Training to Improve PPWI Health Services to Promote Health Equity for Transgender, Gender Nonbinary, Gender Expansive, and Gender Nonconforming (TNG) Individuals

At a Glance

This project aimed to promote equitable health care for transgender, gender nonbinary, gender expansive, and gender nonconforming (TNG) individuals by increasing access to affordable and competent sexual and reproductive healthcare services through health care work force training and patient material improvement. The project accomplished its goal through several key approaches that included focused training for health center and administrative staff and the establishment of a community advisory group to provide input on patient education materials, communication and other resources.

The Challenge

Transgender, gender nonbinary, gender expansive, and gender nonconforming (TNG) individuals are often targets of discrimination, harassment, and violence which exposes them to social and economic insecurity including high rates of unemployment, poverty, and housing instability. Further, transgender individuals have high prevalence of HIV/STDs, victimization, mental health issues, and suicide. Due to lack of health insurance and fear of discrimination, transgender people often postpone or do not seek health care. When TNG individuals do receive health care services, there is a lack of providers who are knowledgeable about their identities and competent in TNG health care needs.

Project Goals

Planned Parenthood of Wisconsin’s (PPWI) primary goal was to increase access to affordable and competent sexual and reproductive health care services for TNG people in Wisconsin by creating a more informed and educated health care work force as well as by improving health care materials, including patient intake forms and education materials.

PPWI approached this goal in two ways. First, they planned to increase staff training to improve access to sexual and reproductive health services for TNG individuals and ensure PPWI creates and maintains an inclusive environment for TNG patients, staff members, colleagues, and other community members. Second, PPWI aimed to improve agency awareness of gender-inclusive resources for patients and other community members in order to provide appropriate referrals to other health and social service providers.

Results

PPWI was successful in achieving their goal through outcomes at health center staff, administrative staff, and community levels.

Health center staff outcomes: A curriculum was developed by the Wisconsin Transgender Health Coalition for the PPWI that focused on providing TNG patients with gender-inclusive sexual and reproductive health care services, such as contraception and sexually transmitted infection (STI) testing and treatment. Six trainings were held across the state for 197 health center staff members, and the training was incorporated into regular onboarding training for all new health center staff members.

Administrative staff outcomes: A separate, but related training was developed for administrative staff which focused on creating a gender-inclusive workplace environment and communicating PPWI’s work to provide gender-inclusive and gender-affirming health care. This training has been incorporated into the annual training requirements for all administrative staff members.

Community outcomes: Eleven TNG individuals were recruited from communities around the state to form a community advisory committee. The advisory committee held 15 meetings where they provided input on patient education materials, aided in the communication surrounding the launch of Gender Affirming Hormone Therapy (GAHT) in PPWI health centers, and developed a resource and referral list for TNG individuals based on the committees’ experiences with other health care providers and social services.

Looking to the Future

The work done on this grant helped leverage additional funding to support their implementation of GAHT across all 21 PPWI family planning centers in the state.

Lasting Impact

Although the community advisory committee is no longer meeting, PPWI remains connected with these TNG community members, many of whom have become ambassadors for the agency within their own communities and most of whom also offered to provide any additional support or input needed in the future.