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Finding Innovative Ways for Health Providers to Best Meet the Needs of Transgender People .

Lesbian / Gay / Bisexual / Transgender / Intersex Health Summit 2002. Finding Innovative Ways for Health Providers to Best Meet the Needs of Transgender People. Presented by Bobbi Williams, Ph.D. Board Member, Rainbow Access Initiative Steering Committee, National LGBT Health Coalition.

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Finding Innovative Ways for Health Providers to Best Meet the Needs of Transgender People .

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  1. Lesbian / Gay / Bisexual / Transgender / Intersex Health Summit 2002 Finding Innovative Ways for Health Providers to Best Meet the Needs of Transgender People. Presented by Bobbi Williams, Ph.D. Board Member, Rainbow Access Initiative Steering Committee, National LGBT Health Coalition

  2. S E S S I O N O V E R V I E W • Review of the results of Transgender Health Practices Research Project • Question and answer session / discussion of results • Brainstorming • Methods for improving communications between health care providers and TG's, • Empowering TG's in the acquisition of adequate health care, • Identifying untapped resources for improving the quality of transgender health. • Follow-on work / Action Items Finding Innovative Ways for Health Providers to Best Meet the Needs of Transgender People

  3. The Transgender Health PracticesResearch Project • [September 2001 – July 2002] • Survey consisted of 20 items • Distributed at Southern Comfort (2001) and IFGE (2002) Conventions. • Also distributed online at: www.Trans-health.com and linked from other sites • Online Returns = 278 Mailed In Returns = 115 Total Returns = 393 Finding Innovative Ways for Health Providers to Best Meet the Needs of Transgender People

  4. The Transgender Health Practices Research Project [Survey Items] • Age • Preferred term to define gender identity 3. Preferred term to define sexual orientation • Gay Man • Lesbian • Bisexual Man • Bisexual Woman • Heterosexual Man • Heterosexual Woman • Polyamorous • Other • Transgendered • Transgenderist • Crossdresser    •     Transvestite •     Transsexual Woman (MTF) •     Transsexual Man (FTM) •     Drag Queen •     Drag King •     Gender Blender •     Gender Queer •     Other: Finding Innovative Ways for Health Providers to Best Meet the Needs of Transgender People

  5. The Transgender Health Practices Research Project [Survey Items] 4. If taking hormones or other gender modifying drugs 5. Names of medications being taken 6. Whether or not medications are under the direction and supervision of a Physician    7. How medications are paid for • Cash (health plan doesn’t cover them) • Co-pay (health plan covers it ) • Cash (no health insurance) • Medicaid • Medicare • Other:  8. Whether or not “street hormones” were ever used. 9. If YES, whether or not they are still being taken Finding Innovative Ways for Health Providers to Best Meet the Needs of Transgender People

  6. The Transgender Health Practices Research Project [Survey Items] 10. Whether or not the individual ever engaged in sex work / prostitution as a transgendered person. 11. Whether or not the individual has a regular primary care physician 12. If YES, whether or not the individual is out to him/her as being TG/TS 13. If not, why. 14. If the individual ever had an illness related to being transgendered (e.g., a hormone related complication such as diabetes, phlebitis, heart trouble, polycythemia, polycystic ovaries, an allergic reaction to make-up, an allergy to gender related clothing, etc.) 15. If YES, whether or not it was treated by someone who knew he/she was transgendered 16. If NO, how treatment for the problem was received Finding Innovative Ways for Health Providers to Best Meet the Needs of Transgender People

  7. The Transgender Health Practices Research Project [Survey Items] 17. Race: • Caucasian • African American • Hispanic • Asian • Pacific Islander • Native American • Other: 18. If the individual regularly is a member of a religious faith or engages in a spiritual practice 19. If YES, religious faith / spiritual practice 20. Range of annual income Finding Innovative Ways for Health Providers to Best Meet the Needs of Transgender People

