I wrote this proposal for a class.
One Call Doc Project: The United Diversity Clinic ~ Trans Health And Wellness for Today’s Community
To: Fund Director, Third Wave Foundation
From: Danelle Wolfe, Proposal Writer
Re: Memo on: One Call Doc Project: The United Diversity Clinic
This proposal is written to acknowledge a very special and significant group within every community, every country, every large city and small, a group called transgenders and the immediate need to improve health care access for these individuals. The United Diversity Clinic , a medical unit built on the health and wellness of the transgender community will offer services to the Sarasota area and outer ally counties. Transgenders are of all colors, races, ages and walks of life. They are our brothers and sisters who were born in the wrong body.
The population is growing every year as individuals find the courage to be true to themselves. With this increase also comes social inequality connected with poor health status. The Human Rights Campaign mentioned, “There has been dramatic increases in the visibility of transgender people and the understanding of transgender issues in the past several years. Focus groups and national polls show that Americans know who transgender people are, and believe that our nation’s laws should treat transgender people fairly.” (http://www.hrc.org/documents/Transgender_handbook.pdf).
These individuals are at a higher risk of medical threats due to lack of access of primary medical care, lack of compassionate physicians and lack of acceptance associated with the fear of repercussions. Moreover, some have no choice but to purchase illegal hormones to continue in their transition with out a physicians guidance.
While there is little statistics regarding the health inequalities of the transgender community, more information will be compiled through in house surveys and researching similar programs. Further research will be conducted on the lack of insurance available to these individuals, alternative funding for surgeries and the transgenders risk of HIV/AIDS.
This planning proposal will be used as a recommendation to take action. Are you, as a member of society, willing to take the necessary steps to take our medical unit to the next level? Can you visualize the incorporation of a humanitarian medical clinic for those in need. The United Diversity Clinic has the potential to offer medical services to the transgender community while politically and economically producing a positive outcome. We are requesting $30,000 from your foundation to save lives, one person at a time.
Thank you for the opportunity to write a pre-proposal for The One Call Doc Project. We look forward to working with you in the future.
Danelle Wolfe, Proposal Writer
Table Of Contents
History and the Problems of Today……………………………………8
Our Plan For a Successful Program…………………………………… 9
Appendix A: Access to Health………………………………………………………..23
The UDC is a community health medical unit that will offer primary care, mental health and counseling for the transgender community. We will provide hormone treatments to transgender patients as a part of their overall primary care. Our harm reduction policy is focused around the patient and we will be developing and implementing treatment programs to suit their physical needs.
Founded in 2009 by a group of medical physicians and transgender health advocates, our clinic will provide the essential options for the transgender community while offering services that are desperately needed.
The United Diversity Clinic is committed to improving health care access while incorporating the quality of life long health care received by transgenders. We will provide personalized healthcare and support services to a community who lack access to quality care because of their sexual or gender identity. We are dedicated to serving the transgender individuals of the Sarasota area and surrounding counties and its allies by medical, educational, diverse programs, support, and cultural consciousness in a open, compassionate, welcoming, and safe environment.
The definitions below may be helpful when reading about transgenderism and transgender health issues and shall mean the following when used in this proposal:
Gender identity means the internal experience of one’s gender.
Gender presentation means how a person demonstrates her or his experience of gender, often through attire, including hair or make-up, and mannerisms.
Transgender individual means a person whose gender identity is different than her or his birth sex.
Transgender woman means a male to female or MTF individual.
Transgender man means a female too male or FTM individual.
Transsexual means a transgender individual who describes herself or himself as transsexual, particularly if she or he has altered her or his body with hormones and/or surgery.
Birth sex or biological sex means one’s physical body at birth, often categorized as male, female, or intersexed.
Intersexed means a combination of male and female genitalia and/or reproductive anatomy. 
Lower surgery means surgical alteration of one’s genitals.
Upper surgery means surgical alteration of one’s chest/breast.
