Comprehensive transgender healthcare: the gender affirming clinical and public health model of Fenway Health

Abstract

This report describes the evolution of a Boston community health center's multidisciplinary model of transgender healthcare, research, education, and dissemination of best practices. This process began with the development of a community-based approach to care that has been refined over almost 20 years where transgender patients have received tailored services through the Transgender Health Program. The program began as a response to unmet clinical needs and has grown through recognition that our local culturally responsive approach that links clinical care with biobehavioral and health services research, education, training, and advocacy promotes social justice and health equity for transgender people. Fenway Health's holistic public health efforts recognize the key role of gender affirmation in the care and well-being of transgender people worldwide.

FIG. 1

Annual growth of transgender patient population at Fenway Health from 1997 to 2013. Data note: figure displays active transgender patients by calendar year. “Active” is defined as a patient who had a visit in that calendar year and accessed the transgender health program (documented in their electronic medical record) before the end of that calendar year.

FIG. 2

Collaboration between The National LGBT Health Education Center, faculty at The Fenway Institute (TFI), and Transgender Health Program to address cultural competency of front-line health care staff to provide gender affirming care to transgender patients. Web resources: Fenway Health (http://www.fenwayhealth.org/). The Fenway Institute at Fenway Health (http://thefenwayinstitute.org/). National LGBT Health Education Center (http://www.lgbthealtheducation.org/). Center for Population Research in LGBT Health (http://lgbtpopulationcenter.org/). TFI Health Policy (http://thefenwayinstitute.org/health-policy/).