Here is some addition information to clarify changes to the gender affirming surgical readiness assessment process recently announced by Trans Care BC. To answer questions about the new process Trans Care BC is hosting two teleconferences for the public on Thursday December 1, 2016 at 5:30pm and Monday December 5, 2015 at 5:30pm. Please email [email protected] and we will send details. Trans Care BC team members: Lorraine Grieves (Program Director) and Marria Townsend (Medical Director, GP) and Dr. Gail Knudson (Expert Medical Advisor, Psychiatrist), will be present with other members of the Trans Care BC team to answer questions.

Why has the surgical assessment process changed? Community engagement through a steering committee (which included many trans individuals and trans community representatives) held between Dec 2014-May 2015 and input from primary care providers, surgical assessors, surgeons, and other stakeholders have all suggested the surgical assessment process could be improved to reduce wait times for clients. Trans Care BC created a Primary Care working group that has recommended changes to the surgical readiness assessment process, which is a first step in a larger strategy to improve access to gender affirming care.

What’s changed about surgical readiness assessments? -

Surgical assessments will continue to be completed by qualified assessors who have already been trained and doing this work Primary care providers will now be able to forward referrals including completed assessmentsc straight to the surgeon of their client’s choice. Effective Dec 5, Dr Knudson will no longer review and approve all surgical assessments. MSP has indicated this extra step is not required. Trans Care BC has taken on coordinating assessments for clients who do not have a provider who does assessments. This means providers or clients can contact Trans Care BC to request an assessment. A standard referral form has been developed for providers to send assessment requests to Trans care BC.

As a member of the Trans Care BC team, Dr. Knudson continues to see clients, based on clinical need and her level of clinical expertise. Providers may still refer clients to see Dr Knudson. To support these changes, - Assessors can now use a standard form that outlines specific information required for surgeons to assess client readiness for surgery. This form assists assessors in completing the necessary documentation faster than previous templates. - Primary care providers will receive a standard checklist for what to include in a surgical referral. - Trans Care BC is working on a web based searchable database of trans service providers, including surgical readiness assessors to be available in 2017.

How can I find a surgical readiness assessor?

Trans Care BC has staff to assist clients and service providers with coordination of surgical assessments with providers in their region, wherever possible. There are clinical staff on the Trans Care BC team who have been trained by Dr. Knudson and Dr. Townsend to conduct assessments. These staff are available (in person or via telehealth) for clients who do not need to see a mental health specialist.

How is Trans Care BC increasing access to surgical assessments? By making the process clearer, it will be easier to bring new providers into this work. In the coming months Trans Care BC will be working to recruit and train new surgical readiness assessors to see youth and adults within the publicly funded system . To bring more providers into this work and to increase access to gender affirming care within primary care, Trans Care BC is developing resources and is providing direct training and mentorship to family doctors and nurse practitioners interested in this work. This will include ongoing training on:  assessing hormone readiness  initiating and monitoring hormone therapy  the process for patients wanting surgery  providing post-operative care  completing surgical readiness assessments We recognize there are many more improvements needed and welcome your feedback on this journey. Trans Care BC is committed to increasing access to gender affirming care for trans and gender diverse individuals. You can learn more on the Trans Care BC web site.