Trans Care BC - PHSA Accessiblce Care Assessment Tool for Care Services i
Creating Affirming Care for Gender Diverse People
Service Provider Reflection Tool for Individual Service Providers & Support Staff
March 2020
DescriptionThis self-assessment tool is for individuals interested in learning opportunities that explore their knowledge and attitudes towards gender diversity, along with their personal approach to supporting trans, non-binary, and gender diverse Two-Spirit individuals.
This tool can be used on its own or in combination with the Organizational Assessment Tool for Health Care & Support Services which is designed for care teams and organizations seeking to make their services more accessible for gender diverse people.
Feedback welcomedWe believe your feedback is one of the best ways to improve our educational resources. Therefore, we have released this beta version with the hope that you will consider using it, reviewing it, and letting us know your ideas for improving it. If you have any questions, comments, or suggested revisions, please email us at [email protected].
Trans Care BC - PHSAService Provider Reflection Toolii
Directions
Select relevant statements in each
category.
Then, consider the following questions:
Where are we currently at? (level)
What would enable us to score
1+ level higher? (action Items)
Who could help us make these
changes? (supports)
When could we take these steps?
(target dates)
Terminology
Gender Diverse refers to individuals who do not identify as the sex they were assigned at birth. This includes, but is not limited to, transgender, non-binary, and Two-Spirit people seeking gender-affirming care.
Client refers to all clients, patients, residents, and service users accessing care unless otherwise specified.
Staff refers to anyone employed by your organization unless otherwise specified. This may also include contractors and volunteers.
People refers to anyone who may be present in your service, including staff, volunteers, contractors, clients, family members, advocates, and all others who access the service or space.
The Assessment Tool may also include other terms that are new to you. Definitions can be found on the Glossary page of the Trans Care BC website.
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# Statement(select the relevant statements) Re
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WHAT(action items)
WHO(supports)
WHEN(target dates)
1 I understand the difference betweenGender Identity and Biological Sex
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2 I understand the difference betweenGender Identity and Sexual Orientation
YN 0 1 2 3 4
3 I understand the difference betweenGender Identity and Gender Expression
YN 0 1 2 3 4
4 I understand that gender diversity has existedhistorically, and in various regions of the world
YN 0 1 2 3 4
5 I understand that gender diversity is a naturalpart of human experience, not a disorder
YN 0 1 2 3 4
6 I understand that I may work with people whosecultural understanding of gender differ from my own
YN 0 1 2 3 4
7 I understand the value of a diverse workforce thatincludes trans, non-binary, and Two-Spirit employees
YN 0 1 2 3 4
8I understand that a gender diverse individual'sdistress connected to gender most often stemsfrom negative reactions from the outside world
YN 0 1 2 3 4
9I understand that colonization has led to the suppressionof Indigenous traditions and teachings, including the awareness and acceptance of Two-Spirit peoples.
YN 0 1 2 3 4
10I understand that the history of labelling genderdiversity as a mental disorder has added to thestigma experienced by gender diverse people*
YN 0 1 2 3 4
11I understand that past mistreatment of genderdiverse people by some care providers has createdlasting fear & distrust of care professions
YN 0 1 2 3 4
12I understand the importance of human rights protection and I'm aware of the federal and provincial human rights protections for gender diverse people within my region
YN 0 1 2 3 4
* Versions of the Diagnostics and Statistical Manual of Mental Disorders have included Gender Identity Disorder from 1980-2013, and Gender Dysphoria from 2013-present.
Foundational Knowledge
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# Statement(select the relevant statements) Re
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WHAT(action items)
WHO(supports)
WHEN(target dates)
1 I understand the importance of care being accessiblefor gender diverse clients
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2 I understand the importance of care being affirmingfor gender diverse clients
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3I understand providing accessible & affirming carecan significanlty improve clients' willingness to returnfor follow up care, improving health outcomes
YN 0 1 2 3 4
4I understand small acts of kindness from care providerscan increase clients' willingness to return for follow up care, even when system level change is slow
YN 0 1 2 3 4
5 I understand that all people, including myself, havesome level of unconscious bias
YN 0 1 2 3 4
6I understand that it becomes easier to avoid making assumptions the more I become aware of myunconscious bias
YN 0 1 2 3 4
7I understand it is important not to make assumptionsabout someone's gender identity based on theirphysical appearance
YN 0 1 2 3 4
8I understand the medical, mental health, and supportneeds of gender diverse individuals are person-specificand may be uniquely different from one another
YN 0 1 2 3 4
9 I understand that using a client's self-identified name and pronouns can be integral for relationship building
YN 0 1 2 3 4
10I understand that gender diverse clients may have legitimate safety concerns when accessing care that cisgender clients do not face
YN 0 1 2 3 4
11I understand that for many gender diverse clients,maintaining privacy & confidentiality are important forsafety (ie. avoid personal questions in public spaces)
YN 0 1 2 3 4
12I understand that a gender diverse client may haveless access to resources and supports usually availableto cisgender clients
YN 0 1 2 3 4
Foundational Approach
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WHAT(action items)
WHO(supports)
WHEN(target dates)
13I understand that a gender diverse cleint's access tocare may also be influenced by other factors, such aswhether or not care:
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A is accessible for people with disabilitiesYN 0 1 2 3 4
B is financially accessible (free, sliding scale,pay-what-you-can, delayed payment, etc.)
