(377) Forming a Gender Diversity Unit on the Outskirts of Portugal: Goals and Challenges

Introduction Transgender and Gender-Diverse (TGD) people are estimated to be around 0,3-4,5% of the general population and need specialized and multidisciplinary healthcare; however, access to such care is often lacking and restricted to few central hospitals. As access to medical care has been a challenge in Portugal, we decided to form a small Gender Diversity Unit in our hospital to aid provide healthcare to this population in one of the largest, and yet rural, parts of the country. Objective To inform and share our experience with creating this Gender Diversity Unit, mainly its goals, challenges and results from the first year of its existence. We also aim to present feedback from our patients regarding their experience of the Unit’s functioning. Methods Clinical information and reports were consulted to measure clinical activity. Feedback from clinicians and patients was also collected. Results The initial Unit consisted of Adult Psychiatry and Adult Psychology appointments, with the promise of later inclusion of a Nursing Team (responsible for organizing therapist-guided support groups for TGD individuals and another one for their relatives) and, if necessary, support from a Child and Adolescent Psychiatrist. We were also able to celebrate a protocol between our institution and a central institution of renown reputation in the field, to better safeguard the assessment and care of our patients. During our first year of activity, we performed 10 adult psychiatry appointments and several psychology appointments to 3 patients we regularly follow-up with. Despite the low number, we believe this to be of vital importance, given the close proximity of care we can provide and the regular care we’re able to schedule, contributing to a better patient-healthcare professional relationship. The main challenge of the unit resides in this low number of patients, for which the main reasons we believe to be: (1) low clinical sensitivity and level of confidence in approaching gender identity with patients in first-line clinicians to detect TGD individuals in need of care, resulting in low referrals; (2) small time of activity, leading to a small amount of clinicians being aware of the existence of this unit; (3) important stigma in society and, in particular, a very rural and small community. We’ve also been able to incorporate, recently, an Endocrinologist to join our Unit, strengthening our wish of a multidisciplinary unit. Therefore, we’re now able to provide, not only mental healthcare to our community, but also hormonal gender-affirming care. We’ve also been active within our community and other healthcare-providing facilities in providing science-based information and divulging the Unit, in order to promote referrals and expand care. This has also been important to de-stigmatize this population and promote a healthier society. Conclusions Creating this small Unit greatly contributed to expanding healthcare and further value trans lives. Despite having few patients in our care, a growing effort is being placed in divulging the unit, expanding its capabilities and combating stigma within society. Disclosure No