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27th March 2019 – Jeremy Wiggins – Churchill Report Best Practice Models of Trans and Gender Diverse Health The focus of the research was Best Practice Models of Health Care for Trans and Gender Diverse Populations. The research aimed to investigate models of health care for trans and gender diverse populations where people of lived experience were meaningfully engaged, consulted and employed to codesign and deliver depathologising health services. Jeremy Wiggins [email protected] Acknowledgment of Country This report was written on the lands of the Wurundjeri people and the Djadjawurrung people of Kulin Nations. Respect is paid to elders past and present and is also extended to the trans and gender diverse First Nations People, the Brotherboys and Sistergirls of these lands. Acknowledgment of Community Throughout history, many trans and gender diverse people have created pathways to improve our health and wellbeing and in doing so have endured hardship, exclusion and denial of access to essential health care and services. This report honours them and recognises their valuable contribution to this space. Thank you. 1 | P a g e www.leaphq.org 27th March 2019 – Jeremy Wiggins – Churchill Report I understand that the Churchill Trust may publish this Report, either in hard copy or on the Internet or both, and consent to such publication. I indemnify the Churchill Trust against any loss, costs or damages it may suffer arising out of any claim or proceedings made against the Trust in respect of or arising out of the publication of any Report submitted to the Trust and which the Trust places on a website for access over the internet. I also warrant that my Final Report is original and does not infringe the copyright of any person, or contain anything which is, or the incorporation of which into the Final Report is, actionable for defamation, a breach of any privacy law or obligation, breach of confidence, contempt of court, passing-off or contravention of any other private right or of any law. Jeremy Wiggins March 27th, 2019 2 | P a g e www.leaphq.org 27th March 2019 – Jeremy Wiggins – Churchill Report It is critical that trans and gender diverse people are in positions of power and have the respect and agency to make leadership decisions about our health care. Table of Contents: Acknowledgments 4 Introduction 5 About the Fellow 5 Locations Travelled 6 Visits 6 Reflections 7 Recommendations 8 - 14 Meeting highlights 15 - 22 Conclusions 23 Contact Details for Visits 24 - 26 Glossary of Terms: TGD – Trans and Gender Diverse Trans – Transgender, or of trans and gender diverse experience 3 | P a g e www.leaphq.org 27th March 2019 – Jeremy Wiggins – Churchill Report Acknowledgments: I would like to pay special thanks and gratitude to the following people and organisations. Thank you to the Winston Churchill Memorial Trust for the opportunity to research this area. My partner Matt who travelled part of the way with me and has provided me with the gentle kindness and support to complete this project. Razz, the mother of our children Ripley and Ginger who supported me in the very early years of my activism and career and who took care of our girls to enable me to travel for the full 8 weeks. Thank you for your positive enthusiasm and encouragement. I want to acknowledge the following people who processed this information with me to develop the final recommendations through a community collaborative process: Starlady, Ted Cook and Ryan Phillips. Thank you for your valuable contribution. I want to acknowledge that although I am the first trans person in Australia to receive a Churchill Fellowship, my contribution is one of many and I want to also acknowledge and thank all people who share a similar experience of living as trans or gender diverse whom are working towards creating a healthier future for us all. I also want to thank Georgie Ferrari for your encouragement to apply for a fellowship. I want to thank Thorne Harbour Health (formerly Victorian AIDS Council), where I was employed whilst undertaking this fellowship. Working at this organisation provided me with the resources and scope to create change for Australia that had not been done before. The informed consent model changed the game for TGD health and I was proud to have engineered the delivery of that model in Australia. A special thanks goes to Dr Pauline Cundill for carrying the informed consent torch as the medical professional on this project. Also thanks to Peter Locke, Equinox Program Manager, Kent Burgess, Director of Services and Simon Ruth, Chief Executive Officer. I would like to wish the best of luck to Thorne Harbour Health as it continues with this important work to improve trans and gender diverse health, a project I am grateful to have led whilst there. Thank you. I want to thank everyone I met with overseas – especially all the trans and gender diverse workers and activists. You are the life blood of this area and it’s our labour, our experiences and our wisdom that informs the progress of our health and we fight hard for it and it does take a personal toll. I have made life long relationships and together we will continue to create important change. Thank you. I also want to acknowledge Dr Tushara Wickramariyaratne, who was also a Churchill Fellow in the same year as me who travelled overseas to investigate models of psychological care of older trans and gender diverse adults. Thanks for meeting with me and for the ongoing connection. 