YN 0 1 2 3 4
C is safe for Indigenous peopleYN 0 1 2 3 4
C is safe for people of colourYN 0 1 2 3 4
D is safe for immigrants, refugees, andundocumented migrants
YN 0 1 2 3 4
Eis fat-positive (ie. chairs without sides, notdenying service based on weight/BMI orrequiring weight loss for access)
YN 0 1 2 3 4
F is safe for people of all sexualities and relationships(ie. non-monogomous, polyamourous, etc.)
YN 0 1 2 3 4
G is sex work/sex worker positiveYN 0 1 2 3 4
H takes a harm reduction and non-discriminatoryapproach to substance/drug use
YN 0 1 2 3 4
Iis trauma-informed (especially important for survivorsof gender-based violence, sexual assault, domesticviolence, and abuse)
YN 0 1 2 3 4
Foundational Approach (Continued)
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WHAT(action items)
WHO(supports)
WHEN(target dates)
1 I feel comfortable responding to clients whocome out to me as trans, non-binary, and Two-Spirit
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2 I feel comfortable continuing to work with clientswho come out to me
YN 0 1 2 3 4
3 I feel comfortable working with transmasculine peopleYN 0 1 2 3 4
4 I feel comfortable working with transfeminine peopleYN 0 1 2 3 4
5 I feel comfortable working with non-binary peopleYN 0 1 2 3 4
6 I feel comfortable working with Two-Spirit peopleYN 0 1 2 3 4
7 I feel comfortable working with gender diverse peoplefrom different cultures than my own
YN 0 1 2 3 4
8 I feel comfortable working with gender diverse youthYN 0 1 2 3 4
9 I feel comfortable working with gender creative childrenYN 0 1 2 3 4
10I feel comfortable listening without judgement toa client's experiences and feelings, including whenthey contradict my own beliefs
YN 0 1 2 3 4
Personal Comfort
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Client Engagement# Statement
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WHAT(action items)
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1 I make my willingness to work with gender diversepeople visible to clients and staff
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2I am conscious of the gendered language I use, andtry to use gender-neutral alternatives wheneverrelevant
YN 0 1 2 3 4
3I feel comfortable using they/them/their(s) as asingular pronoun to refer to a known individual,especially when it is their self-identified pronoun.
YN 0 1 2 3 4
4 I have a practice of offering my own pronouns, even if people rarely misgender me
YN 0 1 2 3 4
5 I engage my client in identifying the approaches theyfeel would fit best in our work together
YN 0 1 2 3 4
6 I acknowledge my limitations and the limitations ofthe system I work within
YN 0 1 2 3 4
7I use informed-consent frameworks that honourthe self-determination and confidentiality ofgender diverse clients
YN 0 1 2 3 4
8 I practice consent when asking for sensitive information from clients
YN 0 1 2 3 4
9I have a clear sense of why I ask questions to genderdiverse clients, and feel confident in communicatingthese reasons to clients before I ask
YN 0 1 2 3 4
10I clearly communicate to my clients if/how/with whominformation they disclose about their gender and/orhealth history will be shared
YN 0 1 2 3 4
11 I practice consent in physical interactions with clientsYN 0 1 2 3 4
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WHO(supports)
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1I invite feedback from clients and staff through variouschannels (in-person, by email, surveys, anonymousoptions, etc.)