  8. Under 5,000 $5,000- 15,000 $15,000-20,000 $20,000-30,000 $30,000-50,000 $50,000- 70,000 Over $70,000 ONLINE 29 43 22 40 52 30 58 HARDCOPY 3 9 6 15 25 28 29 COMBINED 32 52 28 55 77 58 87 % 8.2 13.3 7.1 14.1 19.7 14.9 22.3 The Transgender Health PracticesResearch Project [PRELIMINARY FINDINGS] A G E Average Oldest Youngest Median ONLINE 40.9 66 15 37 HARD COPY 48 72 15 37 COMBINED 43.4 72 15 43 I N C O M E

  9. The Transgender Health PracticesResearch Project [PRELIMINARY FINDINGS] R E L I G I O N Do you regularly practice a religious faith or spiritual practice? YES NO TOTAL #/%#/%RESPONSES ONLINE 113 / 40.5% 166 / 59.5% 279 HARD COPY 61 / 53.5% 53 / 46.59% 114 COMBINED 174 / 44.2% 219 / 55.7% 393 If YES, what is your religious faith / practice? In addition to a fairly even distribution of Jewish, Catholic, and Protestant (Methodist, Lutheran, Episcopal, Prespyterian, etc.) there were some who identified as Wican, Bahai, and “Moment to moment Spiritualist”.

  10. +TG TG’ist CD TV TS (M2F) TS(F2M) DQ DK GB GQ *Other ONLINE 18 27 16 7 164 38 1 0 3 0 HARDCOPY COMBINED % *Other Terminology:T- Lady, Female, Transdyke, Fag, Omnigendered, Transwoman, Dipstick lesbian, Pansexual TransMan/FTM/Transgendered/GenderQueer (I'm diverse!)”, PreOp MTF + Because of an error in the online form, Transgendered was not an option, but was selected as An ‘other’ by 12 respondents The Transgender Health PracticesResearch Project [PRELIMINARY FINDINGS] GENDER IDENTITY

  11. The Transgender Health PracticesResearch Project [PRELIMINARY FINDINGS] GENDER MODIFYING DRUGS Are you taking hormones or other gender modifying drugs? YES NO TOTAL #/% #/% RESPONSES ONLINE 148 / 53% 130 / 47% 278 HARD COPY 54 / 51% 53 / 49% 106 COMBINED 202 / 52.5% 182 / 47.5% 384

  12. The Transgender Health PracticesResearch Project [PRELIMINARY FINDINGS] GENDER MODIFYING DRUGS Are you taking these medications under the direction and supervision of a Physician? YES NO TOTAL #/% #/% RESPONSES ONLINE 121 / 74% 44 / 26% 165 HARD COPY 39 / 79.5% 10 / 20.5% 49 COMBINED 160 / 75% 54 / 25% 214

  13. The Transgender Health PracticesResearch Project [PRELIMINARY FINDINGS] Of those responding YES, more than 50 types of drugs were listed; the primary types cited were: Cyponate | Estradiol | Estrace | Estrofem | Estrogen | Premarin ONLINE 12 27 11 5 8 37 HARD COPY 0 3 0 0 0 5 COMBINED 12 30 11 5 8 42 Progesterone | Proscar | Provera | Spironolactone | Testosterone ONLINE 11 7 13 41 42 HARD COPY 1 0 2 3 0 COMBINED 12 7 15 44 42

  14. The Transgender Health PracticesResearch Project [PRELIMINARY FINDINGS]

  15. The Transgender Health PracticesResearch Project [PRELIMINARY FINDINGS] The following drugs were also cited by three or less respondents: premelle (2) prvien progynova progestagene Prometrium (3) Sustanon (2) tstradiol triestrogen Vitex Valerate (3) Vivelle (2) Zestril phyto-estrogens dydrogesterone estroderm (3) estrovin Estinyl (2) estrogel (2) estogel Estrinal Enanthate (5) Flutamide Inderal Lotion T Medroxyprogesterone (3) Mediproxine Novospiroton Acetate Aldactone (2) Andractim Androcur (2) Androgel (2) “birth control pills” Black Cohosh Bloussant Climara (3) Deca-Durabolin Delestrogen (3) Delestryl (3) Duphaston * No differentiation was made among those indicating use of patch or injection vs. pills