Gender identity disorder Gender identity disorder is a rare, complex condition in which individuals of unambiguous genotype and phenotype identify with the opposite gender. One in 54,000 individuals are estimated to have GID. 75% are biologic males desiring reassignment to female gender (MTF) 25% are females desiring to be male (FTM). It means a conflict between a person’s actual physical gender and the one they actually identify him or herself as. For example, a person identified as a boy may actually feel and act like a girl.
 Here’s what we do know: If you ask experts at medical centers how often a child is born so noticeably atypical in terms of genitalia that a specialist in sex differentiation is called in, the number comes out to about 1 in 1500 to 1 in 2000 births. But a lot more people than that are born with subtler forms of sex anatomy variations, some of which won’t show up until later in life. http://www.isna.org/faq/frequency – Intersexed Society of North America.
 Laden M, Walinder J, Lundstrom B. (1996). Prevalence, incidence and sex ratio of transsexualism. Acta Psychiatr Scand, 93(4), 221–3. Retrieved April 15, 2010, from http://www.jfponline.com/Pages.asp?AID=4784
 Gender identity disorder is characterized by a strong, persistent cross-gender identification; people believe they are victims of a biologic accident and are cruelly imprisoned in a body incompatible with their subjective gender identity. Those with the most extreme form of gender identity disorder are called transsexuals. These disorders are considered mental disorders because the body does not match the person’s psychologic (felt) gender. http://www.merck.com/mmpe/sec15/ch203/ch203b.html
The United Diversity Clinic understands that many transgenders question whether to get healthcare when they perceive they’re not welcome by a physician. A clinical update in the Journal of the Gay and Lesbian Medical Association stated, “…that transsexual patients often have difficulty finding care because many physicians are not comfortable prescribing appropriate hormone regimens.” (http://php.ucsf.edu/PatientEd/MedicalCareofTransexualpts.pdf). Patients will drive for seven hours each way in order to find a compassionate doctor. Some individuals don’t even try. This places their lives in jeopardy. Others will dangerously take matters into their own hands and self medicate by purchasing illegal and untested hormones. Today’s world is constantly changing, and it’s up to us in the medical field to progress with the times.
Every year more and more individuals are coming out of their closet and declaring their individuality. With the increase of medical knowledge pertaining to gender and sexuality the necessity to assist these individuals is the main reason for this proposal. There are several ways in which a transition can occur in an FTM (female to male) or MTF (male to female). They range from individuals taking testosterone or estrogen to those who have had surgeries and those who have not.
Our medical unit has made arrangements with Sarasota Memorial Hospital to co-manage our facility. A medical building that was vacated last year owned by the hospital had been suggested as an option for our intended clinic. It is in need of minimal renovations. Our employees are projected to be salaried staff and professionals in private practice (psychiatrists, psychologists, plastic surgeons, gynecologists, endocrinologists, and speech pathologists) who will operate out of the clinic. These services are geared for transsexuals who need to have their mind match their bodies.
In this grant proposal, we will address the current issues of the need for funding to make this medical unit a reality. It will incorporate all the medical needs of the transgender community “under one roof.”
The requirements to begin the transitional process starts with The Harry Benjamin International Gender Dysphoria Association Standards Of Care For Gender Identity Disorders (Table A). These laws, SOC are intended to provide flexible directions for the treatment of persons with gender identity disorders.
Table A: Standards of Care for Gender Identity Disorders: Eligibility and Readiness Criteria for Hormonal Therapy in Adults – Eligibility Criteria
1. 18 years of age
2. Knowledge of what hormones medically can and cannot do, social benefits and risks
3. Either documented real-life experience for at least 3 months prior to hormones or
4. Psychotherapy of a duration specified by the mental health professional (usually 3 months)
5. Under no circumstances should a person be provided hormones who has fulfilled neither criteria 3 or 4
1. Further consolidation of gender identity during the real-life experience or psychotherapy
2. Progress in mastering problems leading to improving or continued stable mental health
3. Hormones likely to be taken in responsible manner.
Hormones can be given to those who do not desire surgery or real-life experience.