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2 I have systems for openly receiving, incorporating, andadapting to feedback
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3I feel comfortable making changes that seem smallto me, but will have positive effects on myrelationships with gender diverse clients and staff
YN 0 1 2 3 4
4 I am willing to hear how I may have inadvertently hurt someone else, without over personalizing it
YN 0 1 2 3 4
5I acknowledge that I will sometimes make mistakes and will strive to be acountable, to repair harm, and to learn from them, thereby improving the care I provide
YN 0 1 2 3 4
Feedback and Accountability
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1I have time built into my schedule to reflect on mypersonal beliefs and values, and how they are enactedin my work
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2I am focussing on the ethic of dignity, respect, andhumility rather than being motivated by a desire tobe 'politically correct'
YN 0 1 2 3 4
3I acknowledge there are barriers that others willexperience that I may not be aware of as a resultof my privilege and social location
YN 0 1 2 3 4
4I build in time to reflect on my positionality and onhow I am enacting allyship for the improved care ofgender diverse people
YN 0 1 2 3 4
6 I seek out training that will improve my practicewith marginalized populations
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7I have received in-person training that is specificto improving service for trans, non-binary, andTwo-Spirit peoples
YN 0 1 2 3 4
8 I look for opportunities post-training to continuethe discussion or create actionable change
YN 0 1 2 3 4
Self-reflective Practice
Self-reflective practice
Continuing Professional Development
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WHAT(action items)
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1 I strive to advocate and liaise with other care professionals should my client wish for this
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2I strive to be client-led when advocating for them,meaning I follow their lead and whenever possible Iask for their consent before advocating
YN 0 1 2 3 4
3I research care providers & support services beforereferring gender diverse clients, in order to confirmthey are accessible, affirming, and experienced
YN 0 1 2 3 4
4Before referring a client to another service, I makesure to confirm the information, name, and pronounmy client would like shared.
YN 0 1 2 3 4
5I feel comfortable letting others know when I do notappreciate a hurtful statement or joke they have madeat the expense of others
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6 I challenge harmful/limiting myths and stereotypes Ihear expressed about gender diverse people
YN 0 1 2 3 4
7I take initiative to educate my colleagues about issuesthat affect gender diverse people instead of relying ongender diverse staff & clients to do this educating
YN 0 1 2 3 4
8I use my position to intervene in challenging momentswith staff, highlight gaps in service to managers, andadvocate for strategies for accessible & affirming care
YN 0 1 2 3 4
9I advocate for gender diverse people, even if it may beuncomfortable or have negative repercussions for me,knowing that this is a step towards meaningful change
YN 0 1 2 3 4
10I let others know when I've witnessed or appreciatedsomething they've done to support gender diversepeople (ie. reaching out, intervening, ongoing work...)
YN 0 1 2 3 4
11I reachout and work with supportive staff to enhanceinitiatives that improve access for gender diversepeople
YN 0 1 2 3 4
Advocating and Allying
Advocating
Allying
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WHAT(action items)
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1I am aware of my organization’s policies and proceduresfor creating an accessible and affirming environment forgender diverse clients and staff
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2I am aware of our services’ policies and proceduresaround addressing negative or discriminatory commentsor actions against gender diverse people
YN 0 1 2 3 4
3I am conscious of gendered programming, and try to replace them with gender-neutral or trans-inclusive alternatives
YN 0 1 2 3 4
4 I am conscious of gendered forms, and try to replace them with gender-neutral or trans-inclusive alternatives
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5 My organization enacts a “client-centred” approachYN 0 1 2 3 4
6 My organization has clear guidelines about expectations for seeking consent in client-practitioner interactions
YN 0 1 2 3 4
7My organization has guidelines on how to discern whatinformation is necessary from clients, how we will ask,and how we will protect their confidentiality
YN 0 1 2 3 4
Organization-level Supports
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AcknowledgementsThe strategies in this resource are based on the work of countless international community members and care providers, who over the past decades have championed gender-affirming care. The assessment tool was inspired by resources from multiple organizations including the 519 Centre, Rainbow Health Ontario, the National LGBT Health Education Center, FORGE, and many more. Lastly, it was developed in collaboration with Ambit Gender Diversity Consulting, along with community members and care providers within British Columbia.
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9 My organization has opportunities in place for every client/patient to self-identify their pronouns
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10My organization has protocol in place for checking inabout pronouns on a consistent basis, acknowledgingthat pronouns used may change over time
YN 0 1 2 3 4
11When we refer clients, we are aware of which external agencies have accessible and affirming services forgender diverse clients
YN 0 1 2 3 4
12 My organization has systems for receiving feedback and adapting practice
YN 0 1 2 3 4
13 My organization has clear protocol for acknowledging and repairing harm
YN 0 1 2 3 4
14My organization engages in ongoing training to ensure we are offering affirming and accessible (dignifying) services
YN 0 1 2 3 4
15My organization has ongoing conversations about human rights protections and how/whether we are living up to them
YN 0 1 2 3 4
16 My organization has ongoing conversations regarding allyship and intersectional service provision
YN 0 1 2 3 4
Organization-level Supports (Continued)
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Remember, feedback is welcomed!We believe your feedback is one of the best ways to improve our educational resources. If you have any questions, comments, or suggested revisions to this assessment tool, please email us at [email protected].
www.transcarebc.ca