Roadmap of integration of transgender health into healthcare systems: a TRANSCARE study

In this study, we summarize evidence from the European project TRANSCARE to identify key areas for improvement in transgender care and synthesize our experience into a roadmap of knowledge integration into healthcare systems. According to our roadmap, as a public health concern, progress in transgender care requires its integration into health policy, education and training for healthcare professionals, and availability of essential gender-affirming medications and population-specific healthcare services, including both medical and social care. Our roadmap serves as a model for stakeholders to use when determining the elements and steps necessary for transgender care integration and includes the synthesis of multiple actions to address: (1) transgender care inclusion in national health policy, (2) legislation and finance, (3) availability of essential gender-affirming medications, particularly hormone therapy, (4) education and training for health care professionals, (5) implementation of trans-specific care services at primary and secondary care services, (6) implementation of trans-specific services in social care and linkage with medical care. Results and evidence from all project activities are combined to create a pathway with multiple nodes to guide the development of integrated transgender care and to monitor progress. While the study focuses on the health and social context of Greece, our roadmap serve as a model for adaptation in other settings. As with any public health issue, the implementation of the roadmap requires both stakeholder engagement and policy actions to be further piloted, tested, and eventually adopted.