Here is our design of action:
Phase One: We will identify the health needs of the local community, the resources that are available, and the state of current programs. Also identifying existing organizations that offer transgender related programs can facilitate the development of collaborative partnerships necessary for supporting community participation in the delivery of pertinent health and social services.
Phase Two: We will coordinate agreements with fifteen to twenty primary practices that serve clinic clients.
Phase Three: We will develop new guidelines for the training of new and in place employees to ensure that a nondiscriminatory and welcoming environment is provided. We recommend that ongoing training about emerging issues within the transgender environment be part of regular staff education.
CASE EXAMPLE There are Transgender Law Center workshops for providers and offers tips for working with transgender Individuals to help organizations and business create a transgender positive environment.
People who transition from one sex to another face severe challenges. In most states, they can be fired from employment positions, abandoned/rejected by family members/spouses, and have the potential of losing custody of their children if they separate from a spouse or partner. Another major issue is that transgender people are often denied medical care or mistreated by health care providers who are biased or who don’t understand transgender issues.
The advantages of our plan are to intertwine the caring medical community with the transgender community. To break down the barriers of societies misconceptions and to lend a healing hand without discrimination.
History and the Problems of Today
Throughout history and dating back to the early 1400’s there were indications of transgender behavior within various cultures such as Asian (eunuchs), Indian, Pakistan (Hijras), and Native American (Two Spirit). Our culture created the word “Transgender” in the 70’s and was incorporated into our society’s language. The definition of a transgender is someone who was “born in the wrong body.” Their mind doesn’t match their body at birth (birth sex).
In the past decade, the LGBTQQ (Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning) community consisting of an estimate of 8.8 million people has made great strides in educating society and some headway has taken place regarding their equal rights. But, many people still fall by the waste side within this group. The medical establishment for years had fought against transgenders stating they had a mental illness and in 1930 the first physician considered and actually completed a sexual reassignment surgery. It is the transgender that is in need of medical assistance today. It is difficult for an FTM or MTF to either locate the medical support within the medical community that will encourage the transition of these individuals or avoid being denied medical care. As Marks stated, “Denial of the recognition of human rights for any group of individuals is a denial of their humanity, which has a pro-found impact on health.”
Discrimination against transgender people is rooted in fear of difference, ignorance about who transgender people really are, and sexist stereotypes. This discrimination is intensified by various forms of negative representations of transgender people in the cinematic movies such as Psycho or Silence of the Lambs, which had shown transgenders as sexual deviants and even serial killers.
Most have to travel far distances to seek a doctor who is not only willing but, also accepting of the concept of gender identity disorder. The list of medical professionals usually consists of: Endocrinologists (hormonal therapy), Certified Psychologists, Psychiatrists, General Practitioners, Gynecologists, Plastic Surgeons (sex reassignment surgeries), and Speech Therapists.
Today, the numbers are growing within the transgender community and it has become necessary to provide a medical unit that will not only enhance the lives of the transgender community but, also begin the process of educating the diverse cultural community in which they live. The United Diversity Clinic will provide health services for eighteen to fifty plus year old individuals in a secure environment, offering the necessary physicians (several physician’s have been contacted and are willing to participate in the project) to begin or continue their transitional journey. This will include connections with local social services such as local gay churches and temples for religious insight.
The Human Rights Campaign in 2010 commented, “Although the American Psychiatric Association has noted that “…data from small countries in Europe with access to total population statistics and referrals suggest that roughly one per 30,000 adult males and one per 100,000 adult females seek sex reassignment surgery,” this statistic is not an accurate way of predicting the number of transgender people living in the United States. Studies like this one tend to dramatically undercount the population of transgender people because they only include transsexuals who have completed or are in the process of completing sex reassignment surgery…Only one thing is certain: little is known about how many transgender individuals live in the United States, but it is probably much higher than many have believed.”
Our Plan For a Successful Clinic
Our research has proven that this project addresses the needs of this community. To provide a safe zone for medical treatment where transgenders can be seen and treated with respect.
