Transgender Preventive Health Awareness in a Therapy Setting

Background:Transgender individuals experience an increase in health-related problems, including suicide rates up to 40%, a four-fold risk of contracting HIV, increased rates of substance use reported between 25-33%, and unsupervised hormone use reported between 29-63%. While the health-related problems are elevated, 40% of transgender respondents from a 2014 health survey delayed seeking health care compared to 16% of the general population. Utilizing psychotherapists for this demographic with established therapeutic relationships might allow for transgender individuals to explore fears, barriers, and facilitators related to obtaining adequate healthcare and help these clients identify which individual preventive measures may be indicated.Methods:In a roundtable discussion, therapists at an urban LGBTQ+ facility identified common barriers and facilitators their transgender clients encounter when pursuing preventive health care. An evidenced-based practice (EBP) toolkit on transgender preventive health was created and distributed to transgender therapy clients at the facility for one month. Therapists documented each time a toolkit was accepted and the number of conversations about healthcare during the implementation period. The EBP toolkit was implemented by the therapists as a means of encouraging dialogue about preventive healthcare and establishing care with a primary care provider. Therapists filled out a survey following the implementation of the EBP toolkit to report usefulness and feasibility of the intervention.Results:In the roundtable discussion prior to implementation of the EBP toolkit, 12 therapists reported having zero conversations with transgender clients regarding health screenings and pursuing preventive healthcare. At the conclusion of the EBP toolkit implementation period, 61 EBP toolkits were distributed and 36 transgender clients engaged in a health-based discussion with their psychotherapist. Therapists felt the EBP toolkits were received with positive or neutral reactions; none of the therapists reported a negative response from a transgender client who received a toolkit. One therapist advocated for more specific information presented in the toolkit and felt many clients already knew the information included. Cost of healthcare was listed as the primary barrier for transgender clients avoiding preventive care. Overall, the therapists felt the toolkit facilitated positive dialogue regarding healthcare.Conclusions:Although further research in this area is necessary, utilizing evidence-based information in a user-friendly format with the assistance of trained psychotherapists can increase the number of conversations regarding preventive healthcare with transgender clients.