Nothing about us, without us.

Writing by guest contributor, Felix Saturn

Sexual and reproductive health services, and adjacent healthcare providers, love to publicly declare their support for us when it is convenient from a marketing perspective. Think IDAHOBIT, TDOV and other hallmark LGBTQIA+ calendar days that promote awareness and imply support - while simultaneously reducing our unique, ongoing needs and struggles to issues worth recognising for only a few days of the year via social media. This is especially true within our local abortion sector, where actual processes and pathways for TGD specific care are virtually non-existent. While this is obviously most harmful to affected consumers, it also sets a depressing precedent for providers seeking to improve their inclusivity practices - without an accurate blueprint for service reform, how can we expect them to impactfully integrate our needs into their service models?

Put simply, we can’t - not without our community’s active involvement and consultation. As it stands, there are no Australian-based, publicly available resources outlining trans-inclusive abortion practices. Similarly, there are no Australian-based, publicly available studies that specifically target our TGD population who utilise or have utilised abortion services. While international resources are useful, local resources and data are crucial in understanding how trans-inclusivity within this space can look, beyond LGBTQIA+ representation aesthetics. Without this baseline, it is up to our community to collaborate with each other, and with committed providers, to map the way forward. Nothing about us, without us!

Trans-inclusivity within a clinical setting can look like trans-101-basics - such as pronouns on intake forms; separate “known as” name and Medicare name options on forms and patient management software; multiple options for gender selection alongside assigned sex at birth on forms; inclusive language on booking/information sites e.g. “women and pregnant people”; pride and trans paraphernalia in-clinic or online e.g. flags on counter or email signatures; and of course targeted LGBTQIA+ social media marketing. While these inclusivity measures serve an important purpose, they can feel performative and contradictory to consumers when they are not paired with further, consistent service reform.

Service reform and implementations we can strive for include:

• Internal procedures review - What trans-inclusivity measures are we currently implementing into our service models? Is there anything further we could be doing that we could start right away?
• Access and collate local TGD resources - What services are available locally that could benefit our TGD consumers? Are these resources readily available to our consumers on our website or verbally offered, or would they need to ask?
• Warm referrals - Are the care requirements for our client out of our scope? Can they afford our services, can we subsidise them? Could another service be more suitable? Would it be appropriate to connect them directly rather than advising the client to organise this on their terms?
• Request stakeholder feedback - Do we have an anonymous feedback/complaints/suggestions system, in-clinic or online? Are we acting on this information when it is received?
• Staff/workplace training - Are all staff members adequately trained in LGBTQIA+ inclusivity, right through from reception to doctors? Is this training recurring and up to date?
• Rainbow Tick (or similar) accreditation - Do our practices meet benchmark standards?
• TGD-specific peer navigation roles - Do we have capacity to hire a TGD peer navigator? How could that benefit consumers?
• Hire more TGD employees - Is our intention to commit to trans-inclusivity practices for our consumers reflected in the way our workplace is structured? Would it be a safe workplace for TGD people?
• TGD working groups - how are we involving our local TGD community within our work, beyond our consumers? Do we welcome community consultation?
• Build relationships between services - do adjacent LGBTQIA+ healthcare providers know that we are improving our services? Could they assist us in this pursuit? Have we reached out to them?
• Long term action planning - How do we plan to include trans-inclusivity into our long term diversity goals?
• Advocate for local research, justice and structural changes - How can we use our power as an organisation to advocate for this community? What industry connections could we utilise to assist?

As community members, providers and advocates, we are capable of impactful collaboration to move towards these attainable goals. Language and visibility are just the tip of the iceberg - providers need to be more ambitious about their capability to support us.