Back To the Main SiteBeyond Boxes Series: Solutions
Peter Hyndal presented at a Men’s Health Conference in Newcastle, last week. A “National Health Gathering” presented by the Australasian Men’s Health Forum. For the conference he wrote a paper named Beyond boxes: Sex and gender diversity and health service provision
We’ll be posting the contents of his presentation over the next few weeks, in tasty bite sized morsels, and the full paper (with all its references intact) will be available to download as soon as its been confirmed complete.
The story so far:
2 What does sex and gender diversity have to do with Men’s Health?
3 Medical Professionals involvement in Making Men
4 Issues with Primary Health Care
Todays post, and the final post in the series is beyond the cut
Funding Community-Specific Health Services
There is almost no national or state based funding for services responding to sex and gender diverse people’s health needs. One reason for the lack of funding is that sex and gender diverse people are rarely identified in government strategy or policy. This absence or invisibility at the strategy level means that those in positions to make funding decisions do not include sex and gender diverse people, as there is no requirement for them to do so and/or they fear they will not be supported in their funding decisions by those above.
Organisations anchored in the LGBT community have historically often provided the only services addressing the health of sex and gender diverse people. Many of these organisations struggle to obtain competitive funding for health programs and/or are forced to invest significant resources into fundraising and grant applications. In addition, many are not entirely comfortable with the inclusion of sex and gender diversity within a target group more actively focused around sexuality. This is reflected by the fact that many such organisations have ceased the inclusion of intersex people in their official target groups. This feeling is also reflected from many within the sex and gender diverse community – those who themselves identify as fiercely heterosexual, those who identiy as neither intersex nor transsexual and also those who are not comfortable with a further division of their community along the lines of intersex vs transsexual.
It is clear that sex and gender diverse communities have enough specific health needs to warrant specifically targeted and focused health services. The importance of such specific targeting has been recognized in other population groups as evidenced by the prevalence of womens health centres and indigenous health centres.
Given the high degree of specific knowledge required it is clearly more practical to train staff at specific gender centres of excellence than it is to provide all health services with the level of training required to bring them up to this level of expertise.
To be effective, it is critical that such services operate using Standards of Care based on informed consent and mutual respect models. There are currently no such services in Australia.
What you can do in your own service:
Sex and Gender specific health services are an essential but not the complete solution.
It is also critical that sex and gender diverse people are able to access adequate and appropriate health care from mainstream service providers.
On a practical level some things you can easily and quickly implement in your own services are:
- Review your intake/client form – do you currently ask “what is your sex?”. Do you really need to know the answer to that question? What difference does it make to your service delivery if someone ticks M as opposed to F? If you really do need to ask a question like this, change the way it is asked and encourage alternative answers (for example ask “How do you identify (male/female/other)?”
- Don’t make assumptions that someone is intersex/trans/neither/both based on their appearance/voice – instead, ask clients how they identify. If it is not appropriate to ask clients directly, the sex you indicate on data collection forms should be “unsure” unless the person has specifically aligned themselves as being male or female. Ask clients what their preferred pronouns are and respect their choice. If it is not appropriate to ask clients for their preferred pronouns, avoid using a pronoun until you hear the person use a pronoun themselves.
- Where a client identifies as sex/gender diverse respect their confidentiality.
- Ensure your resources don’t assume a necessary alignment between gender identity, legal sex, biological sex, genitals, sexuality or sexual practices
- Remember it is generally inappropriate to ask someone about the shape or functionality of their genitals – do not ask someone for medical diagnosis or surgical status merely out of curiosity.
- Seek out and provide training for staff on the basics of sex and gender diversity issues (such as the information included in this session).
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