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Transgender Care

Trans Care BC aims to enable transgender clients to receive the majority of their care with a primary care provider, with referral to surgeons and specialists as needed.
 

In partnership with a client’s primary care provider, Trans Care BC can:
  • Support GPs and care teams with clinical consultation around the delivery of gender-affirming care including practice supports and resources.
  • Coordinate surgical readiness assessments with qualified assessors via a referral to the care coordination team.
  • Provide pre and post-surgical care coordination support for any client having surgery out-of-province or out-of-country.
  • Provide care planning support and coordination for clients experiencing barriers and challenges for chest surgery or challenges in the surgical readiness assessment process.
Trans Care BC also:
  • Supports clients, parents and caregivers to navigate available services in their local area and provide information for all stages of gender transition.
  • Develops and delivers education to improve service capacity closer to home.
Trans Care BC aligns its practices with World Professional Association for Transgender Health (WPATH) Standards of Care Version 7. The model of care being developed at Trans Care BC is shown below with four tiers. The intent of the model is to encourage shared care with the primary care provider jointly planning care with providers and specialists, in other tiers of care.



Open a printer-friendly version of the tiered model of care.

Tier 1

Tier 1 service offers a culturally safe, inclusive and accessible health care environment that supports clients across the gender and age spectrum (child, youth, adult, older adult). All staff and health care professionals would have a good understanding and incorporation of appropriate use of language, the importance of the used name and a client’s preference of pronouns. 

At this level a health care professional would have a good knowledge of where to refer clients for resources and system navigation. Services provided should include prevention, harm reduction and health promotion strategies. Counselling services at this level would be general in nature but provided in a gender-affirming approach along with a solid understanding of the stages of development for children and youth. 

Clients and/or families would be encouraged and supported in taking an active role in their care. 

Tier 2

Tier 2 services include health care professionals with competencies for trans specific care such as conducting a culturally sensitive physical exam, supporting a client on hormone therapy, familiarity with medications and side effects and the provision of individual counselling (relevant to trans and gender diverse people such as coming out, starting hormone therapy, puberty blockers, exploration of gender identify, etc.). 

Clinicians at this level should be able to differentiate coexisting mental health conditions from gender dysphoria and be able to assist families in adopting a more accepting and nurturing response to their child/youth’s gender expression. Health professionals at this level may work in a shared care model with clinicians with more advanced practice competencies.

Tier 3

In tier 3, health care professionals have the necessary competencies to complete a hormone or surgical readiness assessment and are comfortable initiating and monitoring hormone therapy, and providing or coordinating complex post-operative care.  

At times, clinicians functioning at this level may support colleagues working at Tier 2 in a shared care model of care related to the completion of assessments, supporting a provider starting a client on hormones, etc. 

Tier 4

Clients at times may require the support of specialists to assist in the management of health conditions and/or to support them achieving their gender-affirming goals (endocrinologist, gynecologist, surgeon etc.). 

The goal is to transition clients to Tier 4 services as required with the client remaining attached to their primary care and/or mental health teams in a shared care model. 
 
Help is available for primary care providers who would like to support a trans patient with gender-affirming care but are unsure how to help. 

Trans Care BC education team
Trans Care BC’s education team is committed to raising care provider knowledge, competency and cultural safety. Along with Trans Care BC initiatives, the education team plays a supporting role in fostering the work individuals, communities and agencies across the province are doing to advance gender-affirming care in their region. 

RACE (Rapid Access to Consultative Expertise)
Contact the RACE (Rapid Access to Consultative Expertise) line: 604-696-2131 or toll-free at 1-877-696-2131 and request the transgender option. 

Mentorship call
A mentorship call hosted by Trans Care BC’s medical director, Dr. Marria Townsend, is available to any practitioner new to or currently providing care to transgender clients. The mentorship calls are held on the 1st and 3rd Wednesday of the month from 12-1 p.m. 

No need to register; just call the conference line at 604-681-0455 or 1-877-291-3022, participant code 7019866#.

Primary Care Toolkit
The Primary Care Toolkit is intended to support GPs and NPs who are relatively new to providing care to trans people. It includes some basic information about gender-affirming care options and tools to assist with initiating and/or maintaining hormone therapy. It also directs you to further reading and provides suggestions for where you can access support from more experienced clinicians.

 
 
SOURCE: Transgender Care ( )
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