Primary medical care – Comprehensive primary care services emphasizing prevention and wellness, delivered by providers with extensive expertise in transgender health concerns. Without medical care for example, the gynecologic cancer risks in FTM’s is profound.
The American Cancer Society reported: Ovarian Cancer
- FTM transgendered and transsexual individuals are at a higher risk of ovarian cancer because of the amount of testosterone ingested. Excess testosterone can be converted into estrogen, contributing to an elevated risk for ovarian cancer.
- Due to discomfort with revealing transgenderism, transsexuals may not undergo screening procedures essential for detecting gynecological cancers, including ovarian cancer.
The American Cancer Society reported: Prostate Cancer
- Reduced levels of testosterone may put an MTF individual at an increased risk for prostate cancer.
Breast Cancer Prevention – Sarasota Memorial Hospital Cancer Prevention Services will offer free screening and diagnostic testing for individuals.
The HIV Clinic – Comprehensive, state of the art HIV/AIDS medical care and support services in an integrated model of care, including Care Coordination, HIV Medication Education & Support, and Mental Health services.
An In-house Pharmacy – Offering the medical drugs and supplies at a discounted rate to our clientele.
Staff: Clinic – Fifteen doctors visit the clinic on a rotational basis. Four Psychologist/ two Psychiatrists will visit five days, gynecologist/endocrinologist four days a week, and surgeons twice a week. twelve nurses, two pharmacists and three lab technicians, and six medical assistants.
Transgender health services – Comprehensive, transgender sensitive primary care, breast/chest cancer screening, sexual health services, as well as counseling and education, hormone therapy.
Hormonal therapy – Hormone therapy is for life whether it be through injections, oral medication or creams. It has been shown to profoundly increase the quality of life for transgender individuals. For many transgender people, hormonal therapy is a way to bring the body into greater congruence with gender identity. Integral components of hormonal therapy include assessing the patient’s health status, needs, and values as well as prescribing appropriate hormones and monitoring any potential side effects. Hormonal therapy, such as estrogen, anti-androgens, and testosterone, is often a significant part of gender transition.
Counseling services – Support Groups: offers support groups for patients of transgender experience, family interaction and individuals living with HIV/AIDS. (Appendix A). Everyone has a gender identity. Gender is a fundamental aspect of human identity. It is a deeply rooted element of how we see ourselves and how others see us. People should be able to express the gender that feels right to them and not be forced to conform to other people’s expectations, in the same way that we don’t try to force people to be straight. Transgender people are deeply harmed by efforts to change or hide their true gender.
Education – Providing health information, training, and education to communities to help ensure that transgender people receive safe and supportive health care services.
CASE EXAMPLE The United Diversity program will provide pamphlets and literature to their clients, as well as posting flyers describing community services and upcoming events. Also the clinic has made provisions to develop a library that will be staffed by volunteers presenting nonfiction as well as fiction books on gender related topics.
Effects of Inaction
Our society is in a healthcare crisis, but the transgender community is in a healthcare access crisis. It’s quite simple, by doing nothing lives will be lost. They are fighting a battle not only medically, socially, but also discriminated against through insurance companies, as none of the hormonal treatments or surgeries are covered.
As more focus is placed on individual health and its association for the overall general community health we can see the positive affects of cultural beliefs and attitudes of those living in the community. Therefore, with this in mind, the clinic will provide health benefits creating a healthier environment for all to live.
Finally, due to the lack of research information based on transgender people, there is a lack of funding available for transgender health care that often prevents effective public health services. Implementing the recommendations listed will give transgender people equal access to health care, ultimately saving lives.
As of 2009, Sarasota’s population was 52,488 people. Since 2000, it has had a population growth of 0.43 percent. Surrounding counties are averaging similar growth patterns. By reviewing the problems in our community, it has become important to increase the necessary medical physicians, implement new diversity programs, and increase the community events leading to educational information given by public speakers and presenters to enhance not only a transgenders well being and life but, to encourage others to become open minded in our ever changing world.