4 | P a g e www.leaphq.org 27th March 2019 – Jeremy Wiggins – Churchill Report Introduction: This report aims to communicate findings from my Churchill Fellowship and provide a set of recommendations for consideration in the Australian trans and gender diverse health context. These recommendations will also include a range of principles, values and ethical standards which underpin best practice in developing, establishing and delivering health care services to trans and gender diverse communities. It needs to be acknowledged that historically trans and gender diverse health and policy systems have often been designed by people who have no lived trans or gender diverse experience, nor appropriately engaged or consulted with the key affected populations the work seeks to serve. A primary aim of this report is to provide practical and critical guidelines to inform best practice processes for multiple key audiences in an accessible manner. Should any information in this report be difficult to understand, please email the author for further clarification as nobody should be left behind. Contact details can be found at the end of this report. About the Churchill Fellow: Jeremy Wiggins is the first transgender Australian to be awarded a Churchill Fellowship. Jeremy is a community advocate and has extensive project management experience working in trans and gender diverse health and lesbian, gay, bisexual, transgender and queer (LGBTQ) community development. Jeremy’s background is in grassroots activism and community building. Jeremy is Co- Chair of the Victorian Government Trans and Gender Diverse Expert Advisory Group, a member of the Victorian Government LGBTI Health and Human Services Working Group, Co-Chair of the Peer Advocacy Network for the Sexual Health of Trans Masculinities and was recently announced as 2018 Victorian LGBTI Person of the Year. Jeremy is also the Founder of LEAP and works with governments, organisations and communities to improve experiences and outcomes for LGBTQ people. 5 | P a g e www.leaphq.org 27th March 2019 – Jeremy Wiggins – Churchill Report Locations Travelled: Bangkok London, Manchester, Brighton, Leicester Edinburgh Thailand England Scotland Berlin Toronto New York, Boston, San Francisco Germany Canada United States of America Visits: This is a condensed version of the visits. A full list with names of individuals consulted with can be found at the end of this report. With respect to the full policy cycle that improves health equity and access for our communities, it is important to recognise and value the work of unpaid community members, volunteers, activists, organisers and advocates. A range of individuals not employed by organisations were also interviewed, some of whom requested to not have their names published. Bangkok, Thailand Brighton United Kingdom New York, USA Asia Pacific Transgender Network Hove Polyclinic / NHS Sussex Partnership Trust Callen-Lorde Community Health Center Tangerine Community Health Centre The Clare Project The Center Thai Red Cross AIDS Research Centre Trans Alliance Ali Forney Center London, United Kingdom University of Brighton Sylvia Rivera Law Project Dean Street Clinic Edinburgh, Scotland Boston, USA CliniQ Scottish Trans Alliance Fenway Health GALOP Toronto, Canada AIDS Action Committee CATCH Trans Hate Crime Project Rainbow Health Ontario / Sherbourne Health Centre San Francisco USA Transgender Professional Association for Stonewall Housing Transgender Health St. James Infirmary Leicester, United Kingdom AIDS Committee of Toronto Lyon Martin Health Services De Montfort University Gay Men's Sexual Health Alliance Strut University of Leeds Health Initiative for Men (Vancouver) SF AIDS Foundation Manchester, United Kingdom Macmillan/The Christie NHS Foundation Trust LGBT Foundation TransForum Manchester 6 | P a g e www.leaphq.org 27th March 2019 – Jeremy Wiggins – Churchill Report Reflections I am very grateful to have had such a rare and valuable opportunity to explore and investigate trans and gender diverse health globally. I am incredibly passionate about people living healthy and happy lives and having quality and timely access to essential health services. I’m equally as fortunate to be able to know and work with so many other talented, hardworking and committed trans and gender diverse Australians and I want to dedicate this report to you all. I would like to thank the Winston Churchill Memorial Trust for granting me this opportunity.

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