Authors (including presenting author) :
Lee TMA(1), Chang SPV(1), Poon WFD (1)
Affiliation :
(1) Occupational Therapy Department, Prince of Wales Hospital
Introduction :
Gender incongruence refers to the internal sense of gender is different than which they are assigned at birth. Gender-affirming interventions, such as hormonal treatment and sex reassignment surgery (SRS), are indicated for these individuals. Transgender individuals need to undergo Real Life Experience (RLE) for a minimum period of 2 years before SRS which they live and experience life events in the preferred gender. During RLE, acquisition of living skills is essential in adjusting to the new gender role in four domains, including self-care, vocational, psychosocial, and occupational lifestyle. Prince of Wales Hospital (PWH) is the only hospital providing gender-affirming services with multidisciplinary approach in Hong Kong since 2016. Occupational Therapy (OT) in this clinic aims to facilitate gender role transition with RLE for transgender individuals.
Objectives :
OT collaborates with transgender individuals in leading the meaningful life of their choice. Across different stages of transition, OT aims to facilitate development of skills and adjustment in order to live in the preferred gender and life roles.
Methodology :
OT programs include: 1. Gender expressing self-care domain includes training that enhances skills to dress and behave in their preferred gender. This influences how others perceive their gender, address them, and interact with them. 2. Vocational domain involves training that enhances their skills in job seeking and sustaining and work-related social skills training with the change of gender at work. 3. Psychosocial domain facilitates mood management and enhances social support. 4. Occupational lifestyle domain facilitates establishing meaningful lifestyle and enhances activity engagement with collaboration of patients. At different stage of transition, assessment of quality of life is conducted in order to evaluate treatment outcome and enable patients living a meaningful life.
Result & Outcome :
As at December 2019, 46 patients were referred for OT services, in which 38 are male-to-female (MtF) and 8 are female-to-male (FtM) patients. 2 patients had been discharged from service and 13 patients had defaulted treatment. In general, perceived quality of life and health condition was low as reflected from WHOQOL-BREF (HK) at baseline. Tailor-made OT programs were implemented to match individual needs. Preliminary findings of reassessment showed improved quality of life in physical health, psychological health, and social relationship. Most patients perceived less limitation in community living, and had improved motivation to engage in daily activities. The findings were promising that patients had increased motivation and hope to live a meaningful life and strive for life goals in preferred gender.
