MON-194 Multidisciplinary Care for Adult Transgender/Gender Non-binary Patients: A Novel Healthcare Delivery Model Centered within the Endocrinology Clinic

Abstract

Abstract Despite increased media attention to transgender/gender non-binary people, access to care remains a major health disparity. Several multidisciplinary gender clinics involve children/adolescents seeing multiple providers during the same visit. However, adult transgender clinics are more primary care-based with navigators guiding patients across specialties. Few adult multidisciplinary clinics exist where providers care for transgender patients during a single visit. We know of no published models of care housed within the endocrine clinic, which can serve as a gender-inclusive space where providers/staff have expertise in hormone physiology. Our Integrated Transgender Program launched in September 2017 to provide culturally responsive, multidisciplinary care to transgender adults within a single endocrine clinic visit. School of Medicine faculty in endocrinology, psychiatry, gynecology, internal medicine, and plastic/reconstructive surgery, provide care in this now biweekly collaboration. We also do provider/staff education to increase knowledge within our community. From September 2017 to October 2018, we had 180 visits with 70 unique patients. Visits were with: endocrinology (n=90), psychiatry (44), internal medicine (20), gynecology (18), plastic surgery (8). The 70 patients self-identified as: transwoman (31), transman (29), non-binary (3), transmasculine (3), male (2), female (1), genderqueer (1). Patient ages varied: 18-24 yrs (18), 25-44 yrs (38), 45-64 yrs (11), 65+ yrs (3). Our patients were 70% White, non-Hispanic and came from around our state and beyond. Type of insurance included: commercial (33), Medicaid (11), Medicare (7), self-pay (5), Tricare (4), other (10). In our first 9 months, we saw 13 patients overdue for cervical cancer screening and 11 (85%) underwent testing in our clinic, higher than the 34% screening rate of transmen we previously reported at our institution. Adult transgender/gender non-binary patients benefit from streamlined patient-centered care from a multidisciplinary team. Our endocrine clinic serves as a centralized, gender-inclusive space to improve access to care, particularly services that traditionally come with gender-specific waiting areas. Bringing the specialties into one clinic may allow for familiarity among our younger cohort who may have experienced multidisciplinary pediatric gender clinics. Many patients are younger/middle aged but routine maintenance exams across the lifespan are integral to supportive health care. Not all patients identify as transwomen or transmen. Awareness of non-binary identity or those still congruent with their sex assigned at birth is also important. Patient feedback has been positive, but we plan to conduct formal satisfaction surveys and develop a community advisory board to further assess needs. Supported by: University of Colorado Diversity & Inclusive Excellence Grant