A collaborative model aligning adult sexual health and endocrine gender health services
Sally Woodward
A , Judy Luu B , Joanna Mesure A and Katie Wynne B C *
A Hunter New England Sexual Health Service, Newcastle West, NSW, Australia.
B Department of Diabetes and Endocrinology, John Hunter Hospital, Hunter New England Health, Newcastle, NSW, Australia.
C School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
Sexual Health - https://doi.org/10.1071/SH22027
Submitted: 31 January 2022 Accepted: 7 June 2022 Published online: 12 July 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: The Hunter New England (HNE) endocrinology and sexual health service commenced a co-located gender community clinic in 2018. This paper describes this novel model of service delivery, including the sociodemographics, clinical characteristics, and STI screening rates of trans and gender diverse (TGD) adults attending for gender-affirming hormone treatment (GAHT) and identifies patients accessing the broader skill set of both specialty services in 2018–19.
Methods: This study was a retrospective audit of medical records of all patients with initial consultations for GAHT at the endocrine and sexual health gender clinics from 1 January 2018 to 31 December 2019. A further data set included any adult TGD patient with any attendance, initial or subsequent, between 1 January 2018 and 31 December 2019. Patients with dual attendance at the endocrine gender clinic and sexual health service were further explored.
Results: Baseline sociodemographic data of participants were comparable in both gender clinics attended. Endocrinologists were more likely to use spironolactone for androgen blockade than the sexual health physician (77.8% vs 43.8%, P = 0.0096), but prescribing patterns were otherwise similar. STI screening was more frequently performed in patients accessing GAHT through sexual health than endocrine gender clinics (35% vs 0.9%, P = 0.00). Twenty patients (8.0%) had an attendance at both the sexual health and endocrine services and accessed STI screening, contraception, cervical screening, HIV pre- or post-exposure prophylaxis and estradiol implants.
Conclusions: Co-located gender clinics staffed by endocrinology and sexual health physicians provide care for a similar patient population and facilitate access to GAHT, estradiol implants, STI screening, contraception, and cervical screening for the TGD population.
Keywords: community health, contraception, endocrinology, estradiol, gender-affirming care, gender-affirming hormone treatment, health services, HIV, implants, sexual health, STIs, testosterone, transgender.
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