Interdisciplinary Transgender Veteran Care: Development of a Core Curriculum for VHA Providers

Purpose: The Veteran\u27s Health Administration (VHA) has created a training program for interdisciplinary teams of providers on the unique treatment needs of transgender veterans. An overview of this program\u27s structure and content is described along with an evaluation of each session and the program overall. Methods: A specialty care team delivered 14 didactic courses supplemented with case consultation twice per month over the course of 7 months through video teleconferencing to 16 teams of learners. Each team, consisting of at least one mental health provider (e.g., social worker, psychologist, or psychiatrist) and one medical provider (e.g., physician, nurse, physician assistant, advanced practice nurse, or pharmacist), received training and consultation on transgender veteran care. Results: In the first three waves of learners, 111 providers across a variety of disciplines attended the sessions and received training. Didactic topics included hormone therapy initiation and adjustments, primary care issues, advocacy within the system, and psychotherapy issues. Responses were provided to 39 veteran-specific consult questions to augment learning. Learners reported an increase in knowledge plus an increase in team cohesion and functioning. As a result, learners anticipated treating more transgender veterans in the future. Conclusion: VHA providers are learning about the unique healthcare needs of transgender veterans and benefitting from the training opportunity offered through the Transgender Specialty Care Access Network-Extension of Community Healthcare Outcomes program. The success of this program in training interdisciplinary teams of providers suggests that it might serve as a model for other large healthcare systems. In addition, it provides a path forward for individual learners (both within VHA and in the community) who wish to increase their knowledge

Trans People, Transitioning, Mental Health, Life and Job Satisfaction

For trans people (i.e. people whose gender is not the same as the sex they were assigned at birth) evidence suggests that transitioning (i.e. the steps a trans person may take to live in the gender with which they identify) positively affects extraversion, ability to cope with stress, optimism about the future, positivity towards life, self-reported health, social relations, self-esteem, body image, enjoyment of tasks, personal performance, job rewards and relations with colleagues. These relationships are found to be enhanced by gender affirmation and support from family members, peers, schools and workplaces, stigma prevention programmes, coping intervention strategies, socioeconomic conditions, anti-discrimination policies, and positive actions. Also important are legislation including the ability to change one’s sex on government identification documents without having to undergo sex reassignment surgery, accessible and affordable transitioning resources, hormone therapy, surgical treatments, high-quality surgical techniques, adequate preparation and mental health support before and during transitioning, and proper follow-up care. Societal marginalization, family rejection, violations of human and political rights in health care, employment, housing and legal systems, gendered spaces, and internalization of stigma can negatively affect trans people’s well-being and integration in societies. The present study highlights that although transitioning itself can bring well-being adjustments, a transphobic environment may result in adverse well-being outcomes. Policy makers can learn that policies to facilitate trans people’s transition and create cultures of inclusion in different settings, such as schools, workplaces and health-care services, may help to improve societal well-being and allow the community to develop their potential and to minimize misery

Book of Abstracts: 2019 Health Equity Summer Research Summit Organized by the Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, Texas 77030, USA on June 18th, 2019

Copyright © 2020 Harris. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited