Welcoming environments for transgender people

Key concepts to understand when providing health service for transgender people

As mentioned earlier, one of the barriers to access to healthcare faced by transgender people is the lack of understanding of gender diversity and sensitivity among health service providers. To eliminate that barrier and improve access to health service for transgender people, health service providers should study and understand the following key concepts in providing health service to transgender people.

Transgender-specific health service initiation in Thailand and the development of the Thai Handbook of Transgender Healthcare Services

Recognizing the barriers to health services that transgender people in Thailand and worldwide have to face, Professor Emeritus Dr. Praphan Phanuphak, Director of The Thai Red Cross AIDS Research Centre (TRCARC), took the lead to respond to the issues by initiating the plan to provide health services that are tailored-made for transgender people in Thailand for the first time.

To truly understand the transgender community's health needs, TRCARC hosted a community consultation meeting with the community members in September 2015. Based on the community members' feedback, the meeting concluded that an easily accessible transgender-specific clinic should be established to provide holistic healthcare for transgender people. The clinic should also employ a good proportion of transgender staff and create a meaningful engagement with the community.

The clinic should provide non-judgmental services and respect the dignity of all transgender clients. The clinic was, thereafter, established under the name of "Tangerine Community Health Clinic," and started its operation on November 27, 2015. With the funding from the United States Agency for International Development (USAID), it offers holistic transgender health services by both transgender and non- transgender staff. All staff members were required to attend the gender sensitivity training before taking up their duties. This clinic is also considered a model of a Key Population-led Health Service Delivery (KPLHS). It emphasizes the equal and meaningful engagement from the community, service providers, and partners, who may or may not necessarily be a member of the transgender community.

Nevertheless, without a national guideline on transgender health service provision, doctors, researchers and those who work with transgender people have to rely on the international guidelines. Despite some similarities, there are still many limitations in practice. The idea to develop the Thai Handbook of Transgender Healthcare Services was then brought up with the establishment of the Center of Excellence in Transgender Health, Chulalongkorn University (CETH). The aim of this handbook is to support both transgender health specialists and primary healthcare providers, including community workers in providing health services for transgender people based on the Thai context. The Thai Handbook of Transgender Healthcare Services covers all aspects of health services for transgender people, for example, gender affirming hormone treatment and surgery, sexual health, mental health, reproductive health, substance use, and etc. This handbook is, therefore, an essential resource of holistic healthcare provision for transgender people in Thailand.

Refer: Introduction to Healthcare Services for Transgender People, The Thai Handbook of Transgender Healthcare Services, Center of Excellence in Transgender Health, Chulalongkorn University