Medical Needs in Sarasota: Put Prevention Into Practice
Doctors who are ignorant of or hostile to transgender people may fail to ask the right questions when seeing a patient about medical issues seemingly unrelated to any treatment of transsexualism. Some physicians are unwilling to see transgender patients at all, expressing a fear that their presence in the waiting room may disturb other patients. Over the last decade, our society has begun the process of understanding the needs whether it be physical or psychological of the transgender community.
As the learning progresses so does the population of this group. Out of desperation, the purchasing of illegal hormones puts these individuals at a higher risk. Too often, transgender people, especially those with low incomes, obtain unprescribed hormones that may not have sufficient medical safeguards. Due to discrimination, both in health insurance and in access to basic care, it is difficult for many transgender people to get appropriate treatment. The discrimination that they face and traumatizing effects emotionally places them in a potential state of confusion and statistically prone to suicide. From Sarasota, the closest surgeons for sexual reassignment surgery is four hours away. There are a handful of therapists willing to work with transgenders. To locate an endocrinologist, the drive could be a minimum of an hour. Therefore, we believe our planning proposal to be a successful solution meeting these objectives:
Increase the awareness of the transgender community
Improve access to health care
Increase the promotion of living a healthy lifestyle
Promote preventive medicine within the transgender group
Increase patient/worker satisfaction
Increase quality and years of healthy life
Eliminate health disparities
Develop support groups
Phase One: Examining The Real Transgender Needs
1. Each patient will begin the program by filling out a form not only for the purpose of patient’s medical information but, also utilized as a survey. (Appendix B & C). The analyzing of this data will provide data of the needs of the transgender community. The results will open exploration of future programs. This stage will be an on going analysis.
2. Quarterly reporting:
Survey of staff reflecting the structure of the programs
Review the number of staff members educational updates
Explore improvements beginning and completed
Interview for patient/staff satisfaction
Report client cases and associated programs (on/off hormone or surgical/nonsurgical)
Teleconferencing with Sarasota Memorial Hospital’s director for future programming
Phase Two: Coordination of Care
This is the foundation of the clinic. During this four month period stage we will organize Physicians and Psychologists, Speech Therapists, Nurses and Administrative staff to join our team of benefiting the transgender community.
Phase Three: Designing Training Programs
The staff will be required to attend transgender sensitivity health educational training programs consisting of 5/8 hour classes and three hours through an internet HIV workshop. The more we know, the better to help our clients. Certification is mandated yearly. Lombardi (2001) commented, “Greater sensitivity and relevant information and services are required in dealing with transgender men and women. These individuals need their identities to be recognized as authentic, they need better access to health care resources, and they need education and prevention material appropriate to their experience.”
Who’s on Board:
These name are completely ficticious. I made them up.
Patricia Newman, MSW Director
Richard Stevens, Unit Manager
Rebecca Jason, MBA Fiscal Coordinator
Julie Montgomery, Director of Community Services
Stanley Goldman, Attorney P.A .
David Peterson, Director, HIV Health Services
Pamela Hartford, Administrative Analyst, HIV Health services
Timothy Johnson, Research Associate
Stacy Howards, Research Assistant
Joseph Cantinelli, M.D., Endocrinologist
Catherine Bontega, Ph.D., LMFT, Psychotherapist
Scott Friedman, M.D., F.A.C.E.P., Medical Management and Administration
Denise O’Brian, PharmD, BCPS, Clinical Pharmacist
Christopher Jones, C.P.E., C.C.E., Clinical Electrologist
Joanne Dickenson, D.O., F.A.C.O.G., Certified Gynecologist
Tammy Meyers, Certified Speech Therapist and Sign Language
Thomas Smith, ARNP, Nurse Practitioner
Terry Mathers, R.N, Registered Nurse
At this point in the proposal I’d like to address the alternative solutions to the limited access of medical care for the transgender community in Sarasota. Unfortunately, one does not come to mind. But, I can tell you of a moment in time when I drove four hours to Ft. Lauderdale to a surgeon so my (legal) transgender husband to be could have top surgery completed. The drive there had been full of scenery and joy. The surgery was completed on an out patient basis and he was released two hours after this major surgery. The trip home seemed longer as the miles past and his pain increased. Four hours on a highway seemed too long but, he had no choice. No surgeons who performed sex reassignment surgery were close to Sarasota.
