Seattle Children’s Gender Clinic: A multidisciplinary approach to improve access to care for transgender youth

Grantee: Seattle Children’s Hospital
Timeframe: July 2016 – June 2019 | Total Amount: $519,977

Year 1: July 2016 – June 2017. Amount: $160,000
Year 2: July 2017 – June 2018. Amount: $180,000
Year 3: July 2018 – June 2019. Amount: $179,977

This project will make Seattle Children’s Hospital a center of excellence in care for transgender youth by creating a multidisciplinary clinic with integrated medical and mental services and increasing training for providers working with transgender youth. A growing number of pediatric health centers offer multidisciplinary gender clinics which effectively deliver coordinated care to transgender youth, however, no such clinic existed in the entire Pacific Northwest prior to this project. The multidisciplinary gender clinic at Seattle Children’s will include coordinated services delivered by healthcare providers from multiple disciplines with support from a dedicated Care Navigator, as well as training to staff and community providers. The Gender Clinic will not only improve healthcare access for young transgender patients in the Puget Sound area, but in doing so will potentially save their lives by reducing their gender dysphoria and suicide risk.

The Seattle Children’s Gender Clinic, a one-day-per-week clinic, will be housed within the existing Seattle Children’s Adolescent Medicine Division and directed by Dr. David Breland, who has years of experience treating older transgender teens.  The clinic model will specifically target the barriers identified by patients and families. The clinic’s integrated services will include Adolescent Medicine, Endocrinology, and Psychiatry. They will implement training of key staff as well as of the broader hospital and local communities on transgender patient’s issues. In the first two months of the grant, they will send five members of their team to observe an existing successful multidisciplinary clinic. Additionally, providers will receive training and begin the certification process through the World Professional Association for Transgender Health (WPATH), an organization that certifies providers to provide culturally competent, evidence-based care for transgender persons. Their Clinic Director has already begun the certification process. These two training experiences will allow Seattle Children’s to expand the number of providers in their system trained intensively in delivering gender-affirming care, and will also allow them to develop and consistently implement evidence-based care protocols for transgender youth and families. Grant funds will also be used to employ an Outreach Educator, Julia Crouch, who will be responsible for developing and delivering trainings to hospital staff and community providers to ensure that transgender youth are receiving gender-affirming care. As part of our community outreach efforts, our outreach educator will network with organizations serving youth in Seattle, particularly those serving homeless youth, LGBTQ youth, and youth in foster care. Possibilities include Lambert House, Seattle Counseling Services, Country Doctor, James W. Ray Orion Center, 45th Street Homeless Youth Clinic, and Families Like Ours. We anticipate that initially Ms. Crouch will hold one-on-one meetings with organization leaders in the first six months of the grant period, and then broaden efforts to include talks/workshops in the second half of the grant period. Additional staff include a master’s-level Care Navigator who will have case coordination and mental health training. This person will assist transgender patients and families with care coordination between providers and with navigating insurance barriers. Care Navigators have been successfully implemented in Seattle Children’s Hospital to ensure that all families regardless of race or ethnicity are receiving culturally competent care; a program started in 2009 using PHPDA funds that has become an essential part of care at Seattle Children’s. Providing care navigation to transgender patients is a natural extension. Finally, they will also implement weekly care coordination meetings for all Gender Clinic staff and providers.