Trans-desk or Transgender desk is an office/clinic space located within the Cebu City Health Department (CCHD) established in 2014 as part of the Femina Trans Initiative. The initiative is an active partnership between a community-based organization for transgender women in Cebu City represented by Transgender COLORS, Inc. and the city health department through its Social Hygiene Clinic (SHC) that received a technical and funding support from WHO. It is known that transgender women are more comfortable in accessing health services if accommodated by staff of the same gender identity. Hence, Trans-desk was conceptualized to enhance the accessibility, availability and acceptability of quality HIV prevention, treatment, care and support and other trans-specific health services for transgender women. The desk is staffed by a transgender woman who is also a trained peer educator and HIV counsellor from COLOR, and is supervised by the SHC manager/physician.
Naffi, a registered nurse by profession, is a full time peer educator/ counsellor of Trans-desk that opens its services for transgender women every afternoon from Monday to Friday.
Why and how did you get involved in Femina Trans Initiative?
As a registered nurse, it has always been my interest to work with projects that concerns people’s health. I’m also a member of Transgender COLORS and when we were given the opportunity to be the implementing partner of Femina Trans, I decided to be a part of it. I underwent training on peer education and HIV counselling and testing. Today, I run the Trans-desk full time as its peer educator and counsellor.
Do you think the Trans-desk made a difference in the provision of HIV and STI services to TG women in Cebu City?
Definitely. More transgender women are now accessing the health services of the city health department. Through Trans-desk, transgender women who were tested for HIV in the community are more comfortable in getting their test results in the facility. They know that they would be handled by a fellow transgender woman who can understand their needs. Further, immediate referral for STI diagnosis and treatment and other health needs are then facilitated. In my experience, through trans-desk and my links with other transgender women and organizations, a growing number of transgender women now know the free health services being offered for them.
What are the challenges did you encounter in providing services in Trans-desk?
Transgender women who are accessing the services sometimes came in groups. As I am the only transgender peer counsellor in Trans-desk, waiting time for them may be long as the counselling process can also takes time. This can lead to impatience and a few would like to leave with promises to come back some other time. On the other hand, it is also my responsibility to follow up on those who need to come back for their test results or treatment work-up (for those who are HIV positive). Despite frequent follow-ups on my end, a lot of them procrastinate and some never came.
How did you respond to these challenges?
I just prioritize the needs of transgender women. For a transgender woman who needs to be seen immediately by the physician, I facilitated referral for them first then do other services for others like peer education, risk reduction counselling, and etc. Sometimes I’m lucky, as there are transgender counsellors from Cebu plus organization in city health department that can be available to assist me with other clients. For those clients who never come for follow up, I inform the SHC manager about them and then continue to make frequent contact with them whenever I can.
I think it is also important to re-evaluate the process of providing test results. We think it is best that test results should be provided on site after testing, by then we could provide the test results immediately and counsel them rather than asking them to come for days later in Trans-desk to get their results.
What are the ways forward for you and Transgender COLORS in Trans-desk after the external support for Femina Trans has ended?
COLORS as an organization commits itself to continue to assist the Cebu City Health Department in its HIV intervention program for transgender women. COLORS will continue to provide a peer educator in Tran-desk during the transition period of the implementation of New Funding Model of Global Fund project that involves transgender community-based organization. We will coordinate with SHC manager on how best COLORS can assist its program as we are more than happy to continue what we have started.