  16. The Transgender Health PracticesResearch Project [PRELIMINARY FINDINGS] PRIMARY CARE PHYSICIAN? YES NO TOTAL #/%#/%RESPONSES ONLINE 228 /82 % 50 / 18% 278 HARD COPY 95 / 81% 21 / 19% 116 COMBINED 323 / 82% 71 / 18% 394 “OUT” TO HIM or HER? YES NO TOTAL #/%#/%RESPONSES ONLINE 50 / 35% 92 / 65% 142 HARD COPY 52 /59% 36 / 41% 88 COMBINED 102 / 44% 128 / 56% 230

  17. The Transgender Health PracticesResearch Project [PRELIMINARY FINDINGS] • Some reasons given for not telling the M.D. • “Only knows me as male” • “I don't live full time” • “Don't feel the need right now” • “Came out to 3 previous MDs w/ bad results” • “We haven't discussed it but he probably knows” • “Has a big mouth” • “Never brought the subject up” • “I’m just a crossdresser; not transitioning” Finding Innovative Ways for Health Providers to Best Meet the Needs of Transgender People

  18. Transgender Health Practices [Other Research] from Health and Social Service Needs of Transgender People in ChicagoGretchen P. Kenagy, Principal InvestigatorJane Addams College of Social Work University of Illinois at Chicago In this study, 10 interviewers were trained to conduct a needs assessment survey. Survey respondents were located by interviewers through advertising (flyers). The Surveys were administered during a face-to-face interview which lasted about an hour and respondents given $20 for their time. Total Sample = 111 70 percent MTF (n=78) 30 percent FTM (n=33)

  19. Transgender Health Practices [Other Research] Health and Social Service Needs of Transgender People in Chicago • Average age = 35. • Median Income = $16,900 • Education: • 16% have some high school • 24% are high school graduates (includes GED) • 27% have some college • 24% are college graduates • 10% have post college education/degrees • Sexual Orientation: • 27% are heterosexual • 22% are gay or lesbian • 23% are other (including pansexual and queer) • 13.5% are bisexual • 8% don’t know • 6% are asexual

  20. Transgender Health Practices [Other Research] Health and Social Service Needs of Transgender People in Chicago

  21. Transgender Health Practices [Other Research] Health and Social Service Needs of Transgender People in Chicago

  22. Transgender Health Practices [Other Research] Health and Social Service Needs of Transgender People in Chicago

  23. Transgender Health Practices [Other Research] Health and Social Service Needs of Transgender People in Chicago

  24. Transgender Health Practices [Other Research] Health and Social Service Needs of Transgender People in Chicago

  25. Transgender Health Practices [Other Research] Health and Social Service Needs of Transgender People in Chicago

  26. Transgender Health Practices [Other Research] From Gayhealth.com / October 2000

  27. Transgender Health Practices [Needed Research] • Medical Profession and Health Care Providers • Knowledge • Awareness • Training • Post-Op Transsexuals • Follow-up Studies • Satisfaction Levels • Pharmaceuticals • Drug Effects • Longitudinal Studies • Early Identification • Youth • Aging • Other?

  28. Bobbi Williams, Ph.D.,  is on the Board of Rainbow Access Initiative, a Program funded by the New York State Department of Health which provides LGBTI training to Health and Human Services professionals in the NY capital region and a representative to the National Coalition for LGBT Health where she serves on the Steering and Communications committees. WEB SITE: http://members.tgforum.com/bobbilliams E-MAIL: bobbiwilliams@tgforum.com PHONE: 518.506.6552 Rainbow Access Initiative: http://www.rainbowaccess.org National Coalition for LGBT Health: http://www.lgbthealth.net

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