Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Transgender Health topic
No spam. Unsubscribe anytime.
Health Commission hears update on Transgender Health Program, surgery access and plans for a center of excellence
Summary
DPH described a multi-year transgender health program expansion including training, a surgery referral pathway, a contract for surgeries, roughly 85 referrals and 15 completed surgeries to date, and budgeted funds ($300,000 this year, $500,000 next) to expand surgical access and build in-network capacity.
Dr. Barry Zevin told the Health Commission the Transgender Health Program has expanded services, training and surgical access after years of community advocacy and program development.
Zevin traced the program—rom early specialty clinics in the 1990s through the establishment of Transgender Tuesdays and the 2012 formal Transgender Health Program. He said the department implemented mandatory transgender 101 training for DPH staff and contractors, created a community advisory board, established a transgender health portal on the SFDPH website and developed patient education and preparation sessions for surgical candidates.
On surgical access, Zevin said the city agreed to fund a program to provide sex reassignment surgery (SRS) for uninsured people. The department reported approximately 85 patients had been referred through the centralized system and about 15 patients had completed surgeries as of January; those referrals and surgeries include Medi-Cal and uninsured patients and both in-network and out-of-network care. The department noted a finalized contract with Dr. Curtis Crane to provide surgeries on a contract (out-of-network) basis and said a task force is working to bring procedures into San Francisco General Hospital when operating-room capacity expands.
Zevin described budgeted support for the program: $300,000 allocated this fiscal year and $500,000 proposed for the next fiscal year to pay for out-of-network surgical contracts and to support in-network surgical capacity including salary support for a specialized plastic surgeon. He emphasized that policy questions about scope of services (for example, whether phalloplasty should be covered) remain under discussion and should be guided by evidence and standards of care such as those from WPATH.
Commissioners discussed the possibility of designating San Francisco General as a center of excellence in collaboration with UCSF and private partners; Zevin said a multi-disciplinary work group including clinical chiefs, UCSF leaders and the DPH CMO is already engaged and that San Francisco General has surgical expertise and potentially the operating-room capacity to train providers and expand in-network services.
Zevin said the program has an evaluation plan for referral process performance, patient preparation, and follow-up on patient outcomes; he also noted challenges including limited data on the transgender population and scarce surgical capacity statewide. The commission expressed support for continued monitoring and for returning with further updates on outcomes and implementation.
