To receive credit, a facility must have:

An official written official policy (or policies) or procedure(s) which cover at least 3 of the areas listed in the survey.

More information:

The creation of policies and procedures aimed at eliminating bias and insensitivity, and ensuring appropriate, welcoming interactions with transgender patients and training staff on these policies is particularly important in light of Section 1557 of the Affordable Care Act. Section 1557 prohibits sex discrimination in any hospital or health program that receives federal funds, and courts and the U.S. Department of Health & Human Services, Office of Civil Rights (OCR), has made it clear that this prohibition extends to claims of discrimination based on gender identity and sex stereotyping.

For more information about best practices for care of transgender patients and sample policies, see the publication Creating Equal Access to Quality Health Care for Transgender Patients: Transgender-Affirming Hospital Policies, from HRC Foundation, Lambda Legal, and the LGBT Rights Committee of the New York City Bar Association.

This official written policy (or policies) needs to covers at least three of the topics following topics. This is a different policy than your patient non-discrimination policy.

• Recording of preferred name and pronouns in paper and/or electronic admitting/registration records
• Use of preferred name and pronouns when interacting with and referring to transgender patients
• Protocols for interacting with transgender patients
• Guidelines for room assignments for transgender patients
• Access to restrooms
• Compliance with privacy laws
• Access to items that assist gender presentation
• Access to continued hormone therapy
• Addressing potential problems with insurance/billing claims

Examples:

• Summa Health Akron Campus incorporates a list of Do's and Don't to their Transgender Patient Services and Support policy.
• LAC-USC Medical Center created these guidelines for employees that ensure that transgender patients receive quality care.
• Jersey Medical Center covers several important areas when it comes to providing respectful care to transgender patients.
• Christiana Care Health System provides employees with a variety of Transgender Care Guidelines and Resources.
• Boston Medical Center outlines definitions and practices aimed at ensuring appropriate, welcoming interactions with transgender patients.

To receive credit in the HEI, a facility must:

Must provide a description of the services provided, a link to webpage(s), an upload of brochure(s)/flyers promoting these services or a combination of these options.

More information:

Offer one or more of the following types of service:

• Comprehensive, multidisciplinary clinical care program for transgender adults
• Comprehensive, multidisciplinary clinical care program for transgender and gender-expansive youth
• Trans-affirming gynecological care, including cervical cancer screening and pelvic exams
• Hormone therapy and monitoring
• Psychological, physical, and psychiatric evaluations
• Gender confirming surgeries
• Referrals for gender-confirming surgeries
• Preoperative and postoperative care for gender-confirming surgeries

Examples:

• This flyer from Ann & Robert H. Lurie Children's Hospital highlights their Gender & Sex Development Program gender expansive, gender-questioning and
  transgender children and youth.
• Legacy Mount Hood Medical Center offers complete trans-friendly services in an affirming and welcoming environment.
• Gender Pathway Services (GPS) Clinic at Children's Mercy Kansas City provides interdisciplinary, family centered services for transgender, gender-variant and gender-questioning patients
• You can use the HRC's HEI Facilities Search Tool to find other facilities that provide comprehensive clinical care programs for transgender and gender-expansive youth, many of which are located at HEI Leader facilities.
• The Gender Wellness Program brochure provided by Nemours Alfred I. duPont Hospital for Children provides service information, a direct phone number to schedule an appointment and a small physician directory, provides easier access to the community.

To receive credit, a facility must:

Provide a link to webpage(s) and/or upload of brochure/flyer promoting the LGBTQ+ specific clinic.

More information:

Transgender, non-binary, and gender-expansive communities face unique challenges in healthcare settings and in obtaining health services. Within LGBTQ+ healthcare, it is necessary to recognize these barriers and work towards combating them.

Each year, we see an increasing amount of healthcare facilities taking steps towards trans-inclusive care by creating comprehensive programs for transgender, non-binary, and gender-expansive communities. This interactive map details where clinical care programs can be found specifically for gender-expansive children and adolescents.

For more information about best practices for clinics and hospitals that seek to promote the health and well-being of transgender and non-binary youth through the creation of multidisciplinary care clinics see the publication, Comprehensive Care Clinics for Transgender & Non-Binary Youth from the HRC Foundation.

Examples:

• Children’s Hospital of Pittsburgh of UPMC has an entire Gender and Sexual Development Program focused on providing inclusive and competent care for gender-expansive youth.
• The University of Virginia has two transgender clinics, one for teens and young adults and another for adults. UVA shows that they are committed to providing trans-affirming care to patients of all ages.
• VA Greater Los Angeles Healthcare System created its own Transgender Services Clinic as a way to improve healthcare services for trans veterans.
• The Transgender Health Clinic at Cincinnati Children’s serves transgender youth in an intentionally affirming atmosphere and provided support for both these children and their families.

To receive credit, a facility must:

Must provide a link to a webpage that describes the transgender patient navigator program or services and/or upload a document such as a brochure describing the services or the job description of the navigator.

Examples:

• Northwell Health informs patients about their transgender patient navigator through this brochure.
• Penn Medicine’s Transgender Patient Advocate Program “assists patients in finding appropriate providers, making appointments and ensuring optimal care for transgender patients at their facilities.”
• UCSF has a Transgender Care Navigation Program that works with partner providers and clinics to assist transgender, gender nonconforming, and non-binary people seeking general healthcare or gender-affirming medical care at UCSF. Check out the job description for their transgender patient navigator position.

To receive credit, a facility must:

Must provide number of gender neutral bathrooms in public areas. Must upload a sample of the signage for one of the bathrooms.

More information:

As The Joint Commission’s LGBT Field Guide notes: “Patients whose appearance might not conform to gender stereotypes may feel more comfortable and safe in a single-stall or unisex restroom. Design or clearly identify at least one such restroom. These single-stall or family restrooms can also serve parents caring for opposite-sex children, disabled people accompanied by opposite-sex caregivers, and any other patients wishing to use them. Although making a unisex restroom available is an important signal of acceptance, patients should be permitted to use restrooms that comport with their gender identity and should not be required to use the unisex restroom.”

Note: While single stall bathrooms are important to offer, we also strongly recommend a policy that ensures that patients and visitors may use the bathroom that corresponds to their gender identity.

Examples:

• The All Gender restroom at Callen-Lorde Community Health Center promotes inclusivity for all patients.
• NYC Health and Hospitals affirms their patients' gender identities with this inclusive bathroom policy sign.
• Florida Medical Center - A Campus of Northshore demonstrates their commitment to affirming all genders with their "All-Gender Restroom" signage. Note that they do not use stereotyped images of people with their bathroom sign.