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Pegasus Health has been providing Small Group education for General Practitioners since 1993. Today the education groups are open to GPs, nurse practitioners, practice nurses and community pharmacists. Small Group education meetings are peer-led, evidence informed and encourage teamwork, communication and behaviour change. Topics are chosen based on what is current and where there is a gap between evidence and practice, in order to improve patient care.

A decision was made to offer Small Group Education meetings on gender diversity in April 2018. Louise Kennedy, Team Leader says that as the topic was developed it became apparent just how topical gender diversity is today, and that there was a significant knowledge gap for many health professionals.

“There have been increasing numbers of general news reports on this subject. New Zealand research has reported increasing numbers of transgender patients being referred to Endocrinology services. We had a lot of interest in gender diversity following a 2016 large group session by medical students at Pegasus, it was the right time to deliver this topic,” says Louise.

Ester Vallero, Pegasus Culturally and Linguistically Diverse (CALD) Manager was instrumental in initiating the education.

She says that in spite of increasing awareness of gender diversity in our society, when people who identify as transgender¹ speak of their experience of using primary care services it is obvious that there is space for improvement.

“Many Canterbury GPs and pharmacists told us they want to provide better care for this community but are unsure how. Some are concerned about not having enough specialised expertise. It’s been amazing to see many health professional and the community working together. This is the first step to filling the knowledge gaps and making welcome spaces where transgender people can feel safe and get access to good quality primary health care,” says Ester.

A long list of health professionals and members of the transgender community worked with the Education team to develop the materials. A pre-meeting survey was done to assess attitudes, clinical skills and knowledge about Gender Diversity. Results from a post-meeting survey are currently being analysed.

The education is an introduction to the topic of gender diversity and gender affirming practices. It covers the basics of what GPs, nurse practitioners, practice nurses and community pharmacists need to know to provide safe and respectful patient care to people who identify as transgender.

The sessions covered: Duty of care, barriers to health care, health outcomes for gender diverse patients, transgender health issues, the importance of words and patient experiences. One of the tools used in the session was ‘The gender unicorn’ – an exercise to reflect on the concepts of gender identity, gender expression, sex assigned at birth, physical and emotional attraction. Handouts with practical tips like ‘Changing Gender on official documents,’ ‘Importance of pronouns, using preferred name and gender neutral language’ and lists of online resources were also made available.

A total of 688 health professionals attended the Gender Diversity Small Group Education sessions in April/ May.

The knowledge made available in the sessions has also been shared much wider than the education groups. Ester and her colleagues presented a session at the Administration and Practice Management Excellence (APEX) forum in August this year incorporating content from equity and gender diversity materials used in Small Group sessions.

The Pegasus Mental Health team and Partnership Community Workers have also taken part in workshops on gender diversity and gender affirming practices. Education materials have been shared with the University of Otago. Directories to further professional development opportunities for health professionals, and to information and resources for transgender patients and their whānau have been developed and are now available to all Canterbury GP practices.

Pegasus Health is also supporting work towards the update of the new Community Health Pathway for gender affirming care, and a co-design project with health professionals and members of the community to continue improving Canterbury health services responsiveness to the needs of transgender patients.

Read more about Pegasus Health’s Clinical Quality and Education Programme

¹Transgender is used here as an umbrella term for people whose gender identity is different from their sex assigned at birth. We acknowledge that people may use this term or other terms to describe their gender identity, including Māori and Pasifika terms.

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