By developing The United Diversity Clinic individuals will have the option of local sympathetic physicians with easier accessibility to healthcare regarding their transitions.
Dissemination and Implementation
Our main objective is to open the doors to other cities and states, to motivate community members in developing a medical services unit such as ours to offer a full service health care stressing primary and preventative care, health maintenance, disease prevention, counseling and education. We are optimistic regarding educational speakers and new pamphlets (and other educational materials) that will help in educating the community and clients.
We plan to disseminate our research results in both areas of academic, journal articles and scholarly trade publications. Serving as a resource to research projects concerning transgenders and medical practices, we will examine the possibility of publication of our own training materials within a medical trade journal. Our web site will be updated weekly and will provide pertinent information regarding the transgender community. We are also working on creating a link to provide our internet informational services in Spanish.
By improving the access of necessary clinical preventive services to our community, we will create stronger tools and resources in support of the transgender community while engaging our health care system.
The plans of the project will be modified as needed through an ongoing assessment of research involving surveys, questionnaires and interviews by the clients and staff. The results will be forwarded to city and state agencies.
What once may have seemed unthinkable now seems plausible…
ACCESS TO HEALTH
This medical information is completely confidential and is intended to help us understand the health care needs in the County of Sarasota, Florida.
1. How did you learn about this clinic? Please select only one. □ Friends/family
□ newspaper □ Physician □ Community Health Program □ A colleague
□ Internet □ Phone book □ Other, please specify: ___________________________________________________________________
2. How do you identify your gender? Please select only one.
□ Female □ FTM (female-to-male) □ Male □ Gender Queer □ MTF (male-to-female)
□ Intersex □ Gender variant □ Questioning □ Transgender □ Decline to answer
□ Other, please specify: _______________________________________________________________
3. How do you identify your sexual orientation? Please select all that apply.
□ Queer □ Gay □ Questioning □ Lesbian □ Bisexual □ Decline to answer
□ Intersex □Other, please specify: _______________________________________________________________
4. How do you identify your ethnicity or race? Please select all that apply.
□ Asian or Asian American □ Pacific Islander □ Native American □ Black or African American □Latina(o)/Hispanic □ White/Caucasian □ Middle Eastern □ Decline to answer
□ Multiracial □ Other, please specify: _______________________________________________________________
5. What language do you speak most frequently at home? Please select all that apply.
□ English □ Spanish □ Other (specify): _________________
6. Are you Bilingual? □ Yes □ No
7. What is your age?
□ 20 to 29 years old □ 30 to 39 years old □40 to 49 years old □50 + years old □ Decline to answer
8. Which county do you live in?
□HillsboroughCounty □ Other (specify): _________________
EMPLOYMENT AND INSURANCE
9. What best describes your current job (work) situation? Please select one.
□ Employed full-time (33-40 hours/week)
□ Employed part-time (Less than 33 hours/week)
□ Working part-time and on disability
□ On disability – looking for work
□ Not working – on full disability
□ Not working – applied for disability
□ Not working – looking for work
□ Not working – student/homemaker/volunteer/other
□ Other, please specify: _______________________________________________________________
10. Do you have health insurance? □ Yes □ No (skip to question #11)
11. If YES, what kind of health insurance do you have? Please answer “yes” or “no” to each item below.
Health Insurance Yes No
|Insurance through work|
|COBRA or OBRA (insurance through my last employer)|
|Private insurance/HMO, not through work|
|Veteran’s Affairs (VA)|
HEALTH CARE SERVICES
12. When was your last visit with a doctor, nurse, or other health care provider?
□ Less than 6 months ago
□ Six to 12 months ago
□ More than a year ago
13. Where did you receive your medical care (doctor’s name or place)? ______________________________
14. Were you satisfied with the services you received?
□ Yes □ No
□ If NO, please explain:________________________________________________________
15. How much do you think each of the following factors could prevent you from seeing a doctor, nurse or other health care provider?
