Providing gender-affirming hormone therapy through primary care: service users’ and health professionals’ experiences of a pilot clinic
Alex Ker 1 5 , Gloria Fraser 2 , Antonia Lyons 3 , Cathy Stephenson 4 , Theresa Fleming 31 School of Social and Cultural Studies, Victoria University of Wellington, Wellington, New Zealand
2 School of Psychology, Victoria University of Wellington, Wellington, New Zealand
3 School of Health, Victoria University of Wellington, Wellington, New Zealand
4 Mauri Ora, Student Health and Counselling Service, Victoria University of Wellington, Wellington, New Zealand
5 Corresponding author. Email: alex.ker@vuw.ac.nz
Journal of Primary Health Care 12(1) 72-78 https://doi.org/10.1071/HC19040
Published: 10 March 2020
Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
Abstract
INTRODUCTION: Primary health care providers are playing an increasingly important role in providing gender-affirming health care for gender diverse people. This article explores the experiences of a primary care-based pilot clinic providing gender-affirming hormone therapy in Wellington, New Zealand.
AIM: To evaluate service users’ and health professionals’ experiences of a pilot clinic at Mauri Ora (Victoria University of Wellington’s Student Health and Counselling Service) that provided gender-affirming hormones through primary care.
METHODS: In-depth interviews were conducted with four (out of six) service users and four health professionals about their perspectives on the clinic. Interviews were transcribed verbatim and analysed using thematic analysis.
RESULTS: Three themes were identified in service users’ interviews, who discussed receiving affirming care due to the clinic’s accessibility, relationship-centred care and timeliness. Three themes were identified in the health professionals’ interviews, who described how the clinic involves partnership, affirms users’ gender and agency, and is adaptable to other primary care settings. Both service users and health professionals discussed concerns about the lack of adequate funding for primary care services and the tensions between addressing mental health needs and accessing timely care.
DISCUSSION: The experiences of service users and health professionals confirm the value of providing gender-affirming hormone therapy in primary care. Models based in primary care are likely to increase accessibility, depathologise gender diversity and reduce wait times.
KEYwords: Gender-affirming health care; primary health care; transgender; LGBTQ persons; gender minorities
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