Transhealth is a health organization in Western Massachusetts with the goal of expanding access to transgender-friendly medical services outside of major metropolitan areas. Ahead of the 2021 opening of their first clinic in Northampton Massachusetts, the founders of this organization wanted to establish a strong digital presence through a web application that would give future patients quick, intuitive access to resources they need as well as solve for pre-existing pain points specific to the trans user experience in digital medical spaces.

What sorts of pain points? 

We knew for sure that our application would need special tailoring to the needs of trans and gender-nonconforming users, and would have to conduct discovery to understand what those needs were.

We also knew that starting out, administrative staff would be limited and managing many tasks vital to the clinic's success. As such, we aimed to ease the task of patient intake for staff and users alike with a simple flow for prospective patient registration and learning about offered services.

The success of this project hinged upon an early and thorough understanding of trans and gender-nonconforming users seeking medical care and the pain points they have historically encountered in that process.

Leading the research efforts on this project, I combined pre-existing findings from the PATH Project with my own primary research. This research took the form of an anonymous survey focusing on trans and gender non-conforming respondents that live or have lived in Western Massachusetts. By working with LGBTQ organizations in the area we were able to receive 50 submissions for analysis. You can check out my synthesis of these fully anonymous results here.

Overall, responses pointed to a consistent cluster of pain points:

1. Historically Justifiable Distrust

68% of survey respondents reported that having to educate healthcare professionals on their unique needs was an either somewhat common or extremely common occurrence when navigating medical spaces.

The consistent need to educate a population of authority figures proves both socially exhausting and disquieting. What is the point of going to an expert if the expert lacks expertise, and how might incorrect medical advice harm physical health? This experience contextualizes the hesitance observed within trans populations to trust medical advice or even bother visiting medical providers in the first place.

2. Primary Tasks are Draining

On many medical platforms, the flows for primary tasks force a user to navigate multiple screens and repeatedly view/input potentially triggering content such as their deadname, biological sex, etc. These obstacles disincentivize proactivity in setting up health checks, renewing prescriptions, and other crucial tasks for wellness.

This concept may be difficult for some cisgender readers to grasp. The best way I can simply describe it is this: recall a memory or concept that physically and mentally disturbs you significantly, and then imagine having to interact with that memory or concept whenever you are filling out a simple form. You would likely not want to be filling out forms under those conditions, either. 

3. Existing Resources are Profit-Driven, Lack Community, Unrepresentative

Multiple respondents commented that their hesitance to visit new clinics was also partially rooted in their past experiences trusting supposedly trans-focused organizations that more often than not proved to be profit-focused "boutique healthcare facilit[ies] for skinny white nonbinary people with expensive insurance plans" rather than intersectional, financially accessible community institutions.

This attitude of profit and exclusivity can manifest in ways varying from the obvious (limited insurance offerings outlined, no mention of financial assistance), to the more nuanced (photography choices limited to a narrow and unrepresentative window of the community).

In order to succinctly capture learnings, we synthesized the results of my research into two primary user personas, as well as a secondary user community of parents, providers, and those who may be gender questioning.

Through the needs shared by our primary personas, we were able to glean the primary characteristics necessary for successful user movement across the application.

1. Streamlining Popular Task Flows

One of the strongest immediate needs expressed by our users in their feedback was the ability for those who felt discomfort completing medical tasks to complete such tasks and finish their session as quickly as possible. We accomplished streamlining of popular task flows by positioning access to the Patient Portal front, center, and loud in the navigation. We also positioned navigation to resources for new intake above the fold of the home page on both desktop and mobile experiences to show the user our best guess on what they need within their first look.

2. Share Staff Backgrounds

In order to help assuage levels of distrust surrounding staff qualifications and background with transgender patients, we designed clinician profiles to center background and credentials and include personal peripheries such as an interests section and headshot.

This tool not only allows users to request providers with relevant backgrounds to their specific needs, but can also at least marginally reduce pre-appointment anxiety by humanizing providers through their image and biographical information. While feelings of anxiety cannot be fully avoided for some users, establishing kinship between provider and patient prior to an appointment certainly helps.

3. Ideate Beyond Profit, Foster Community

To support users beyond the realm of paid medical services and emphasize attention to holistic community health, we designed a resource tool with an extensive library of curated content related to the many dimensions of wellness in the trans community. This tool not only provides helpful guidance to our primary personas but also our secondary communities, including parents of trans children and healthcare providers seeking to better serve their patients.

For those looking to forge connections within the community, we outfitted the application with an events tool that connected to Eventbrite, Facebook, and Google Calendar so that users could easily make plans to engage socially and add event information to their calendar before they had a chance to forget.

4. Warm Things Up!

In a competitive audit of adjacent solutions, our team noticed that a majority of health-centered web applications had very cold, clinical color palettes. We sought to challenge this visual trend and introduce feelings of warmth and welcomeness while still upholding professionalism. To achieve this, we decided upon a color palette that was vibrant without feeling gendered or infantilizing and embellished with inclusive photography and a custom icon set.

Since in May of 2021, Transhealth has made a tangible impact on access to care outside of New England's urban communities as well as an ideological impact on how transgender medical care is viewed through consistent media engagement on trans issues.

• Over 2,000 unique patients have been served in 3 years
• Successful patient influx and retention has led to a clinic expansion and a quadrupling of staff
• The clinic currently sits at over 150 media mentions

While some small changes have been implemented since launch, the lion's share of this application has remained the same, including the features discussed in this case study. I couldn't be more proud to have contributed to this project and of all the continued hard work Transhealth does for the community!