Please check the box beside the statement that most describes your experience.
1. Location of services/ transportation
2. Days and hours of operation
3. Having to disclose your gender identity
4. Concerns about confidentiality
5. Lack of health insurance/what services might cost
6. Feeling comfortable talking about health and sexuality
7. Length of waiting time to get an appointment or see someone
8. Not able to communicate or interact with the service provider in my
9. Sensitivity of the person or organization providing services
10. Feeling discriminated against by the service provider or the
organization providing services
11. Not getting along with the people providing services
12. Experience or expertise of the person providing services
13. Lack of professional support to help navigate the health care
16. Have you had any personal experiences with these or other barriers that you would like to share?
THOUGHTS ON HIV/AIDS
17. For each item below, please say if you believe there is a high, medium, low or no likelihood of occurring.
1 – Highly,
2 – Moderately
3 – Less Likely
4 – Not Likely
1. Using condoms will effectively reduce the likelihood of infecting someone with
2. A receptive partner in unprotected anal or vaginal sex can infect someone else
3. An insertive partner in unprotected anal or vaginal sex can infect someone
else with HIV.
4. One HIV+ person can re-infect another HIV+ person.
5. A person’s viral load can affect the transmission of HIV.
6. A person can be infected with HIV by having oral sex of any kind with
someone else who has the virus.
7. A person can be at risk for HIV when combining recreational drugs with sex
(i.e., party ‘n play, tweak ‘n freak).
18. Please mark whether or not each of the following statements is true for you.
1. Are you or anyone you know infected or affected by HIV/AIDS? _________
2. Do you know where you can get tested for HIV inSarasotaCounty? _________
3., Do you know where you can get health care services specializing in HIV inSarasotaCounty? _________
4. Do you know where you can get health care inSarasotaCountythat is accepting of your
sexual orientation and/or gender identity? _________
5. Do you know where you can get health care without having medical insurance? _________
6. Would you feel comfortable disclosing your sexual orientation or gender identity to your health
care provider? _________
7. Have you been sexually active in the last six months? _________
19. Do you have any other comments or stories about your access to health care services? You may use the back of this form if you need more room.
Human Rights Campaign. (2010). Retrieved April 10, 2010, from http://www.hrc.org/documents/Transgender_handbook.pdf
Lombardi, E. (2001). Enhancing transgender health care. Am J Public Health, 91(6), 869-72. Retrieved April 20, 2010, from http://ajph.aphapublications.org/cgi/reprint/91/6/869?view=long&pmid=11392924
Martin, K.A. (2007). Transsexualism: Clinical Guide To Gender Identity Disorder. Current Psychiatry, 6 (2), 1-11. Retrieved April 18, 2010, from http://www.changelingaspects.com/PDF/Transsexualism-Clinical%20Guide%20To%20Gender%20Identity%20Disorder.pdf
National Center for Transgender Equality. (2009) Retrieved April 5, 2010, from http://www.transequality.org/Issues/health.html
Oriel, K. A. (2000). Medical Care of Transsexual Patients. Journal of the Gay and Lesbian Medical Association, 4(4), 185-194. Retrieved April 17, 2010, from http://php.ucsf.edu/PatientEd/MedicalCareofTransexualpts.pdf
Transgender Law and Policy Institute (2010). Retrieved April 12, 2010, from http://www.transgenderlaw.org/
Marks, S.M. (2006). Global Recognition of Human Rights for Lesbian, Gay, Bisexual, and Transgender People. Health and Human Rights, 9(1), 33-42. Retrieved April 15, 2010, from http://www.jstor.org/stable/4065388
The American Property Group. (2010). Retrieved April 5, 2010, from http://www.americanpropertygroup.com/
The National Coalition for LGBT Health. (2010). Retrieved April 10, 2010, from http://www.lgbthealth.net/side_hp2010.shtml