service provider reflection tool · 2020. 5. 26. · trans care bc - phsa accessiblce care...

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].

http://www.transcarebc.ca

http://www.phsa.ca/transcarebc/Documents/HealthProf/Organizational_Assessment_Tool_Beta.pdf

http://www.phsa.ca/transcarebc/Documents/HealthProf/Organizational_Assessment_Tool_Beta.pdf

mailto:[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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http://www.phsa.ca/transcarebc/trans-basics/glossary#undefined

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Insert Trans Care BC logo

# 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

2018-12-10 DRAFT: Self-assessment tool for care provision services 1


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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.)

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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)

WHO(supports)

WHEN(target dates)

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)

WHEN(target dates)

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

YN 0 1 2 3 4

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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WHAT(action items)

WHO(supports)

WHEN(target dates)

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

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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)

WHO(supports)

WHEN(target dates)

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

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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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WHEN(target dates)

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

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3I am conscious of gendered programming, and try to replace them with gender-neutral or trans-inclusive alternatives

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4 I am conscious of gendered forms, and try to replace them with gender-neutral or trans-inclusive alternatives

YN 0 1 2 3 4

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


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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WHAT(action items)

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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

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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

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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)


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].


mailto:[email protected]

www.transcarebc.ca
