Serving transgender people: clinical care considerations and service delivery models in transgender health.
The World Professional Association for Transgender Health (WPATH) standards of care for transsexual, transgender, and gender non-conforming people (version 7) represent international normative standards for clinical care for these populations. Standards for optimal individual clinical care are consistent around the world, although the implementation of services for transgender populations will depend on health system infrastructure and sociocultural contexts. Some clinical services for transgender people, including gender-affirming surgery, are best delivered in the context of more specialised facilities; however, the majority of health-care needs can be delivered by a primary care practitioner. Across high-income and low-income settings alike, there often remains a dearth of educational programming for health-care professionals in transgender health, although the best evidence supports introducing modules on transgender health early during clinical education of clinicians and allied health professionals. While these challenges remain, we review the increasing evidence and examples of the defined roles of the mental health professional in transgender health-care decisions, effective models of health service provision, and available surgical interventions for transgender people.
University of Sheffield, Sheffield, UK; Porterbrook Clinic, Sheffield, UK. Electronic address: k.r.wylie@sheffield.ac.uk.
Kevan
K
Wylie
Department of Psychiatry, University of British Columbia, BC, Canada.
Gail
G
Knudson
Program for HIV and AIDS, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
Sharful Islam
SI
Khan
Gender Dysphoria and Sexology Department, University Hospital La Conception, Marseille, France.
Mireille
M
Bonierbale
Suporn Clinic, Division of Plastic Surgery, Aikchol Hospital, Chonburi, Thailand.
Suporn
S
Watanyusakul
Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA.
Stefan
S
Baral
D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D005783:Gender Identity; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration; D017146:Models, Organizational; D011787:Quality of Health Care; D063106:Transgender Persons / Q000523:psychology*; D014189:Transsexualism / Q000628:therapy*; D008297:Male; D005260:Female