Clinical environments

From a patient’s first interaction with your booking system, to receiving any follow up or results, your clinical environment extends well beyond the face-to-face appointment.

Clinical environment can include:

• Clinical spaces

• Offices, waiting rooms, and reception spaces

• Bathrooms

• Promotional material, including posters and targeted advertising

• Reading material available in waiting rooms

• Websites and social media

• Outreach and community interaction

• Follow up and post-visit services

• Referral pathways

When establishing an affirming clinical environment, it is important to be meaningfully explicit. A trans person will notice a policy, poster and other resources that are specifically supportive of their community. Check out our downloads hub where you can find some of our resources.

The team at ACON’s Pride in Health + Wellbeing membership program offer assistance and support for organisations and individuals who are seeking to strengthen cultural competency and to become more inclusive for people of diverse sexualities, and genders under their care.

All doctors have the opportunity to be a gender affirming doctor. Gender affirming medicine is a part of general medical care within the primary health care system. Any GP is able to prescribe gender affirming hormonal therapy for most people aged 16 and above, without requiring approval from a mental health professional or endocrinologist.

Doctor wishing to register to be listed on ACON’s Gender Affirming Doctor List can do so by filling out this form.

Affirming also means not assuming. This includes asking for patient pronouns, names, and other details that affirm them in your service, as well as establishing work-arounds for systems that aren’t often designed to affirm trans people, such as IT systems.

It is important that all patient-facing staff are trained regularly so they can support and affirm trans patients, from the front desk staff to students or trainee personnel. If a trans person has a bad experience with just one staff member, that is the interaction they may take with them.

Fenway Health, Boston have developed a resource about best practice for frontline staff when working with trans patients, which you can find here. When people feel affirmed, they are more likely to engage and form a trusted relationship with their health professional, return to the service when necessary, have improved health outcomes, and promote the service to others.

When conducting any follow-up care, including the for test results, further test bookings, or other information, it’s important to ensure that the language a patient uses for themselves is used correctly. This may be their name and/or pronouns, but could also include words they use for their body, e.g. receiving results after a screen but having their chest referred to as breasts might be distressing.

You can find out more about how to implement affirming IT systems on our Medical Records page.

When referring trans patients for clinical investigations or further consultation with other specialists, try to ensure you refer only to other services known to be inclusive and safe for your patient.

One great way to assess if a service or individual will be the right fit for your patient is to ask them a few questions prior to referral or the first appointment. The below resource provides 10 questions you can adapt to find out if a service is trans-competent and confident.

Assisting your patients to have positive experiences across various services will maintain the positive therapeutic relationship you have established, and ensure their optimal engagement with the health system. This can also help to ensure that trauma and harm is not caused through experiences of discrimination in healthcare settings, occurrences which unfortunately remain very common1.