Trans and Gender Diverse in Community Health Initiative

Trans, gender diverse, non-binary, and gender questioning people (Trans, or TGD people) face significant barriers in accessing gender affirming care and face high rates of health issues, stigma, discrimination and disadvantage. Despite the availability of guidelines supporting general practitioners (GPs) to deliver gender affirming care in the community, there is a chronic and long-term undersupply of gender affirming care in Victoria. This results in demand for access far exceeding the supply of practitioners who deliver this care. As a result, health outcomes for TGD people are significantly poorer compared to the cisgender population. The Trans and Gender Diverse in Community Health Initiative (TGDiCH) initiative is funded by the Victorian Department of Health and is delivered by a consortium of four organisations (Your Community Health (lead), Ballarat Community Health, Austin Health and Thorne Harbour Health, and aims to increase access to gender affirming care in the community.

The evaluation of the TGDiCH initiative aimed to assess the implementation of the initiative across the three program components (multidisciplinary clinics, statewide health practitioner training, and the Peer Navigator program) to determine the extent to which they are working as intended and achieving outcomes as expected.

ARTD Consultants conducted a lapsing program review and comprehensive process and outcomes evaluation of the TGDiCH initiative. Key activities in our evaluation included:

• Conducting a desktop review of key program documents
• Analysing existing administrative program data and healthcare practitioner training surveys
• Conducting interviews with a range of initiative staff and stakeholders
• Conducting interviews and an online survey of people who used the service

The evaluation of the TGDiCH initiative has provided a robust evidence base for understanding the impact of the initiative. We found that these workforce issues had been addressed and that each component of the initiative was being implemented broadly as intended, and that clients that accessed the service were affirmed in their gender and experienced a broad range of positive outcomes, including improved physical and emotional wellbeing, access to gender affirming hormone therapy, improved understanding of the healthcare system and greater trust in the healthcare system.

These findings informed recommendations to support the future delivery of the TGDiCH initiative. Following the lapsing program review, the Victorian Department of Health has funded the TGDiCH initiative on an ongoing basis.