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Clued Up

Clued Up. A Clinic Familiarisation Intervention for Trans People Nick Douglas, LGBT HIP Coordinator. Overview. LGBT Health and Inclusion Project The intervention Evaluation Results Conclusions and implications New initiatives. Background. LGBT Health and Inclusion Project (LGBT HIP)

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Clued Up

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  1. Clued Up A Clinic Familiarisation Intervention for Trans People Nick Douglas, LGBT HIP Coordinator

  2. Overview • LGBT Health and Inclusion Project • The intervention • Evaluation • Results • Conclusions and implications • New initiatives

  3. Background • LGBT Health and Inclusion Project (LGBT HIP) • Evidence of need (Hounsfield, 2007, Browne 2008) • Aims: • Enable trans people learn about clinic services and use the clinic independently in future • Provide an opportunity for the clinic to consult with trans people • Intervention preparation • Contact with the clinic • Briefing about LGBT HIP • Trans awareness training

  4. Intervention and evaluation • Intervention – two hour session • Recruitment • Food/introductions/ground rules • Clinic tour – Q&As • Consultation role-play • Cancer prevention quiz • Brief discussion • Evaluation • Staff training evaluation forms (=32) • Participant pre and post intervention surveys (pre=15, post = 17) • One-hour staff team interview (2 sexual health advisors, 1 health trainer)

  5. Results • Demographics • Changes in • Knowledge • Attitudes • Intended behaviour • Training, information and services • Qualitative feedback

  6. Demographics

  7. Knowledge

  8. Attitudes and beliefs

  9. Intended behaviour

  10. Training and information

  11. Services provided

  12. What participants said… • Staff training • Communication - pronouns • Privacy and confidentiality • Gender presentation and perceptions • Clinic processes and procedures • Forms and administration • “How useful is it to ask if I am a man or a woman? What they actually want to know is what my genitals are. So why not ask? This is a sexual health clinic. That might seem a bit of an abrupt question, but it’s going be a question that’s gonna come up later. And for me, I find that I’d rather they ask that than if they ask if I’m a man or a woman because that’s not really what somebody’s asking.”

  13. What the staff said… • Staff trans awareness training essential • Structure of the session – timing • Having a range of staff involved • Skilled and knowledgeable facilitation • Following up and capitalising on the opportunity • Understanding trans people’s experiences and struggles • “I don’t think that I’d maybe fully appreciated people’s vulnerability, you know in the community, you know outside of the clinic and what people have faced and what they’ve been through. I think also from my own perspective I will be less hung up about trying to get the words right and just being, you know, up front, honest and asking if I don’t know something, asking them, asking that person. Rather than worrying so much about getting it wrong.”

  14. Conclusions • Proof of concept – it can be done • Too small numbers for strong conclusions but potential for gains in raising awareness about clinic services and increasing confidence in respectful, culturally competent treatment • Gains less clear on intended behavioural outcomes • Trans people want reassurance of staff training and more information in places accessible to them • Also important to examine impact for staff • We need this to be replicated elsewhere – promising intervention.

  15. Getting it wrong, Getting it right • “I saw this guy doing his gynae rotation who was clearly mortified to be dealing with me and he was bright purple the whole time and he kept talking about ‘um, down there’.... [I thought] if you say ‘front bottom’ I’m going to smack you!” • “Once I went in I said I’m a trans guy, this is my situation, there was a sensitivity with the staff... Just the sensitivity and also the willingness to say: am I getting this right, have I, you know, is this an OK way to approach this? And it’s not necessarily knowing all the answers it’s being willing to ask for guidance and to say I’m not too sure of my ground, please bear with me. That I found really much more helpful to deal with than someone who doesn’t know and doesn’t care.”

  16. New Initiatives: Clinic T Pilot • Lawson Unit, Claude Nicol Clinic, Brighton • Every three months • By appointment • Full range of sexual health services • LGBT HIP volunteers ‘greeters’

  17. New Initiatives: THT Guides www.tht.org.uk/sexual-health/Resources/Publications/Trans/Transmen-Trans-Health-Matters www.tht.org.uk/sexual-health/Resources/Publications/Trans/Trans-Women-Trans-Health-Matters

  18. Acknowledgements Many thanks to: • Jonathan Roberts, Jules Davies, Claude Nicol Centre, Brighton • Clare McEwan, Sussex Community NHS Trust • Michelle Ross, Terrence Higgins Trust • Phil Seddon, NHS Sussex • LGBT Health and Inclusion Project Consortium • Bridie Phillips, LGBT HIP Volunteer • Ben Castle, LGBT HIP Volunteer • Contact: nicolas.douglas@tht.org.uk • www.lgbt-hip.org

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