A Rainbow Connection

MScBMC Kelly Speck
Monday, September 12, 2016 - 8:06am
Carla DeMarco
Biomedical Communications student finds a way to deliver better healthcare services to the trans community

When U of T Mississauga Master of Science Biomedical Communications (MScBMC) student Kelly Speck set out to work on her Master’s research project, she wasn’t entirely sure where the research might lead, but the overarching goal was to improve visual communications in health care.

It didn’t take long to identify a niche that incorporates three great points of interests for her: gender, health, and diversity. Speck also pinpointed that with her passion, skills and background she could improve educational resources to help primary care providers meet the needs of underserved populations.

“I was looking into health gaps, and found that where knowledge is especially lacking in medical education was in LGBT health,” says Speck.

“The ‘T’ – the trans part of the acronym – in particular is overlooked, in that a lot of healthcare professionals aren’t actually versed in these problems or with providing information to this population.”

While delving deeper into this area Speck came across Sherbourne Health Centre, a local community organization based in Toronto that focuses on LGBT health, and Rainbow Health Ontario (RHO), a program within that centre. Speck found the organization was very amenable to her proposed collaboration, and was also keen to enhance support and healthcare resources for the trans community.

Through her work Speck has identified two challenges encountered by primary-care providers when it comes to trans-health resources. First, there is some pretty dense information to sift through, including a recently updated manual released by Sherbourne Health Centre in May 2016, that provides guidelines and protocols for healthcare providers and covers hormone therapy for transgender clients.

Secondly, educational resources for trans care were limited and only available in the form of in-person workshops for healthcare professionals run by RHO’s Trans-Health Connection Team in Toronto. While this has proven to be a helpful resource, it is not ideal for those living outside the city or far afield from Toronto.

Speck’s ensuing project was therefore multidimensional in its aims.

She wanted to help organize and consolidate the available information in a more approachable, comprehensive and accessible online format via a website to augment what was included in the guidelines. Also, by making the material accessible online, multiple primary-care providers across Ontario can improve their knowledge and care for the trans community. Lastly, she wanted to cover some other empirical considerations that were not addressed in the available material.

“From consultations with primary care providers, I found out that many didn’t know how to approach the topic of hormone therapy or the care of trans clients. I felt that available resources could be improved by emphasizing cultural competency skills and how to make clients feel comfortable,” says Speck.

“There are a lot of fears and misconceptions about care and hormone therapy as many assume it to be a specialty area such as endocrinology, so with the website we wanted to emphasize that trans care falls in the scope of primary care and to provide information necessary for doctors and nurses to welcome trans clients into their practice. ”

Speck highlights the fact that most primary care providers already have the clinical knowledge to deliver proper care to the trans community as they prescribe similar hormone therapy to, for example, postmenopausal women. She also emphasizes that something as simple as offering this kind of treatment can significantly improve quality of life, whereas withholding this care can lead to dire consequences: for instance, suicide rates among the trans community are at a staggering level. According to the Ontario Mental Health Association, 77% of trans respondents of an Ontario-based survey had seriously considered suicide and 45% had attempted suicide.

Speck developed a prototype website based on what she calls an "iterative design" research strategy. She explains that with an iterative design she conducted usability tests, trying out the site design and navigation with MScBMC students and BMC faculty, to change it up according to their feedback throughout the duration of her project.

She also involved trans clients in formative evaluations of the draft illustrations that she created. Although the website is meant for primary-care providers working with the trans community, Speck said their input was integral to the process.

“Because we are dealing with visuals, this is such a sensitive area with the trans community, and sometimes involves being uncomfortable with the body they are in, I wanted to hear their ideas and feedback on what types of visuals to include,” says Speck.

“It was actually really helpful, such as wording that they flagged or something that might be potentially uncomfortable for somebody to see on screen.”

With the RHO website officially launching in September 2016, this is primarily an Ontario-based initiative with more locally applicable information, however the basic concepts could potentially be consulted by outside healthcare providers, and Speck is delighted to contribute to the broader, diversity-based dialogue.

“I would be happy to see the website being used across Canada,” says Speck. “And if it enables somebody to look at the trans-health guidelines more in-depth, that would be great.”

To see the newly launched Trans Primary Care Guide on the RHO website, please see http://www.rainbowhealthontario.ca/trans-health-connection/, and to find out more about Kelly Speck’s work please visit her website at http://bmc1.utm.utoronto.ca/~kelly/kelly_speck/mrp.html