various steps required for legal name and gender marker changes. With this feedback, and in collaboration with the Trans and Nonbinary Surgical Navigation Team, we created a digital TGD Resource Hub to help improve access to gender-affirming care and facilitate complex healthcare navigation for our TGD patients. So far, we’ve developed several new digital resources for the hub, including:
- A TGD Services & Programs Factsheet: Provides information about what GAC is and what resources, such as hormone therapy, surgical options, behavioral health, and legal services are available at our clinics.
- An internal TGD Resources & Referrals Database: An internal database of gender-affirming medical, behavioral health, and legal service providers across Chicago to help our teams make referrals for patients to address all their needs safely.
- Gender Marker & Legal Name Change Roadmap: A step-by-step guide available on our external website for patients to navigate through the various steps and required documents for legal name and gender marker change in IL.
Policy Analyst Camille Ellison presented our work on this project at the InnovationEx Conference hosted by NACHC in October 2023, and we were awarded additional funding to expand on this project. As we move forward with the expansion of the Hub, we are considering the addition of several new resources to help TGD patients access the care they need. For example, one consistent barrier to care for TGD patients is insurance coverage so we want to work closely with our trans health team, patient navigators, and TGD patients to develop tools and resources to navigate and eliminate insurance barriers. We will also be increasing our community outreach to find the best ways to support the needs of the TGD community. This will include systematic feedback from TGD community members and affirming providers on medical, behavioral health, and social/economic needs to improve our resources and understand evolving needs.
You can see some of our initial work on the digital hub and you can visit NACHC’s Innovation Incubator page to learn more about the project.
We would like to thank NACHC, Camille Ellison, Jory Zhang, Tim Wang, Ella Jasso, ZiRenae Young, Wren O’Kelley, and Sarah Halpin for all the hard work and support on this project.
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