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Exploring affirming homecare and its impact
by Meg Herndon

As bills banning gender-affirming care rise nationally, VNS Health’s Gender Affirmation Program (GAP) aims to provide patient-centered, informed care to transgender and nonbinary (TGNB) individuals recovering from gender-affirmation surgery. The program, which began in 2016, has served more than 1,500 individuals and has trained hundreds of clinicians in cultural sensitivity and transgender health.

The program allows patients to receive affirming care in their homes—which is important for a safe recovery, said Shannon Whittington, clinical director of the Gender Affirmation Program (GAP) at VNS Health. Nurses help patients manage post-surgical care and follow-up appointments with their doctors, provide skilled nursing services, aid in self-care habits to help with anxiety, dysphoria or depression and address other needs. Additionally, the program has a full-time social worker with trans experience who offers counseling and care coordination.

Before programs like GAP, which is based in New York (VNS Health was formerly VNSNY), Whittington said those seeking gender-affirming care had few options. Often, they would end up either leaving the country for care or recuperating at home alone—both with mixed results.

“Patients who receive homecare, research shows, have much better outcomes than those who don’t,” Whittington said.

The path to creating a training program for VNS Health nurses was important to Whittington, who said there’s a knowledge gap in nursing schools when it comes to affirming care. Although this has changed over the years, Whittington said, students from across the U.S. often reach out to VNS Health seeking more information on the topic.

“For people to have a clinician come in who knows specifically how to take care of them is so reassuring,” Whittington said. “These patients feel it. You know, we get so many letters and calls about, ‘Oh, my gosh, my nurse was amazing, my aide was amazing, the therapist was great, the social worker was great,’ because we have to realize that this isn’t the norm, unfortunately. So, when everything goes great, and they feel wonderful with the care they’re receiving, they want to tell everybody about it.”

In addition to helping patients recover physically, GAP provides resources for anyone who might struggle mentally after an operation.

“A big part of what I do is I offer crisis intervention and also supportive counseling,” said Asia Lyons, a social worker with the Gender Affirmation Program (GAP) at VNS Health and an individual with transgender experience herself. “After surgery, those mental health conditions can be exacerbated, right? Because they have a new body that they’re not familiar with. They’re seeing things such as blood and discharge, sutures, discoloration, bruises—many things that can really impact how they feel about themselves in that moment, how they’re feeling overall, as a person.”

Lyons addresses these concerns by making sure patients understand things look different in the days following surgery versus three months or six months after. Additionally, Lyons said, she helps instill hope by talking to patients about her
own experience.

“And I do get the calls from them six months down the line,” Lyons said. “They’re like, ‘You were so right. You know, I am feeling way better. I am so much happier. I thank you so much for your support.’ So, absolutely our work is paramount.”

Overall, GAP wants TGNB individuals to know they have someone by their side.

“I think one thing that I would like my community to know is they have someone that can advocate for them,” Lyons said. “A big part of social work is not just counseling, it’s also advocacy. And oftentimes, people need to know that they have someone in their corner who’s going to stand up for them and support them when they’re feeling out of control or powerless, or voiceless.”

Meg Herndon is the managing editor of HomeCare Media.