Surrey-North Delta Division of Family Practice

Creating a Gender-Affirming Care Project: Learning Through Humility

FP Lead: Dr. Alex Yang

 

In April of 2024, the Surrey-North Delta Division of Family Practice showcased eight health system enhancement initiatives that we and our partners have been undertaking in our community. These are the stories behind the storyboards.  


As an area of medicine that is rapidly growing in visibility and understanding, gender-affirming care raises many questions for Family Physicians in Surrey-North Delta and beyond. What can seem like a simple question -- for example, “How can I identify my patient’s preferred pronoun in my EMR?” -- is not always easy to answer and often matters deeply to the patient.   

To better understand what gender-affirming care looks like currently in our community, a working group was assembled in the Fall of 2023 that included Family Physicians, Endocrinologists, OB-GYNEs, Fraser Health Authority partners, Indigenous Health partners, and Foundry and Trans Care BC representatives.  

The aim of this group was to assess the patient and provider needs in our community to provide a foundation of understanding for future gender-affirming care improvement work. 

Recognizing how easy it could be to “get it wrong” and how harmful it would be if we did, the working group was very intentional in the way we conducted conversations and moved the work forward. Using a grace-based approach, participants openly acknowledged the level of “unknowing” that they were bringing to the table. The first learning? That our project title – The Transgender Care Project – was exclusionary of some gender identities! 

Having conducted successful provider and patient surveys in the EOI phase, this group has now been approved for a full Shared Care project to improve gender-affirming care in Surrey-North Delta. 

Project Manager April Bonise is passionate about this work – read her thoughts below. 

--> Want to learn more? See our storyboard HERE.

 

What have been the highlights of working on this initiative? 

Learning together as a working group through an intentionally designed “grace-based approach” was a true highlight of this work for me. We were able to learn and grow, and do meaningful work, because we were empowered to express our lack of knowledge when it arose, to safely challenge assumptions, and to engage in a mutually respectful way with a deeply personal and often misunderstood topic. 

The work we did in designing our patient survey to ensure that the voice of the patient is represented in our findings, and that the safety and wellbeing of those who answered the survey were taken into consideration was another really important aspect of the project for me. 

Why do you feel that the work being done here is important? What is the impact you’re hoping it will have for physicians? For patients? 

We know how difficult it is for patients to receive gender-affirming care in Surrey-North Delta. Our team is dedicated to de-stigmatizing gender-affirming care and promoting access to services for patients and their families.   

The impact of this for physicians, we hope, will be greater confidence to provide gender-affirming care and increased knowledge about when and where to refer to their specialist colleagues for a collaborative and collegial team-based care approach.   

We believe that having physicians who are better equipped to provide well-informed gender-affirming care will help to improve patients’ trust in the system in addition to enabling them to better access the care they need, when they need it. 

How has member participation contributed to this project’s success? 

In addition to Family Physician members, our large working group represents a variety of physician and community stakeholder groups and even patients.  

Without each of these unique members being involved in this work, we would not be able to accomplish our goals.  

What’s next for this work? 

We recently received approval for an 18-month, fully-funded project, whose work has already begun. As part of this work, we are designing an education series for physicians and educational and support materials for patients and their families - the first session will be on September 25!

How Can Members Get Involved?

There are a number of ways that Division members can get involved in promoting better gender-affirming care in our community; working to destigmatize gender-affirming care is one way. Another is advocating for the Health Authority and Ministry of Health to increase gender-affirming care services in Surrey-North Delta and specifically at JPOCSC.   

And don't forget to register for our first CME - Gender-Affirming Care in SND: Centering the Patient Experience.

--> REGISTER HERE