The wait time to get into the program is 1 year. So, we encourage you to support your client by initiating hormone therapy because it’s within your scope of practice as a primary care provider and “there is a potential for harm by denying access to appropriate treatments” (The Standards of Care V7, World Professional Association of Transgender Health, 2011, p.55).
About the Trans Health Klinic
Team Approach
- The team consists of medical assistant, peer supporter, nurse coordinator, nurses, medical practitioners (physicians and nurse practitioners), and psychologist
- We use a shared care model to ensure timely access for clients
Transitioning Care Clinic
- We provide care to gender diverse individuals 16 years of age and older seeking transitioning care (hormone start, procedures, and surgery)
- Once the client reaches their medical transition needs, we will transfer the care back to the primary care provider (family doctor or nurse practitioner). The primary care provider will continue to prescribe and hormone therapy, and this can be done while the client is seeing us for care as well
- We DO NOT provide primary care, urgent care, or emergency care
- We require our clients to have a primary care provider, for example a Nurse Practitioner or Doctor.
- If the client does not have a primary care provider, they should contact Family Doctor Finder:
- Phone: 204-786-7111 or Toll free: 1-866-690-8260
- gov.mb.ca/health/familydoctorfinder (list of trans friendly primary care providers available)
Client’s Journey at Trans Health Klinic
Our Peer Support Worker is available for support or questions at any point along the client’s journey.
Transfer of Care
- Once the client is at a stable dose of their hormone therapy, care will be transferred to their primary care provider
- Trans health practitioners will send a formal transfer of care letter to primary care providers which details trans health lab monitoring and primary care screening guidelines
Referral and Consultation
- If you are sending a referral, please include the client’s chosen name and pronouns and personal phone number.
- If you are a health care provider seeking consultation for hormone therapy adjustment or dosing, please fax a letter to Klinic or send an e-consult
- Since practitioners utilize a shared care model, address the consultation letter as, Attention: Trans Health Klinic Practitioner
Trans Health Klinic Learners
- The Trans Health Klinic promotes capacity building by encouraging health care provider learners to shadow the trans health team
The Basics
Guidelines/Fact Sheets
- Trans Terminology by Klinic Community Health
- Gender Inclusive Language fact sheet by Transcare BC
- Making Mistakes and Correcting Them fact sheet by Transcare BC
- Creating a Trans Health Program (see page 11) by Centre of Excellence***
Free Training Modules/Webinars/Videos
- “Pronouns/Trans/One word” video- Watchcut
- Transgender Healthcare Story Time video
- Intro Gender Diversity online course by Transcare BC
- Intro to Gender Diversity expanded online course by Transcare BC:
- Indigenous Gender Diversity: Creating Culturally Relevant and Gender-Affirming Services online course by Transcare BC
- Trauma Informed Care for Trans and Gender Diverse Patients Recorded Webinar by Fenway Institute
Primary Care & Hormone Therapy
Guidelines/Fact sheets
- Hormone therapy prescribing by Klinic Community Health
- Estrogen and Anti-androgen Therapy Guidelines by Klinic Community Health (NEW)
- Testosterone Therapy Guidelines by Klinic Community Health (NEW)
- Standards of Care for the Health of Transgender and Gender Diverse People by World Professional Association for Transgender Health (WPATH)– Worldwide clinical guideline*** (NEW)
- Sherbourne Guidelines-Dec-2019 by Sherbourne Health Centre– Ontario’s clinical guidelines for hormone therapy and primary care***
- Gender-affirming Care for Trans, Two-Spirit, and Gender Diverse Patients in BC: A Primary care toolkit – British Columbia’s clinical guideline for primary care of trans patients** (NEW)
Sexual and Reproductive Health
Guidelines/Fact sheets
- Sexual Health screening from the Primary Care Tool Kit– British Columbia’s guidelines for sexual health screening of trans patients
- Reproductive Options for Trans People by Rainbow Health Ontario***
- HIV PrEP considerations for gender-diverse patients by Transcare BC
Free Modules/Webinars/Videos
Mental Health
Guidelines/Fact sheets
Free Modules/Webinars/Videos
- Assessment and Care for TGD Clients in the Setting of Serious Mental Illness or Trauma Webinar by Fenway Institute
- Behavioural Health Care for Transgender Adults webinar by Fenway Institute
- Providing Mental Health Assessments for Gender Affirming Surgery Referral Letters webinar by Fenway Institute
Surgery
Manitoba Health Requirements
Manitoba Health requires a diagnosis of Gender Dysphoria (GD) for surgeries to be funded.
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- Manitoba Health requires 1 referral letter by one of Klinic’s providers that are on both approved provider lists for Health Professionals as well as Mental Health Professional to confirm GD.
- Your medical practitioner may refer you to the psychologist if you are wanting a surgery referral
- Your psychologist will perform an in-depth assessment for surgical readiness
- Your referrals will be sent to the surgeon and Manitoba Health
Trans Health Klinic Referral Process
- Step 1: Must be a client at the Trans Health Klinic to request voice training, hair removal, top/upper surgery, bottom/lower surgery
- Step 2: Request a referral from a trans health practitioner during a visit
- Step 3: Trans health practitioner may refer a client to an in-house psychologist for a surgical readiness assessment (1 year wait time) OR the client can seek a private psychologist (we have a list that clients can see)
- Step 4: Client will attend their surgical readiness assessment
- Step 5: Psychologist and trans health practitioners will write their referral letters
- Step 6: Referral letters will be sent to an approved Manitoba health surgeon or GRS Montreal surgeon and Manitoba Health
Procedure/Surgery/Social Transitioning Coverage
Clients must pay up front for their transportation costs to Montreal. Keep receipts & plane tickets for reimbursement by Manitoba Health.
Surgery Information
Medical Forms
Local Resources
- Rainbow Resource Centre
- Two-Spirit Manitoba
- SERC MB
- Diversity Essentials
- Culturally Responsive Learning Resources
Workshops:
Providing Gender-Affirming Care*
**This workshop is open to healthcare professionals and students only.
There are two training sessions offered in the Providing Gender-Affirming Care workshop. Please read below for more information. Certificates will be provided to attendees at the end of the day. Please note: participants are required to attend both sessions in order to receive a certificate.
Session 1: Transgender and Gender Diversity Awareness & Inclusion
Facilitated by Trans Health Klinic staff including peer supporters with lived experience, this training explores impacts of systemic anti-Trans discrimination and explores strategies to create positive space and inclusive practices.
Session 2: Gender-affirming Hormone Therapy
This interactive workshop will encourage participants to explore patients/clients’ gender journey and goals, partake in informed consent discussions with clients/patients requesting hormone therapy, assess readiness for hormone therapy, prescribe and monitor hormone therapy, manage side effects and common concerns about hormone therapy, and seek ongoing clinical support.
Upcoming Workshop Date:
Date: Saturday, Jan. 18, 2025
Workshop Time: 8:30am – 4:30pm
Location: Klinic Community Health (167 Sherbrook St)
Cost: $100/person**
**Student pricing available. Please contact Rhea for more information (rmossmansims@klinic.mb.ca) or 204-784-4090.
Schedule is subject to change.
Click here to register for this workshop!
Registration questions? Email education@klinic.mb.ca or call 204-784-4066