Study Examines Health Care Services for Transgender and Gender-Diverse Communities in Rural, Suburban New England

In 2019, The Fenway Institute, in partnership with Cooley Dickinson Health Care and researchers from Harvard Medical School, launched Plan and Act for Transgender Health (PATH), an extensive research study to assess the quality and accessibility of health care and social services in central and western MA, VT, NH, CT, and eastern upstate NY.

The PATH Project implemented a mix-measures research strategy, consisting of an online survey for transgender and gender-diverse adults and parents of transgender and gender-diverse children under the age of 18, as well as a number of community focus groups and one-on-one provider interviews.

In total, the PATH Project collected quantitative data from 379 participants across 25 counties, along with qualitative data from 70 focus group participants, and 30 health care providers. Community focus groups were held for transgender and gender-diverse adults, as well as specific groups for college students, the deaf and hard of hearing, monolingual Spanish speakers, and parents of transgender and gender-diverse children under 18. Health care provider input was gathered in one-on-one interviews with an array of provider disciplines, as well as a focus group for front-line and administrative staff from around the region.

“This area is home for many gender-diverse people and allies who are actively engaged in efforts to improve health care,” said Virginia Vedilago, Program Manager at The Fenway Institute. “Through the PATH Project, we connected with community members who offered insight into their experiences with local health care services and we had the opportunity to hear their ideas for how to make the patient experience more affirming.”

“With the launch Pioneer Valley TransECHO, we’ll build on the relationships we’ve established over the past year and use the feedback that we’ve collected from community members and providers to tailor a program that best meets the needs of health care organizations in the region,” Vedilago added.

Data collected from the PATH Project helped to identify opportunities and gaps in services in the region, which has been used to help inform the curriculum for the Pioneer Valley TransECHO, an ECHO-based approach to disseminating knowledge and creating networks with health care providers and staff, in central and western MA, VT, NH, CT, and upstate NY.

The program seeks to improve the quality and accessibility of gender-affirming health care in the region by sharing clinical expertise, helping provider locations to create gender-affirming environments, developing and refining strategies that enable provider locations to collect and utilize sexual orientation and gender identity data, and to build relationships with other organizations that will facilitate peer learning experiences.

“Because no prior data exists on trans and gender-diverse communities in the region, the PATH Project engaged directly with community members and providers to better understand the specific needs and gaps in services in these more rural cities and towns,” said Brooke Stott, Program Coordinator at The Fenway Institute. “It is really exciting to be able to use what we learned from PATH to inform and adapt the content of the recently launched Pioneer Valley TransECHO, to better address the specific needs of the region.”

From January 2020 through December 2020, the Pioneer Valley TransECHO will be hosting two sessions per month, one for adult and pediatric clinical health care providers, and one for front-line and administrative staff. The 2020 cohort is made up of 25 provider locations, with a total of about 150 registered participants.

In addition to the ECHO sessions themselves, the Pioneer Valley TransECHO team will conduct in-person site visits with participating locations, and offer individualized support and connection to resources as needed.

“While our national TransECHO program focuses specifically on serving federally qualified health centers, the Pioneer Valley Transgender ECHO is a great opportunity to broaden our technical assistance to engage hospital-based programs and other types of health care organizations in Western Massachusetts, Connecticut, New Hampshire, Upstate New York, and Vermont,” said Dr. Alex Keuroghlian, Director of Education and Training Programs at The Fenway Institute.

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