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APHA Scientific Session and Event Listing

Recorded presentation

Chris Grasso, MPH¹, Ulrike Boehmer, PhD², Ellen Rottersman, MSW³, Anne Marie Forth, MD⁴, and Judith Bradford, PhD¹. (1) The Fenway Institute, Fenway Community Health Center, 7 Haviland Street, Boston, MA 02115, 617-927-6018, cgrasso@fenwayhealth.org, (2) Health Services, Boston University School of Public Health, 200 Springs Road (152), building 70, Bedford, MA 01730, (3) Mental Health Care and Counseling, Fenway Community Health Center, 7 Haviland Street, Boston, MA 02115, (4) Medical Department, Fenway Community Health Center, 7 Haviland Street, Boston, MA 02115

Background: Understanding the medical and mental health needs of tansgender patients is integral in designing and providing appropriate health services. At Fenway Community Health Center, transgender patients presenting for treatment have their case monitored and reviewed by the Transgender Clinical Team.

Objective: To better understand the needs of transgender patients who seek medical or mental health care.

Methods: Information for this study was extracted from an electronic medical record system using a standardized chart review survey. At intake, a complete history of the person's presenting problem and relevant developmental history, prior medical, mental health and substance abuse treatment, current symptoms and areas of impaired functioning is documented.

Results: A chart review was conducted of transgender patients (n=139) who received medical or mental health care between January 2003 and May 2005. Assigned gender at birth was predominantly male (70%) and self-reported gender at intake was female (53%) while 43% reported their transgender awareness at 12 years old or younger. At intake, 53% of patients were unemployed; 48% had government sponsored insurance or no insurance. Of patients who had a mental health intake (n=78), 49% reported being physically abused during their lifetime and 61% reported a history of substance abuse. Among mental health patients, at least one suicide attempt was reported by 30%, 20% were assessed to have current suicidality and major depression was present in 23%.

Conclusion: Transgender patients reported significant health needs and difficulties finding adequate care. Psychosocial and environmental problems are key factors when evaluating and treating transgender patients.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Prioritize key psychosocial and environmental factors to evaluate at intake for transgender patients.
• Identify the essential ingredients of treatment programs for transgender patients who seek treatment.
• Discuss the importance of a Transgender Clinical Team in providing comprehensive care.

Keywords: Health Assessment, Access to Health Care

Related Web page: www.fenwayhealth.org

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation